Neuromuscular training and muscle strengthening in patients with patellofemoral pain syndrome: a protocol of randomized controlled trial.

Nayra Deise Dos Anjos Rabelo,Liu Chiao Yi,Bruna Lima,Amir Curcio Dos Reis,André Serra Bley,Thiago Yukio Fukuda,Leonardo Oliveira Pena Costa,Paulo Roberto Garcia Lucareli

doi:10.1186/1471-2474-15-157

Abstract

BackgroundPatellofemoral pain syndrome (PFPS) is a common musculoskeletal condition, particularly among women. Patients with PFPS usually experience weakness in the gluteal muscles, as well as pain and impaired motor control during activities of daily living. Strengthening the hip muscles is an effective way of treating this disorder. Neuromuscular training has also been identified as a therapeutic tool, although the benefits of this intervention in patients with PFPS patients remain inconclusive.DesignThis is a protocol of randomized controlled trial with a blind assessor. Thirty-four women with a clinical diagnosis of PFPS participated. These participants were allocated into two groups (experimental and control). The experimental group performed twelve sessions to strengthen the knee extensors, hip abductor and lateral rotator muscles in association with neuromuscular training of the trunk and lower extremities. The control group performed the same number of sessions to strengthen the muscles of the hip and knee. The primary outcome was functional capacity (Anterior Knee Pain Scale – AKPS) at 4 weeks. Pain intensity, muscle strength and kinematic changes were also measured during the step down test after four weeks of intervention. Follow up assessments were conducted after three and six months to assess functional capacity and pain. The effects of the treatment (i.e. between-group differences) were calculated using mixed linear models.DiscussionThe present study was initiated on the 1st of April 2013 and is currently in progress. The results of this study may introduce another effective technique of conservative treatment and could guide physical therapists in the clinical decision-making process for women with PFPS.Trial registrationCurrent Controlled Trials NCT01804608.

Highlights

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition, among women
The results of this study may introduce another effective technique of conservative treatment and could guide physical therapists in the clinical decision-making process for women with PFPS
The aim of the present study was to compare the effects of a program of neuromuscular training of the trunk and lower limbs, associated with strength training of the hip and knee muscles of women with PFPS, with a program that only involved strengthening of these same muscles in relation to functional capacity

Summary

Introduction

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition, among women. Patients with PFPS usually experience weakness in the gluteal muscles, as well as pain and impaired motor control during activities of daily living. Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that is prevalent among women [1,2]. Exercise programs based on strengthening the quadriceps and gluteal muscles have been shown to decrease pain and improve motor function [14,15] and lower limb movement patterns [16]. It is common knowledge that these patients do not have normal control of lower limb movements [3,4,17] and exhibit deficient neuromuscular parameters, such as the activation time and electromyographic activity of the hip muscles [18]. It is known that abnormalities of lower limb movement patterns during weight-bearing activities can directly affect referred pain [19]

Objectives

Methods

Findings

Conclusion