The Treatment Effects of Additional Hip Abductor and External Rotator Strength Training to Leg Press Exercise in Patients with Patellofemoral Pain Syndrome
|Keywords:||髕股關節疼痛症候群;髖關節肌肉力量;髖關節內轉角度;patellofemoral pain syndrome;hip muscle strength training;hip kinematics||Issue Date:||2008||Abstract:||
Background: Quadriceps strength training exercise has been shown to be effective in treating patellofemoral pain syndrome without relevant effective treatment strategies. It is suggested that the problem may not derive just from patellofemoral joint but alterd kinematic from proximal part.(hip and pelvic). According to recent studies, weakness of hip abductors and hip external rotator muscles was discovered in this population while quadriceps weakness was evident. However, if improved hip muscle strength are related to hip kinematics changes difference was interested in current study.urpose: The first purpose was to compare the difference between leg press exercise(LPE) and additional hip abductor and external rotator muscle strength training to leg press exercise(LPE+HAE) in muscle strength, hip kinematics during step down, pain severity and function for patients diagnosed with patellofemoral pain syndrome. The second one was to discover the relationship between the change in muscle strength performance and the difference of hip joint kinematics post treatment.ethods: 85 individuals diagnosed with PFPS are randomized into 3 groups of intervention (leg press exercise(LPE), additional hip abductor and external rotator strength training to leg press exercise(LPE+HAE) and control). Tow exercise group received 8 weeks of 3 times per week strength training. Outcome measures were muscle strength (quadriceps, hip abductor, hip external rotator, hip internal rotator and hip extensor muscle strength) by hand-held dynamometry, hip joint kinematics during step down by electromagnetic motion tracking system (FASTRAK, Polhemus ), pain severity by PFPS pain severity scale (PSS), functional performance by Anterior Knee Pain Scale(AKP). All the tests mentioned above are measured at the baseline and after 8 weeks of treatment. esults: After 8 weeks of exercise intervention, patients with patellofemoral pain showed significant muscle strength improvements in knee extensors, hip abductors, and hip internal rotators, accompanied with significant reduction in pain(PSS)nd functional improvements (Anterior knee pain scale)(p<.005). Muscle strength performance in hip abductors, PSS and AKP demonstrated with statistical significance between each exercise group and control (p<.008). There was no significant difference in hip kinematics performance after treatment while the change in hip internal rotation angle seems relevant larger in additional hip muscle strength training group (3°).When pooled the reduction in hip adduction and internal rotation angles and the improvement of every hip muscle strength of both exercise group post treatment, the change in hip abductor muscle group was correlated with change in hip internal rotation angle during stair decent(r=-.39. p<.05).onclusion: Both exercise groups demonstrated with significant improvement in muscle strength performance, pain severity and function. Even though there was no statistical significant difference in hip kinematic performance after 8 weeks of treatment, the improvement of hip abductor muscle strength and reduction in hip internal rotation angle were correlated. The relevant reduction in hip internal rotation angle of additional hip muscle strengthening group after treatment might suggest that additional hip muscle strength training may be helpful in reducing excessive hip internal rotation during stair decent.
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