Can we replace exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in women with patellofemoral pain? A randomized controlled trial

Abstract

Objective: To verify the effects of replacing exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in a rehabilitation program for patellofemoral pain (PFP).

Design: Randomized Controlled Trial.

Participants: Fifty women with PFP.

Methods: PFP participants were randomized into the standard rehabilitation group (SRG, n = 25) or distal exercise group (DEG, n = 25). Knee pain, patient-reported function, dynamic knee valgus and muscle strength were measured at baseline and after six and twelve weeks of the program start.

Results: SRG and DEG presented similar responses to rehabilitation (except for muscle strengthening). Knee pain reduced after 6 weeks (SRG: -37.7%, ES = 1.23; DEG: -30%, ES = 0.93) and 12 weeks (SRG: -47.4%, ES = 1.53; DEG: -43.3%, ES = 1.46). Patient-reported function improved after 6 weeks (SRG: +7.3%, ES = 0.45; DEG: +3.8%, ES = 0.22) and 12 weeks (SRG: +14.1%, ES = 0.80; DEG: +8.8%, ES = 0.50). Dynamic knee valgus reduced after 12 weeks (SRG: -29.7%, ES = 0.38; DEG: -34.5%, ES = 0.32). Both groups experienced increases in knee extension strength (SRG: +9%, ES = 0.28; DEG: +6%, ES = -0.29), but only SRG had strength gains for hip abduction (+10%, ES = 0.36) and extension (+11%, ES = 0.44).

Conclusion: Exercises targeted on core/hip muscles can be replaced by exercises targeted on leg/foot muscles in a lower limb exercise-based rehabilitation program for women with PFP.

Clinical trial registration: NCT03663595.

Keywords: Anterior knee pain; Physical therapy; Women.