Adding motor control training to muscle strengthening did not substantially improve the effects on clinical or kinematic outcomes in women with patellofemoral pain: A randomised controlled trial

Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain?

“…Interestingly, however, recent prospective studies have demonstrated that although strength training of the gluteal muscles promotes a gain in force and significant improvement in symptoms, it is unable to generate movement changes in women with PFP. 24 , 28 , 29 In addition, strength training associated with movement control training did not alter the kinematics 28 , 30 and did not promote additional benefits to the clinical outcomes obtained from strength training alone. 24 …”

“…This novel concept has become the basis for treatment strategies based upon a possible causal relationship between hip muscle weakness and movement disturbance in patients with PFP. This has become even more likely because few clinical trials have demonstrated that treatment protocols involving proximal muscles strengthening alone 21 , 22 or associated with strengthening of the quadriceps, 23 , 24 resulted in significant improvement of pain and disability of patients compared to patients who received other interventions, such as knee braces, 25 patellar taping 26 and electro-physical agents. 27 Nevertheless, there are no studies that directly comprised interventions mentioned above.…”

Step down tests are the tasks that most differentiate the kinematics of women with patellofemoral pain compared to asymptomatic controls

“…The NPRS consists of a scale from 0 to 10 points, where higher scores characterize higher intensity of pain [14]. The first clinical examination of the volunteers was conducted by two experienced physiotherapists to verify the eligibility criteria [15].…”

Effects of neuromuscular training and strengthening of trunk and lower limbs muscles in women with Patellofemoral Pain: A protocol of randomized controlled clinical trial, blinded

“…In view of the kinematic characteristics of this population, the integration of neuromuscular training to the strengthening protocol may be important. However, the evidence-base is poor and unclear [32, 33, 35–37]. We found only five studies that evaluated these phases of physical therapy in patients with PFP.…”

“…One was a case report [32]; two studies observed the effect of motor control under dynamic alignment during gait [35, 36]; one study evaluated trunk and lower-limb kinematics following an isolated knee-strengthening and stretching program versus a hip-strengthening program associated with neuromuscular training [33]. Moreover, only one study evaluated the additional effect of neuromuscular training, concluding that the addition of neuromuscular training does not promote significant improvement in the kinematics of the trunk and lower limb [37]. However, the small sample size, relatively unchallenging motor-control protocol, and short, 4-week, intervention period could have influenced the results [37].…”