Strengthening the hip muscles in individuals with patellofemoral pain: what can be learned from the literature?

Authors: Dorey, C. and Williams, J.M.

Journal: Physical Therapy Reviews

Volume: 20

Issue: 2

Pages: 63-72

eISSN: 1743-288X

ISSN: 1083-3196

DOI: 10.1179/1743288X15Y.0000000008

Abstract:

Background: The precise aetiology of Patellofemoral Pain Syndrome (PFPS) remains unclear; however, the efficacy of employing hip abductor and lateral rotator muscle strengthening interventions in the rehabilitation of patients with PFPS has been previously documented. Despite this it remains unclear as to the most efficacious protocol to optimise outcome. Objectives: To synthesise the literature regarding different hip strengthening protocols and their effect on decreasing pain and increasing hip strength in individuals with PFPS. Methods: A systematic search of Medline, Google Scholar, SPORTDiscuss, Science Citation Index, OAIster, CINAHL, Academic Search Complete, Science Direct, Scopus was completed in October 2013. Critical appraisal was completed using multiple tools depending on study design. Results: Five articles satisfied the inclusion criteria. Overall articles scored highly on critical appraisal and positive effects of proximal strengthening were identified as was a reduction in pain in individuals with PFPS. No correlation was established between change in strength of hip lateral rotators or hip abductors and change in pain (R2s = 0.003; R2s = 0.010). A programme incorporating open and closed chain exercises was more effective than open chain alone for decreasing pain. Higher frequency and longer duration of exercise was identified as resulting in greater reduction of pain. The frequency required may be linked to participant's strength before intervention. Conclusions: Hip strengthening results in significant gains in strength and reductions in pain in individuals with PFPS. Exercise protocols incorporating open and closed kinetic chain, with high frequency and long duration seem to be important in optimising their effect on pain and strength.

Source: Scopus