Immediate Improvements in Patellofemoral Pain Are Associated With Sagittal Plane Movement Training to Improve Use of Gluteus Maximus Muscle During Single Limb Landing

• Published in: Physical therapy Vol. 101; no. 10; pp. 1 - 7
• Main Authors: Atkins, Lee T, James, C Roger, Yang, Hyung Suk, Sizer, Phillip S, Brismée, Jean-Michel, Sawyer, Steven F, Powers, Christopher M
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.10.2021
• Subjects: Biomechanical Phenomena; Exercise therapy; Exercise Therapy - methods; Female; Hip; Hip - physiopathology; Humans; Isometric Contraction; Lower Extremity - physiology; Methods; Movement - physiology; Muscle Strength - physiology; Muscle, Skeletal - physiology; Muscles; Patellofemoral Pain Syndrome - physiopathology; Patellofemoral Pain Syndrome - therapy; Patient outcomes; Young Adult; United States; Gluteus Maximus; Patellofemoral Pain; Hip Internal Rotation; Movement Training
• ISSN: 0031-9023; 1538-6724; 1538-6724
• DOI: 10.1093/ptj/pzab165

Abstract Objective The authors sought to examine the immediate effects of movement training aimed at improving use of gluteus maximus (GMAX) in the sagittal plane on hip internal rotation and self-reported patellofemoral pain (PFP) during single-limb landing. Methods Seventeen females with PFP participated. Lower extremity kinematics and kinetics, GMAX activation, and self-reported PFP were obtained before and after a single-session movement training program aimed at increasing the use of GMAX. Dependent variables of interest included self-reported PFP, average GMAX activation, average hip extensor moment, and peak hip internal rotation. Post-training changes were evaluated using paired t tests and Wilcoxon signed rank tests. Results Following movement training, self-reported PFP decreased significantly (mean [standard deviation]) (3.9 [1.1] vs 0.8 [1.3] on a 0–10 scale). Additionally, significant increases were observed for the average hip extensor moment (0.6 [0.3] vs 1.8 [0.4] Nm/kg) and average GMAX activation (41.0% [18.3] vs 51.6% [25.7] maximum voluntary isometric contraction), whereas peak hip internal rotation decreased significantly (8.5 degrees [5.8] vs 6.0 degrees [5.3]). Conclusion Movement training aimed at improving the use of GMAX in the sagittal plane resulted in clinically relevant changes in self-reported pain, GMAX activation, and hip kinetics and kinematics. Improving the use of GMAX during movement merits consideration when designing rehabilitation programs for females with PFP. Impact The current study highlights the clinical utility of movement training for persons with PFP and provides a biomechanical rationale for its use as a potential intervention in this population.