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

• Published in: Gait & posture Vol. 58; pp. 280 - 286
• Main Authors: Rabelo, Nayra Deise dos Anjos, Costa, Leonardo Oliveira Pena, Lima, Bruna Maria de, dos Reis, Amir Curcio, Bley, André Serra, Fukuda, Thiago Yukio, Lucareli, Paulo Roberto Garcia
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.10.2017
• Subjects: Adult; Anterior knee pain; Biomechanical Phenomena; Exercise Therapy - methods; Female; Hip; Hip Joint - physiology; Humans; Kinematics; Knee Joint - physiopathology; Motor control; Motor Skills - physiology; Muscle Strength - physiology; Muscle Weakness - physiopathology; Muscle, Skeletal - physiology; Pain Measurement; Patella; Patellofemoral Pain Syndrome - physiopathology; Patellofemoral Pain Syndrome - therapy; Physical Therapy Modalities; Young Adult; Anterior knee pain; Patella; Motor control; Hip; Kinematics
• ISSN: 0966-6362; 1879-2219
• DOI: 10.1016/j.gaitpost.2017.08.018

•Knee and posterolateral hip muscle strengthening should be used in the treatment of women with PFP.•Hip muscle strengthening caused no significant changes in the movements of the patients during the step down task.•Movement control training added to a conventional strength training program did not present better results during four weeks. Randomized controlled trial. Patients with Patellofemoral pain (PFP) usually present muscular weakness, pain and impaired motor control. Muscle strengthening is an effective treatment strategy for PFP, but the additional benefits of movement control training remain unknown. Therefore, the aim of this study was to compare the effects of movement control training associated with muscle strengthening, with a conventional program of strengthening alone in women with PFP. Thirty-four women were randomly assigned to two groups. The Strengthening group (S group) performed 12 sessions to strengthen the knee and hip muscles. The Movement Control & Strengthening group (MC&S group) performed the same exercises and movement control training of the trunk and lower limbs. Effects of the treatment (i.e., between-group differences) were calculated using linear mixed models. Primary outcomes were function and pain intensity after completion of the treatment protocol. Secondary outcomes were; muscle strength and kinematic outcomes during the step down task after 4 weeks of treatment; and function and pain intensity 3 and 6 months after randomization. The MC&S group did not present significantly better function (MD −2.5 points, 95% CI;−10.7–5.5) or pain (MD −0.3 points, 95% CI;−1.7–1.0) at 4 weeks. There was a small difference in favour of the MC&S group for AKPS scores at 3 months (MD −8.5 points; 95% CI;−16.8 to −0.3). No significant between-group differences were observed for the other outcomes. Movement control training was no more effective than the isolated strengthening protocol, in terms of pain, function, muscle strength, or kinematics.