A 6-week hip muscle strengthening and lumbopelvic-hip core stabilization program to improve pain, function, and quality of life in persons with patellofemoral osteoarthritis: a feasibility pilot study

Abstract

BackgroundPatellofemoral joint (PFJ) osteoarthritis (OA) is prevalent in middle-aged and older adults. Despite this, there are minimal studies which have examined conservative interventions for PFJ OA. Weakness of proximal lower extremity muscles is associated with PFJ OA. It is unknown if a hip muscle strengthening and lumbopelvic-hip core stabilization program will improve symptoms and function in persons with PFJ OA. This study examined the feasibility and impact of a 6-week hip muscle strengthening and core stabilization program on pain, symptoms, physical performance, peak muscle torques, and quality of life in persons with PFJ OA.MethodsTen females with PFJ OA and ten age- and sex-matched controls participated in baseline tests. PFJ OA participants attended ten twice-a-week hip strengthening and core stabilization exercise sessions. Outcome measures included questionnaires, the Timed-Up-and-Go, and peak isometric torque of hip and quadriceps muscles. Data were tested for normality; parametric and non-parametric tests were used as appropriate.ResultsAt baseline, the PFJ OA group had significantly worse symptoms, slower Timed-Up-and-Go performance, and lower muscle torques than control participants. PFJ OA group adherence to supervised exercise sessions was adequate. All PFJ OA participants attended at least nine exercise sessions. Five PFJ OA participants returned 6-month follow-up questionnaires, which was considered fair retention. The PFJ OA participants’ self-reported pain, symptoms, function in daily living, function in sport, and quality of life all improved at 6 weeks (P < 0.05). Timed-Up-and-Go time score improved at 6 weeks (P = 0.005). Peak hip external rotator torque increased (P = 0.01). Improvements in pain and self-reported function were no longer significant 6 months following completion of the intervention.ConclusionsPFJ OA participants were adherent to the supervised sessions of the intervention. Improvement in symptoms, physical performance, and muscle torque were found after 6 weeks. Participant retention at 6 months was fair, and significant changes were no longer present. Our findings suggest that a hip strengthening and core stabilization program may be beneficial to improve symptoms, function, and physical performance in persons with PFJ OA. Future studies are needed, and additional measures should be taken to improve long-term adherence to exercise.Trial registrationClinicalTrials.gov NCT02825238. Registered 6 July 2016 (retrospectively registered).Electronic supplementary materialThe online version of this article (10.1186/s40814-018-0262-z) contains supplementary material, which is available to authorized users.

Neuromotor control during stair ambulation in individuals with patellofemoral osteoarthritis compared to asymptomatic controls

“…During stair ascent, GMax activation during stance phase on the top step was 11% shorter in the PFOA group than the control group (d = 0.76). Previous studies have shown that individuals with PFOA have lower hip strength compared to healthy controls [19,20] and utilize different pelvic and hip kinematics to ascend stairs [9]. However, it is uncertain whether the 11% reduction in GMax activation duration identified in the PFOA group is of a sufficient magnitude to impart any clinical impact.…”

Comparative Effect of a Balance Training Program and Core Stabilization Program on Factors Related to the Prevention of Falling in Healthy Middle-Aged Individuals: A Double-Blind Randomized Controlled Clinical Trial

“…They found a significant increase in dynamic balance after 6 weeks when measured using the timed up and go test, after core strength training in 10 patellofemoral osteoarthritis. 37 Additionally, from the study of Newell et al in 2012 38 , they found a significant increase in stride length and gait velocity after Pilates training, 1 time a week, for 8 weeks in 9 elderly people.…”

Impaired muscle capacity of the hip and knee in individuals with isolated patellofemoral osteoarthritis: a cross-sectional study

“…However, the results of a pilot feasibility study suggest that hip strengthening and a core stabilization program may be beneficial in improving symptoms, function, and physical performance in people with PFOA. 71 These findings are preliminary but promising, and further clinical studies will determine which muscle group should be addressed and whether concentric, eccentric, and/or isometric strengthening is more effective in improving pain symptoms, especially during functional activities, in the rehabilitation program for patients with PFOA.…”