Meta‐analyses showed no significant changes in strength for any of the interventions . •
BACKGROUND : The addition of hip strengthening to knee strengthening for persons with patellofemoral pain has the potential to optimize treatment effects .
OBJECTIVE : To examine the efficacy of hip strengthening , associated or not with knee strengthening , to increase strength , reduce pain , and improve activity in individuals with patellofemoral pain .
Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial.
CONTEXT Patellofemoral pain ( PFP ) is the most common injury in running and jumping athletes . R and omized controlled trials suggest that incorporating hip and core strengthening ( HIP ) with knee-focused rehabilitation ( KNEE ) improves PFP outcomes . However , no r and omized controlled trials have , to our knowledge , directly compared HIP and KNEE programs . OBJECTIVE To compare PFP pain , function , hip- and knee-muscle strength , and core endurance between KNEE and HIP protocol s after 6 weeks of rehabilitation . We hypothesized greater improvements in ( 1 ) pain and function , ( 2 ) hip strength and core endurance for patients with PFP involved in the HIP protocol , and ( 3 ) knee strength for patients involved in the KNEE protocol . DESIGN R and omized controlled clinical trial . SETTING Four clinical research laboratories in Calgary , Alberta ; Chicago , Illinois ; Milwaukee , Wisconsin ; and Augusta , Georgia . PATIENTS OR OTHER PARTICIPANTS Of 721 patients with PFP screened , 199 ( 27.6 % ) met the inclusion criteria ( 66 men [ 31.2 % ] , 133 women [ 66.8 % ] , age = 29.0 ± 7.1 years , height = 170.4 ± 9.4 cm , weight = 67.6 ± 13.5 kg ) . INTERVENTION(S ) Patients with PFP were r and omly assigned to a 6-week KNEE or HIP protocol . MAIN OUTCOME MEASURE(S ) Primary variables were self-reported visual analog scale and Anterior Knee Pain Scale measures , which were conducted weekly . Secondary variables were muscle strength and core endurance measured at baseline and at 6 weeks . RESULTS Compared with baseline , both the visual analog scale and the Anterior Knee Pain Scale improved for patients with PFP in both the HIP and KNEE protocol s ( P < .001 ) , but the visual analog scale scores for those in the HIP protocol were reduced 1 week earlier than in the KNEE group . Both groups increased in strength ( P < .001 ) , but those in the HIP protocol gained more in hip-abductor ( P = .01 ) and -extensor ( P = .01 ) strength and posterior core endurance ( P = .05 ) compared with the KNEE group . CONCLUSIONS Both the HIP and KNEE rehabilitation protocol s produced improvements in PFP , function , and strength over 6 weeks . Although outcomes were similar , the HIP protocol result ed in earlier resolution of pain and greater overall gains in strength compared with the KNEE protocol
Meta‐analyses showed no significant changes in strength for any of the interventions . •
BACKGROUND : The addition of hip strengthening to knee strengthening for persons with patellofemoral pain has the potential to optimize treatment effects .
OBJECTIVE : To examine the efficacy of hip strengthening , associated or not with knee strengthening , to increase strength , reduce pain , and improve activity in individuals with patellofemoral pain .