The goal of this prospective study was to evaluate the efficacy of open versus closed kinetic chain exercises in the nonoperative management of patellofemoral pain. Sixty patients were randomized into a 5-week program that consisted of only closed kinetic chain exercises or only open kinetic chain exercises. Muscle characteristics, subjective symptoms, and functional performance were evaluated in this study at the time of the initial physical examination, at the end of the treatment period, and 3 months later. Both groups experienced a statistically significant decrease in pain and an increase in functional performance. This study shows that both open and closed kinetic chain exercise programs lead to an improved subjective and clinical outcome in patients with anterior knee pain. The few significantly better functional results for some of the tested parameters in the closed kinetic chain group suggest that this type of treatment is a little more effective than the open kinetic chain program in the treatment of these patients.

Twenty-five patients with chronic Achilles tendinopathy were clinically and ultrasonographically evaluated. A positive correlation existed between power Doppler ultrasonography (PDU) and tendon thickness (r=0.63, p<0.001) and patient 's age (r=0.40, p<0.05). A negative correlation existed between PDU and a functional test (number of toe raises to pain) (r=−0.57, p<0.005) and one recorded item of the Victorian Institute of Sport Assessment Achilles score (VISA-A questionnaire, item 6: jumping capability) (r=−0.46, p<0.05). Three patients had no detectable blood flow on PDU. PDU of Achilles tendons does not seem to be strictly related to symptoms but rather to functionality and chronicity of tendinopathy as indicated by toe-raises testing, jumping capability, patient age and tendon thickening. RésuméVingt-cinq malades avec une tendinopathie chronique du tendon d'Achille ont été évalué d'une manière clinique et ultrasonographique. Une corrélation positive existait entre l'amplitude au doppler, l' épaisseur du tendon (r=0.63, p<0.001) et l'âge du malade (r=0.40, p<0.05). Une corrélation négative existait entre le doppler, un test functionnel et une article du 'Victorian Institute of Sport Assessment Achilles' questionnaire (VISA-A article 6: la capacité de saut) (r=−0.46, p<0.05). Trois malades n'avaient aucun courant sanguin détectable au doppler. L'amplitude ultrasonographique au niveau du tendon d'Achille ne paraissait pas en rapport avec les symptomes mais plutot avec la fonction et la chronicité de la tendinopathie comme indiqué par les différents test, l'age du patient et l'épaississement du tendon.

No abstract

The burden of hip muscles weakness and its relation to other impairments has been well documented. It is therefore a pre-requisite to have a reliable method for clinical assessment of hip muscles function allowing the design and implementation of a proper strengthening program. Motor-driven dynamometry has been widely accepted as the gold-standard for lower limb muscle strength assessment but is mainly related to the knee joint. Studies focusing on the hip joint are less exhaustive and somewhat discrepant with regard to optimal participants position, consequently influencing outcome measures. Thus, we aimed to develop a standardized test setup for the assessment of hip muscles strength, i.e. flexors/extensors and abductors/adductors, with improved participant stability and to define its psychometric characteristics. Eighteen participants performed unilateral isokinetic and isometric contractions of the hip muscles in the sagittal and coronal plane at two separate occasions. Peak torque and normalized peak torque were measured for each contraction. Relative and absolute measures of reliability were calculated using the intraclass correlation coefficient and standard error of measurement, respectively. Results from this study revealed higher levels of between-day reliability of isokinetic/isometric hip abduction/flexion peak torque compared to existing literature. The least reliable measures were found for hip extension and adduction, which could be explained by a less efficient stabilization technique. Our study additionally provided a first set of reference normalized data which can be used in future research.

Extracorporeal shock wave therapy shows a comparable functional outcome to surgery in a cross-sectional analysis of patients with chronic proximal patellar tendinopathy resistant to conservative treatment.