Anteromedial versus posterolateral hip musculature strengthening with dose-controlled in women with patellofemoral pain: A randomized controlled trial.

OBJECTIVE: To compare the effectiveness of adding anteromedial versus posterolateral hip musculature strengthening to knee strengthening in women with patellofemoral pain (PFP). DESIGN: Randomized controlled trial. SETTING: University physiotherapy clinic. PARTICIPANTS: Fifty-two women with PFP were randomized to receive either anteromedial (AMHG) or posterolateral (PLHG) hip musculature strengthening. MAIN OUTCOME MEASURES: The primary outcomes were pain intensity by the numeric pain rating scale and function by the Anterior Knee Pain Scale in six weeks. Secondary outcomes were pain and function at six months, global perceived effect at six weeks and six months, pain in step down, isometric torque of abductors, adductors and hip rotators measured with hand-held dynamometer, and dynamic knee valgus by step down in six weeks. RESULTS: Both groups showed improvement in primary outcomes; however, no differences were found between groups in pain intensity and function in six weeks and the secondary outcomes. Group x time interaction found superior gains in abductor strength in the PLHG and increase in the strength of the adductors and internal rotators in AMHG. CONCLUSION: There was no difference between the addition of anteromedial or posterolateral hip musculature strengthening to knee strengthening in improving pain and function in women with PFP.

Immediate Effect of Ankle Mobilization on Range of Motion, Dynamic Knee Valgus, and Knee Pain in Women With Patellofemoral Pain and Ankle Dorsiflexion Restriction: A Randomized Controlled Trial With 48-Hour Follow-Up.

CONTEXT: Restriction in ankle dorsiflexion range of motion (ROM) has been previously associated with excessive dynamic knee valgus. This, in turn, has been correlated with knee pain in women with patellofemoral pain. OBJECTIVES: To investigate the immediate effect of 3 ankle mobilization techniques on dorsiflexion ROM, dynamic knee valgus, knee pain, and patient perceptions of improvement in women with patellofemoral pain and ankle dorsiflexion restriction. DESIGN: Randomized controlled trial with 3 arms. SETTING: Biomechanics laboratory. PARTICIPANTS: A total of 117 women with patellofemoral pain who display ankle dorsiflexion restriction were divided into 3 groups: ankle mobilization with anterior tibia glide (n = 39), ankle mobilization with posterior tibia glide (n = 39), and ankle mobilization with anterior and posterior tibia glide (n = 39). INTERVENTION(S): The participants received a single session of ankle mobilization with movement technique. MAIN OUTCOME MEASURES: Dorsiflexion ROM (weight-bearing lunge test), dynamic knee valgus (frontal plane projection angle), knee pain (numeric pain rating scale), and patient perceptions of improvement (global perceived effect scale). The outcome measures were collected at the baseline, immediate postintervention (immediate reassessment), and 48 hours postintervention (48 h reassessment). RESULTS: There were no significant differences between the 3 treatment groups regarding dorsiflexion ROM and patient perceptions of improvement. Compared with mobilization with anterior and posterior tibia glide, mobilization with anterior tibia glide promoted greater increase in dynamic knee valgus (P = .02) and greater knee pain reduction (P = .02) at immediate reassessment. Also compared with mobilization with anterior and posterior tibia glide, mobilization with posterior tibia glide promoted greater knee pain reduction (P < .01) at immediate reassessment. CONCLUSION: In our sample, the direction of the tibia glide in ankle mobilization accounted for significant changes only in dynamic knee valgus and knee pain in the immediate reassessment.