Effect of Hip Adduction Combination with Knee Extension Exercise on Morphology of Quadriceps Muscles, Pain and Functional Outcomes in Patients with Patellofemoral Pain Syndrome
Date Issued
2006
Date
2006
Author(s)
Song, Chen-Yi
DOI
zh-TW
Abstract
Background and purpose：Patellofemoral pain syndrome（PFPS） is a common knee disorder characterized by anterior or retropatellar pain associated with activities that load the patellofemoral joint. Previous studies reveal that the vastus medialis obliquus（VMO） is an important dynamic medial stabilizer of the patella. Insufficiency of the VMO leads to lateral shift of the patella and the increases of patellofemoral contact pressure. Thus VMO-specific training is a well-accepted clinical treatment conservatively. Hip adduction is thought to enhance VMO contraction because of its anatomic origin from hip adductors. In order to determine its training effect, we used ultrasonography as a measurement tool to examine the VMO morphology changes after hip adduction combination with knee extension exercise training compared with traditional terminal knee extension exercise training and control in patients with PFPS.
Methods：62 PFPS patients with age under 55 were recruited for the study and then randomly assigned to either one training or control group. Muscle morphology of VMO（including fiber angle, cross-sectional area on patella-base level, and volume under patella-base level）, 10 cm-visual analog scale of usual pain（VAS-U）,worst pain (VAS-W), activity pain (VAS-activity), and Lysholm Scale scores were measured before and after 8-wk leg press exercise training or control periods.
Results：Significant improvements of VMO cross-sectional area, volume, VAS-U, VAS-W, VAS-activity, and Lysholm Scale scores were found after 8-wk training in both exercise groups（p< .005）, but not in the control group. The improvements were also significantly different between the exercise and control groups（p< .005）, except for the VMO cross-sectional area and volume（p= .011~ .042）, and for the VAS-activity between the hip adduction combination with knee extension exercise and control groups（p= .016）. However, no differences were found between two exercise groups. In all three groups, no significant differences were found in VMO fiber angle throughout the experiment.
Conclusion：The results suggest that immediate effects of VMO hypertrophy, pain reduction, and functional ability improvement occurred following hip adduction combination with knee extension exercise. Treatment effects did not show significant differences between two exercise groups; therefore, therapists could choose either of these two exercise programs. Moreover, clinical practices may consider the application of leg-press exercise with terminal knee extension alone since additional equipments are not required.
Subjects
髕股關節疼痛症候群
股內斜肌
超音波
下肢推蹬運動
髖內收
Patellofemoral pain syndrome
vastus medialis obliquus
ultrasonography
leg press exercise
hip adduction
Type
other
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