Patellofemoral pain (PFP) is a frequent knee condition. The aim of this study was to investigate strength, flexibility and postural control in people with and without PFP. Fifty-five participants between 14 and 54 years of age (PFP = 18, control group = 37) were included. Strength and flexibility for all trunk, hip, knee and ankle muscle groups were measured along with postural control outcomes. Analyses were conducted based on the “affected” and “non-affected” leg within-group and between-groups. Between-groups analysis demonstrated a statistically lower strength of trunk muscles (range: 35.8–29.3%, p < 0.001), knee extensors (20.8%, p = 0.005) and knee flexors (17.4%, p = 0.020) in PFP participants. Within-group analysis proved an 8.7% (p = 0.018) greater hip internal rotation strength and ankle extension flexibility (p = 0.032) of the “affected side” in PFP participants. This was, to our knowledge, the first study to investigate the strength of all trunk muscle groups. The results indicate that participants with PFP exhibit impaired strength of trunk muscle groups, along with knee muscle deficits, which may present a rehabilitation target. Clinicians should consider implementing trunk strengthening exercises into PFP programs along with knee-targeting exercise programs.
Objective: Previous research suggests that muscle strength exercise is the most effective rehabilitation methods in patients with patellofemoral pain (PFP). This systematic review with meta-analysis compared the effects of Hip&Knee, Hip-only and Knee-only exercise programs on pain relief, muscle strength, and functional performance in patients with PFP. Methods: Literature searches of PubMed, PEDro and CINAHL databases revealed twentyone studies included in the final descriptive review, thirteen of which were included in the meta-analysis. Data extraction included baseline and post-intervention means and standard deviations of all eligible outcome measures both for the intervention and control groups, participants baseline demographics and intervention characteristics. Results: The results showed that Hip&Knee and Hip-only exercise programs were comparatively effective, while the Knee-only exercise programs proved to be inferior to the above-mentioned approaches. The Hip&Knee exercise programs showed the greatest pain relief (mean difference = −1.71 (−3.11, −0.30); p = 0.02; I 2 = 96%) and functional improvement (standardized mean difference = 1.28 (0.45, 2.12); p = 0.003; I 2 = 84%), although the subgroup analysis did not show any significant difference compared to Hip-only exercise programs (p > 0.05). Conclusion: Overall, Hip&Knee exercise programs appear to reduce pain and improve function more than other exercise programs and could be used as a primary rehabilitation approach in patients with PFP. However, the difference between the subgroups in most outcome measures suggests that Hip&Knee exercise programs are no more effective than Hip-only exercise programs.
Premature death, chronic disease, and productivity loss can be reduced with the help of programs that promote a healthy lifestyle. Workplace health promotion programs have been shown to be an efficient way of improving employee health. These can also benefit employers by improving retention, reducing worker turnover, and lowering healthcare costs. In Slovenia, a workplace health promotion program called “STAR-VITAL—Joint Measures for the Vitality of Older Workers” targeting small- and medium-sized enterprises has been ongoing since September 2017. We hypothesize that this workplace health promotion program will yield long-term health changes for the included employees and employers. Methods/Design: The manuscript presents a workplace health promotion program design that introduces some novel approaches and solutions to workplace health promotion program implementation. It also introduces a measurement of their effects that address the problem of low participation rates and the effectiveness of workplace health promotion programs, as follows: (1) the multifaceted and individualised approach to implementation, (2) customer relationship management (CRM) -based interaction management with program participants, and (3) impact evaluation based on employee health and labour market data observing both intermediate outcomes and the final outcomes based on national micro administrative data. Discussion: Although the novel approaches introduced with the STAR-VITAL program proved to be effective during the COVID-19 pandemic, they deserve the attention of scholars and practitioners. Further research is called for to further explore the potential of CRM in health promotion contexts, the effectiveness of multifaceted and individualised workplace health promotion program interventions, and micro administrative data-based impact evaluations. Conclusions: The STAR-VITAL program introduces several new approaches addressing the problem of low participation rates and the effectiveness of WHPPs. Further research is called for to discover and explore the potential of those novel approaches.
Uvod: Patelofemoralna bol (PFB) jedna je od najučestalijih boli u području koljena. Smanjena jakost okolnih mišićnih skupina može prouzrokovati lokalne biomehaničke promjene, koje posljedično pridonose razvoju PFB-a. Cilj je našeg rada identificirati, usporediti i procijeniti značajke maksimalne izometričke kontrakcije (MVIC) mišića kuka, trupa i gležnja kod žena i muškaraca s PFB-om. Metode: Izveden je sustavni pregled literature te je za daljnju analizu izabrano devet istraživanja koja su odgovarala unaprijed postavljenim kriterijima. Rezultati: Znatno veći broj istraživanja proučava MVIC mišića kuka u žena s PFB-om nego u muškaraca s istom patologijom. Kod žena su istraživanja složna te izvještavaju o smanjenoj jakosti abduktora, aduktora i ekstenzora kuka, dok su u slučaju dvaju istraživanja koja su proučavala MVIC laterofleksora trupa rezultati oprečni. Našim pretraživanjem nisu nađena istraživanja koje proučavaju utjecaj MVIC-a gležnja kod PFB-a. Zaključak: U oba se spola područje kuka pokazalo potkrijepljeno znanstvenim istraživanjima te su rezultati MVIC-a kod PFB-a na tom području homogeni. Sustavnim pregledom trenutačno dostupne literature utvrđena je djelomična zastupljenost MVIC-a područja trupa kod osoba s PFB-om. Također, vidljiv je nedostatak znanstvenih istraživanja MVIC-a područja gležnja i stopala kako kod žena tako i kod muškaraca s PFB-om.
Patellofemoral pain (PFP) is often associated with impaired muscle strength, flexibility, and stability. It has been suggested that inter-leg asymmetries have an important role in increasing the risk of musculoskeletal injuries, including PFP. Thus, the aim of this study was to identify significant asymmetries and determine the effects of a symmetry targeted exercise program in patients with PFP. Eighteen patients aged 13 to 54 years (24.17 ± 12.52 years) with PFP participated in this study. Strength, flexibility and stability outcomes of the trunk, hip, knee and ankle muscles were assessed. A single-group pretest–posttest design was used to assess changes in inter-leg and agonist–antagonist asymmetries resulting from the 8-week period of the supervised exercise program. Results indicated a significant improvement in inter-leg symmetry regarding bilateral stance in a semi-squat position (p = 0.020, d = 0.61, df = 17) and ankle plantarflexion (p = 0.003, d = 0.32, df = 17) and ankle dorsiflexion strength (p < 0.001, d = 0.46, df = 17). In addition, the ratio of ankle dorsiflexion/plantarflexion (p = 0.036, d = 1.14, df = 17) and hip extension/flexion (p = 0.031, d = 0.94, df = 16) changed significantly during the intervention period. To our knowledge, this was the first study to evaluate inter-leg asymmetries resulting from a period of a supervised exercise program. The results indicate that an exercise program focusing on individual asymmetries may influence specific deficits and contribute to better rehabilitation outcomes.
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