Hip Strength and Hip and Knee Kinematics During Stair Descent in Females With and Without Patellofemoral Pain Syndrome

Bolgla, Lori A.; Malone, Terry; Umberger, Brian R.; Uhl, Timothy L.

doi:10.2519/jospt.2008.2462

Cited by 309 publications

(325 citation statements)

References 33 publications

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“…These values are very similar to previously reported strength in patients with PFPS (4.6 and 2.2, respectively). 5 Our postintervention strength values at 8 weeks for HABD and HER (6.4  1.4 and 2.5  0.8, respectively) were again similar to values reported for a healthy cohort (6.5 and 3.2, respectively). 5 Because we used a relatively unique means of reporting torque that controlled for individual variance due to height and weight, we additionally converted our strength measures for isometric HABD and HER into a percentage of bodyweight for further comparison to studies that did not use these corrections (TABLE 4).…”

Section: Secondary Outcome Measuressupporting

confidence: 69%

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Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial

Dolak¹,

Silkman²,

McKeon³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

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174

223

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Study Design Randomized clinical trial. Objectives To determine if females with patellofemoral pain syndrome (PFPS) who perform hip strengthening prior to functional exercises demonstrate greater improvements than females who perform quadriceps strengthening prior to the same functional exercises. Background Although PFPS has previously been attributed to quadriceps dysfunction, more recent research has linked this condition to impairment of the hip musculature. Lower extremity strengthening has been deemed an effective intervention. However, research has often examined weight-bearing exercises, making it unclear if increased strength in the hip, quadriceps, or both is beneficial. Methods Thirty-three females with PFPS performed either initial hip strengthening (hip group) or initial quadriceps strengthening (quad group) for 4 weeks, prior to 4 weeks of a similar program of functional weight-bearing exercises. Self-reported pain, function, and functional strength were measured. Isometric strength was assessed for hip abductors, external rotators, and knee extensors. A mixed-model analysis of variance was used to determine group differences over time. Results After 4 weeks, there was less mean ± SD pain in the hip group (2.4 ± 2.0) than in the quad group (4.1 ± 2.5) (P = .035). From baseline to 8 weeks, the hip group demonstrated a 21% increase (P<.001) in hip abductor strength, while that remained unchanged in the quad group. All participants demonstrated improved subjective function (P<.006), objective function (P<.001), and hip external rotator strength (P = .004) from baseline to testing at 8 weeks. Conclusion Both rehabilitation approaches improved function and reduced pain. For patients with PFPS, initial hip strengthening may allow an earlier dissipation of pain than exercises focused on the quadriceps. Level of Evidence Therapy, level 2b-. J Orthop Sports Phys Ther 2011;41(8):560–570. Epub 7 June 2011. doi:10.2519/jospt.2011.3499

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Section: Secondary Outcome Measuressupporting

confidence: 69%

“…The normalization procedure resulted in strength being expressed without units, and allowed for comparison across all participants, without bias for height, weight, or limb length. 5,21 These values were used for statistical analysis.…”

Section: Data Processingmentioning

confidence: 99%

Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial

Dolak¹,

Silkman²,

McKeon³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

Self Cite

174

223

View full text Add to dashboard Cite

show abstract

“…Their findings suggest that the anterior and posterior fibers are activated in the same manner and not in isolation. However, these results were derived from subjects with numerous musculoskeletal disorders 2,15,[25][26][27] . Therefore, this provides further evidence that rehabilitation programs aimed at increasing the strength and activation of hip muscles, such as the GM, are effective at reducing pain and disability and improving lower limb kinematics and athletic performance 2,5,27) .…”

Section: Discussionmentioning

confidence: 99%

EMG Analysis of Gluteus Medius Subdivisions during Modified Unilateral Biofeedback Exercises for the Lower Limbs

Heo

Yoo

et al. 2013

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to investigate the activation of subdivisions of the gluteus medius during modified unilateral weight-bearing exercises using a pressure-biofeedback unit in order to suggest the most effective exercise method.[Subjects] We recruited 15 healthy adult females with no pain in the gluteus medius and no other orthopedic problems in the lower limbs.[Methods] The enrolled individuals performed four modified unilateral biofeedback exercises: wall-press with adduction force, WP-ADD; wall-press with abduction force, WP-ABD; wall-squat with adduction force, WS-ADD; and wall-squat with abduction force.[Results] The anterior and middle fibers of the gluteus medius were highly activated during WP-ADD, and the posterior fiber of the gluteus medius was activated during WS-ABD.[Conclusion] These results suggest that weight-bearing exercises for gluteus medius strengthening should be more specific, and chosen based on the characteristics of each subdivision.

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“…So, the most frequent problem of overtraining is the atrophy of the medial heads of the quadriceps femoris muscle and the dominance of the lateral and intermediate head, with their work reinforced by the tensor fasciae latae muscle. This leads to the dominance of forces that draw the knee cap in the lateral direction, and the excessive lateral pressure syndrome [2,5]. The knee cap is a type of block which reinforces the work of the thigh muscles.…”

Section: Introductionmentioning

confidence: 99%

“…An even greater load is observed for movement on an uneven surface: stepping down a 35 cm step causes that 3.5 times the body weight is transferred to the knee cap. Therefore, if the knee cap does not move on its proper course, it is prematurely worn down and chondromalacia patellae is observed, that is, softening of the cartilage in the knee joint [5].…”

Section: Introductionmentioning

confidence: 99%

Lower limb loading during knee up in step aerobics: a pilot study

Błażkiewicz

Wiszomirska

Kaczmarczyk

et al. 2016

Biomedical Human Kinetics

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Summary Study aim:Step aerobics is a form of aerobic power distinguished from other types of aerobic exercise by its use of an elevated platform. The purpose of this study was to examine how the aerobic exercise "knee up" affects kinematic and kinetic parameters and, above all, the length of the muscle contractions. Material and methods:The study analysed ten female fitness instructors with at least six years of experience. The task consisted in the knee up move performed using a 15 cm step and music with the beat frequency of 148 BPM. Kinematic and kinetic parameters were recorded using the Vicon system synchronized with two Kistler force plates. OpenSim software was used for calculation of the length of involved muscles. Results: Ranges in angles and torques suggest that the location that is the most prone to injuries and overtraining is the knee joint, followed by the hip and ankle joints. Greater values of the vertical component of ground reaction forces were observed during stepping down, which suggests greater load to the joints. The greatest work in the move analysed in this study was performed by the sartorius muscle and the tensor fasciae latae muscle. Conclusions: Despite the benefits that have been demonstrated when step classes are structured correctly and adapted to the participants, further research is needed concerning biomechanical load, exercise prescription, and injury prevention.

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Hip Strength and Hip and Knee Kinematics During Stair Descent in Females With and Without Patellofemoral Pain Syndrome

Cited by 309 publications

References 33 publications

Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial

Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial

EMG Analysis of Gluteus Medius Subdivisions during Modified Unilateral Biofeedback Exercises for the Lower Limbs

Lower limb loading during knee up in step aerobics: a pilot study

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