hip kinematics

Mentoring Minutes: Patellofemoral Pain Syndrome

REFERENCE & VIDEO NOTES

 

J Orthop Sports Phys Ther. 2009 Jan;39(1):12-9. doi: 10.2519/jospt.2009.2885.

Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain.

Souza RB1, Powers CM.

            - Twenty-one females with PFP and 20 pain-free controls

-Hip kinematics and activity level of hip musculature were obtained during running, a drop jump, and a step-down maneuver. Isometric hip muscle torque production was quantified using a multimodal dynamometer.

- Runners with PFPS, best predictor of hip IR: isotonic hip extension endurance

 

J Orthop Sports Phys Ther. 2012 Jun;42(6):491-501. doi: 10.2519/jospt.2012.3987. Epub 2012 Mar 8.

Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome.

Nakagawa TH1, Moriya ETMaciel CDSerrão FV.

 - 4 groups: females with PFPS, female controls, males with PFPS and male controls

- Outcomes: trunk, pelvis, hip, and knee kinematics; gluteal muscle activation during SL squat; hip abd+ER eccentric strength

- During SL squat PFPS patients had significantly greater ipsilateral trunk lean, contralateral pelvic drop, hip adduction, and knee abduction with SL squat

- Pts with PFPS had 18% less hip abd and 17% less hip ER strength

- females with PFPS had more hip IR and less glut med activation during SL squat

 

J Orthop Sports Phys Ther. 2009 Jul;39(7):532-40. doi: 10.2519/jospt.2009.2796.

Gluteal muscle activation during common therapeutic exercises.

Distefano LJ1, Blackburn JTMarshall SWPadua DA.

- Which exercise is best for patients with PFPS for glut med and max strengthening

            - Glut med: Side lying hip abd (81% MVIC), Single limb squat: 64%

            - Glut max: Single limb squat and Single limb deadlift (both 59%)

 

J Orthop Sports Phys Ther. 2013 Feb;43(2):54-64. doi: 10.2519/jospt.2013.4116. Epub 2012 Nov 16.

Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes.

Selkowitz DM1, Beneck GJPowers CM.

- Best exercises for activating glut max – bilateral bridging, clam, quadruped hip ext with knee extended, quadruped hip extension with knee flexed, side step, squat, and unilateral bridges

All of these exercises produces 50% higher normalized EMG amplitudes for both gluteal muscles compared to TFL

Clamshells with band– highest glut max normalized EMG amplitude; unilateral bridges – second highest normalized EMG amplitude

Hip abduction in sidelying and hip hike – highest glut med normalized EMG amplitude compared to TFL and glut max

 

J Orthop Sports Phys Ther. 2012 Jan;42(1):22-9. doi: 10.2519/jospt.2012.3704. Epub 2011 Oct 25.

The effects of isolated hip abductor and external rotator muscle strengthening on pain, health status, and hip strength in females with patellofemoral pain: a randomized controlled trial.

Khayambashi K1, Mohammadkhani ZGhaznavi KLyle MAPowers CM.

- Isolated hip abductore and ER strength with PFPS. RCT

- 28 females with PFPS split into 2 groups; 1 group did hip abduction and ER strengthening 3x a week for 8 weeks;

measured pain, womac, strength,

- performed standing abduction and seated Er both with resistance. Starting 3 sets of 20, increasing reps and resistance from TB.. Pain and health status both sustained at 6 month follow up.

- pain, health status, and bilateral hip strength improved in the exercise group following the 8-week intervention but did not change in the control group.

- Improvements in pain and health status were sustained at 6-month follow-up in the exercise group.

 

J Orthop Sports Phys Ther. 2011 Sep;41(9):625-32. doi: 10.2519/jospt.2011.3470. Epub 2011 Jul 12.

The effect of a hip-strengthening program on mechanics during running and during a single-leg squat.

Willy RWDavis IS.

- evaluate a simple gait retraining technique, using a full-length mirror, in female runners with patellofemoral pain and abnormal hip mechanics.

- Had them just practice running in front of a mirror with verbal cues… slowly deceasing the feedback Transfer of the new motor skill to the untrained tasks of single leg squat and step descent was also evaluated.

- significant changes in only 2 weeks, (8 sessions)  with improved mechanics and decrease in pain, with feedback decreasing after 4, also recheck at 1 month and 3 months after.  Were shown their video of running to see faults- that transferred over to other tasks (SL squat) and was sustained up to 3 months later

-Subjects reduced peaks of hip adduction, contralateral pelvic drop, and hip abduction moment during running

- Skill transfer to single leg squatting and step descent was noted, and maintained through 3 months post retraining.