Effects of Core Neuromuscular Training on Pain, Balance, and Functional Performance in Women With Patellofemoral Pain Syndrome: A Clinical Trial

Abstract

Objective: The purpose of this study was to determine the effects of core neuromuscular training on pain, balance, and performance in women with patellofemoral pain syndrome (PFPS). Methods: This randomized single-blind trial was based on a convenience sample of 28 women with unilateral PFPS. All participants were assigned randomly to the intervention or control group with a block randomization method. The control group received routine physical therapy exercise for PFPS. The intervention group received core neuromuscular training in addition to routine physical therapy exercise. The outcome measures evaluated were pain intensity (Visual Analog Scale), function (Kujala patellofemoral questionnaire and step-down performance test), and balance (Y balance test). Results: In both groups the pain score was significantly lower after treatment (P = .001). The slope of this trend was greater in the intervention group. The Kujala and step-down scores improved significantly after treatment in both groups, although the improvements were greater in the intervention group. The Y balance score improved in all 3 directions after therapy in both groups (P b .05); improvement was significantly greater in the intervention group only in the posteromedial direction (P = .016). Conclusion: For the group of participants studied, a 4-week core neuromuscular training plus routine physiotherapy exercise was more effective than routine physiotherapy exercise alone for improving pain, balance, and functional performance in individuals with PFPS.

Effects of proprioceptive exercises and strengthening on pain and functionality for patellofemoral pain syndrome in women: A randomized controlled trial

“…32 In the present study, it was possible to observe muscle performance progress, which enabled greater body awareness, reported functional capacity and pain improvement after exercise therapy. Our findings are consistent with the results of some randomized clinical trials and systematic reviews that analyzed the addition of hip and knee muscle strengthening 33,34 and proprioceptive exercises 21,22 for women with PFPS. Nakagawa et al 33 concluded that the combination of hip strengthening associated with strengthening the knee extensor musculature was more effective than the isolated strengthening of the knee extensor apparatus in reducing pain and function evolution in women with PFPS.…”

“…Similarly, Baldon et al 21 demonstrated that strengthen hip muscles and proprioceptive exercises of the lower limbs and trunk was more helpful in improving pain, physical function, kinematics and muscle strength when compared to an exercise program only for knee muscles. More recently, Motealleeh et al, 22 showed that proprioceptive exercises focused on correcting movement pattern associated to resistance training for lower limbs brought better results than just performing exercises against resistance loads.…”

“…Despite increasing evidence related to the dysfunctions mentioned above, few randomized controlled clinical trials have attempted to compare the benefit of strengthening the hip and knee muscles associated with proprioceptive exercises in relation to other types of interventions. 21,22 In addition, recent systematic reviews, guidelines and consensus of clinical practice emphasize the need for more research addressing neuro-motor control and the use of combined interventions in people with PFPS. 1,23 The objective of the present study was to evaluate the efficiency of a resisted and proprioceptive exercises program for knee, trunk and hip muscles, compared to educational, cognitive and behavioral guidance in terms of pain and function in women with PFPS.…”

Anais Do v Congresso De Ortopedia E Medicina Do Esporte Da Universidade Federal De Juiz De Fora - Mg / I Congresso Multidisciplinar De Ciências Do Esporte

“…Nos artigos foram realizados treinamento neuromuscular central com enfoque nos músculos abdominais profundos, exercícios de rotina, fortalecimento e flexibilidade dos músculos quadríceps, isquiotibiais, abdutores, adutores, flexores e extensores de quadril. Os artigos indicaram que houve melhora da cinemática, função, dor e equilíbrio dos membros inferiores quando realizados fortalecimento do quadríceps, do quadril e treinamento neuromuscular central (MOTEALLEH A, et al, 2019;SAAD MC, et al, 2018). Já na Guideline foram indicados: uso de órteses pré-fabricadas a curto prazo, acupuntura para alívio da dor, treinamento de marcha com enfoque em ante pé, educação do paciente e combinação de intervenções fisioterapêuticas (exercícios + órteses + educação do paciente).…”

Effects of whole body vibration with exercise therapy versus exercise therapy alone on flexibility, vertical jump height, agility and pain in athletes with patellofemoral pain: a randomized clinical trial

“…According to earlier research, several rehabilitation therapies have been suggested to treat PFP including exercise therapy, neuromuscular training and manual therapy. In relation to the factors that contribute to PFP, a combination of stretching and strengthening exercises (especially combinations of exercise therapy with lower-limb stretching) was found to effectively improve symptoms in patients with PFP [ 19 , 29 – 31 ].…”