Comparing Rehabilitation Programs for Patellofemoral Pain Syndrome

Not Applicable

Completed

Interventions: Other: Quad Progressive Resistive Exercises
Other: Hip Progressive Resistive Exercise

Brief Summary: Patellofemoral pain syndrome (PFPS) is a common knee disorder affecting physically active people. Despite the growing base of support for the early introduction of hip strengthening exercises into the rehabilitation of PFPS, there have been few randomized clinical trials comparing isolated hip to isolated quadriceps strengthening. The purpose of this study is to determine how different exercises affect pain, strength, muscle activity, and function in female subjects with patellofemoral pain. The researchers hypothesize that females diagnosed with PFPS who initially participate in a hip strengthening program will report a greater perceived level of function, greater strength, less pain, and improved neuromuscular activity than those who participate in a progressive quadriceps strengthening intervention.

Detailed Description: Methods: Thirty-three females with PFPS will perform either initial hip strengthening (hip group) or initial quadriceps strengthening (quad group) for 4 weeks, prior to 4 weeks of a similar program of functional weight-bearing exercises. Self-reported pain, function, and functional strength were measured. Isometric strength was assessed for hip abductors, external rotators, and knee extensors. A mixed-model analysis of variance will be used to determine group differences over time.

Recruitment & Eligibility

Inclusion Criteria

anterior or retropatellar knee pain reported during at least 2 of the following activities: ascending and descending stairs, hopping and running, squatting, kneeling, and prolonged sitting
insidious onset of symptoms not related to trauma
pain with compression of the patella
pain on palpation of the patellar facets

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Quad Progressive Resistive Exercises	Quad Progressive Resistive Exercises	Exercises targeting quadriceps musculature such as quadriceps isometric setting, terminal knee extensions, and straight leg raises that was progressed by increased resistance following typical progressive resistive exercise approach..
Hip Progressive Resistive Exercises	Hip Progressive Resistive Exercise	Exercises targeting hip musculature such as hip abduction and hip external rotation that was progressed by increased resistance following typical progressive resistive exercise approach.

Primary Outcome Measures

Name	Time	Method
Subjective Function by Lower Extremity Functional Scale Report Form	Baseline, Mid-Intervention, and Post-Intervention
Visual Analog Pain Scale (Describing Worst Pain Felt During the Past Week)	weekly	0 to 10 cm line with 0 representing no pain and 10 representing severe pain
Visual Analog Pain Scale	8 week	Visual analog pain scale at end of intervention. 0 to 10 cm line with 0 representing no pain and 10 representing severe pain

Secondary Outcome Measures

Name	Time	Method
Strength by Isometric Dynamometer	Baseline, Mid, and Post-Intervention
Neuromuscular Activity by Surface Electromyographical Amplitude During Stair Descent	Baseline, Mid and Post-Intervention
Hip Abduction Strength	8 week	Side lying Hip Abduction maximal muscular contraction with a hand held dynamometer
Objective Function by Step-down Task for 30 Seconds	Baseline, Mid, and Post-Intervention