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

Abstract

Background Patellofemoral pain (PFP) often affects young women, and the etiology is multifactorial and poorly understood. Conservative intervention has been focused on risk factors or aggravating factors and is composed of hip- and knee-strengthening exercises, as this population often has muscle weakness and poor motor control during daily and sports activities. The objective of this study was to evaluate the additional effects of neuromuscular training in a conservative treatment of trunk-, hip-, and knee-muscle strengthening on pain, function, and kinematics of the trunk, pelvis, and lower limb in women with PFP. Methods This is a randomised clinical trial, controlled, blinded. Ninety women who are active and engage in physical activity up to twice a week will be recruited. All participants will undergo an individual physiotherapy assessment and then will be allocated randomly into two groups. Thereafter, both groups will undergo a 12-week intervention protocol: group 1 will perform strengthening exercises for the trunk, hip, and knee muscles, while group 2 will receive the same treatment, with the inclusion of neuromuscular training exercises on the fourth week. At the end of the intervention, the volunteers will be evaluated. The primary outcomes will be pain intensity (using a Visual Analog Scale: over the last month, squat 90°, and step of 26 cm during 1 min), functional capacity (Anterior Knee Pain Scale and Activities of Daily Living Scale), and 2D kinematics of the trunk, pelvis, and lower limb during the single-leg squat. The secondary outcomes correspond to the isometric muscular strength of the lower limb and the level of satisfaction from the intervention. Discussion The present study was initiated on 28 January 2018 and is currently in progress, scheduled for completion in July 2019. The results of this study should contribute to the physiotherapeutic treatment of women with PFP by aggregating information on the benefits of adding neuromuscular training to strengthening of the trunk and lower-limb muscles. Trial registration Registro Brasileiro de Ensaios Clínicos, ID: RBR-8c7267. Registered on 2 August 2017.

Do exercises for patellofemoral pain reflect common injury mechanisms? A systematic review

“…The authors of this review acknowledge the multidimensional nature of PFP etiology, and the complex interactions between anatomical, biomechanical, neurophysiological and biopsychosocial factors, and how these impairments intertwine with pain science. 19,42,[57][58][59][60][61][62][63][64] This review only focuses on a small portion of the exercise therapy and methods that may potentially optimize a hip focused rehabilitation for PFP. Indeed, there is evidence that incorporating exercises involving more complex task repetition with feedback is the most effective for correcting aberrant running patterns associated with PFP.…”

Analysis of Predictors Affecting Biomechanical Function of the Knee Joint and Its Relation to Anterior Knee Pain

“…Various physical activities like squatting, running, climbing stairs, and sitting crossed leg can exacerbate the conditions [1]. According to the recent literature, this condition is becoming a major problem in the young and sporting population [1][2][3]. The patellofemoral joint has been the topic of fascination for researchers for decades because individuals of all ages are affected by it.…”