Supplementation of strengthening of hip abductor and lateral rotator muscles in a strengthening quadriceps exercise programme provided additional benefits with respect to the perceived pain symptoms during functional activities in patients with patellofemoral pain syndrome after six weeks of treatment.

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Context: Patellofemoral pain syndrome (PFPS) is a common knee condition in athletes. Recently, researchers have indicated that factors proximal to the knee, including hip muscle weakness and motor control impairment, contribute to the development of PFPS. However, no investigators have evaluated eccentric hip muscle function in people with PFPS.Objective: To compare the eccentric hip muscle function between females with PFPS and a female control group.Design: Cross-sectional study. Setting: Musculoskeletal laboratory.Patients or Other Participants: Two groups of females were studied: a group with PFPS (n 5 10) and a group with no history of lower extremity injury or surgery (n 5 10).Intervention(s): Eccentric torque of the hip musculature was evaluated on an isokinetic dynamometer.Main Outcome Measure(s): Eccentric hip abduction, adduction, and external and internal rotation peak torque were measured and expressed as a percentage of body mass (Nm/kg 3 100). We also evaluated eccentric hip adduction to abduction and internal to external rotation torque ratios. The peak torque value of 5 maximal eccentric contractions was used for calculation. Two-tailed, independent-samples t tests were used to compare torque results between groups.Results: Participants with PFPS exhibited much lower eccentric hip abduction (t 18 5 22.917, P 5 .008) and adduction (t 18 5 22.764, P 5 .009) peak torque values than did their healthy counterparts. No differences in eccentric hip external (t 18 5 0.45, P 5 .96) or internal (t 18 5 20.742, P 5 .47) rotation peak torque values were detected between the groups. The eccentric hip adduction to abduction torque ratio was much higher in the PFPS group than in the control group (t 18 5 2.113, P 5 .04), but we found no difference in the eccentric hip internal to external rotation torque ratios between the 2 groups (t 18 5 20.932, P 5 .36).Conclusions: Participants with PFPS demonstrated lower eccentric hip abduction and adduction peak torque and higher eccentric adduction to abduction torque ratios when compared with control participants. Thus, clinicians should consider eccentric hip abduction strengthening exercises when developing rehabilitation programs for females with PFPS.

The purposes of this study were to compare lower-limb kinematics between genders, and determine the relationships among eccentric hip abductor and lateral rotator torques and lower-limb kinematics. The movements of the pelvis, femur, and knee were calculated for 16 women and 16 men during the single-leg squat. Eccentric hip abductor and lateral rotator torques were measured using an isokinetic dynamometer. The results showed that women had greater contralateral pelvic depression, femur adduction, and knee abduction than men. The eccentric hip abductor and lateral rotator torques were correlated with coronal plane femur and knee movements in the overall sample. When the genders were analyzed separately, it was observed that women with greater eccentric hip abductor torque exhibited less femur adduction and femur medial rotation, and greater knee adduction excursion. No significant relationship was observed between the isokinetic and kinematic variables in the male group. The differences between the genders help to explain the greater rate of knee disorders observed in women. Moreover, the eccentric hip abduction action seemed to be more important in women to control the lower-limb movements.

Strengthening of the hip abductor and lateral rotator muscles associated with functional training improves dynamic lower limb alignment and increases the strength and functional performance.

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INTRODUÇÃO: Diversas pesquisas têm sido realizadas para determinar os fatores biomecânicos responsáveis pela maior incidência da síndrome da dor femoropatelar e das lesões do ligamento cruzado anterior em mulheres quando comparadas aos homens. OBJETIVO: O objetivo deste estudo foi realizar uma revisão de literatura não sistemática das diferenças biomecânicas entre os gêneros, especialmente aquelas referentes à articulação do quadril, potencialmente responsáveis pela maior incidência de lesões no joelho em mulheres, bem como verificar as suas implicações na elaboração de intervenções preventivas. METODOLOGIA: Artigos publicados entre 1985 e 2008 foram selecionados por dois revisores independentes nas seguintes bases de dados: LILACS, MEDLINE, Cochrane e PubMed. Foram selecionados estudos teóricos, transversais e de correlação, assim como ensaios clínicos controlados, com desenhos experimentais bem esclarecidos. RESULTADOS E DISCUSSÃO: Os estudos selecionados revelaram que as mulheres realizam atividades funcionais com menores ângulos de flexão de joelho e quadril, assim como maior valgo dinâmico do joelho, adução e rotação medial do quadril. Sugere-se, ainda, que as diferenças observadas nos planos coronal e transversal do quadril são mais significativas para a instalação de lesões nas mulheres do que aquelas que ocorrem unicamente no plano sagital. Por fim, as pesquisas demonstram que o treino neuromuscular melhora o alinhamento dinâmico do membro inferior nas mulheres, diminuindo a incidência de lesões no joelho. CONCLUSÃO: Há evidências de que as mulheres apresentam diferenças biomecânicas do padrão de movimento do membro inferior, quando comparadas aos homens, que podem contribuir para as maiores incidências de lesões no joelho observadas nesse gênero.

Patients with PFP might benefit from strengthening of the hip muscles to improve frontal plane lower limb and trunk kinematics during functional tasks.