title: Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up.
abstract: METHODS
  Randomized controlled trial.
  
  
  OBJECTIVE
  To determine if adding hip-strengthening exercises to a conventional knee exercise program produces better long-term outcomes than conventional knee exercises alone in women with patellofemoral pain syndrome (PFPS).
  
  
  BACKGROUND
  Recent studies have shown that a hip-strengthening program reduces pain and improves function in individuals with PFPS. However, there are no clinical trials evaluating long-term outcomes of this type of program compared to conventional knee-strengthening and -stretching exercises.
  
  
  METHODS
  Fifty-four sedentary women between 20 and 40 years of age, with a diagnosis of unilateral PFPS, were randomly assigned knee exercise (KE) or knee and hip exercise (KHE). The women in the KE group (n = 26; mean age, 23 years) performed a 4-week conventional knee-stretching and -strengthening program. The women in the KHE group (n = 28; mean age, 22 years) performed the same exercises as those in the KE group, as well as strengthening exercises for the hip abductors, lateral rotators, and extensors. An 11-point numeric pain rating scale, the Lower Extremity Functional Scale, the Anterior Knee Pain Scale, and a single-hop test were used as outcome measures at baseline (pretreatment) and 3, 6, and 12 months posttreatment.
  
  
  RESULTS
  At baseline, demographic, pain, and functional assessment data were similar between groups. Those in the KHE group had a higher level of function and less pain at 3, 6, and 12 months compared to baseline (P<.05). In contrast, the KE group had reduced pain only at the 3- and 6-month follow-ups (P<.05), without any changes in Lower Extremity Functional Scale, Anterior Knee Pain Scale, or hop testing (P>.05) through the course of the study. Compared to the KE group, the KHE group had less pain and better function at 3, 6, and 12 months posttreatment (P<.05). For the Lower Extremity Functional Scale, the between-group difference in change scores from baseline at 3, 6, and 12 months posttreatment favored the KHE group by 22.0, 22.0, and 20.8 points, respectively.
  
  
  CONCLUSIONS
  Knee-stretching and -strengthening exercises supplemented by hip posterolateral musculature-strengthening exercises were more effective than knee exercises alone in improving long-term function and reducing pain in sedentary women with PFPS.
authors.affiliation: Department of Physical Therapy, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), Centro Universitário SãoCamilo (CUSC), São Paulo-SP, Brazil. tfukuda10@yahoo.com.br
authors.forename: Thiago Yukio
authors.initials: TY
authors.lastname: Fukuda
authors.forename: William Pagotti
authors.initials: WP
authors.lastname: Melo
authors.forename: Bruno Marcos
authors.initials: BM
authors.lastname: Zaffalon
authors.forename: Flavio Marcondes
authors.initials: FM
authors.lastname: Rossetto
authors.forename: Eduardo
authors.initials: E
authors.lastname: Magalhães
authors.forename: Flavio Fernandes
authors.initials: FF
authors.lastname: Bryk
authors.forename: Robroy L
authors.initials: RL
authors.lastname: Martin
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006615:Hip / Q000503:physiopathology*; D006801:Humans; D007717:Knee / Q000503:physiopathology; D053580:Muscle Strength / Q000502:physiology*; D052580:Muscle Stretching Exercises / Q000379:methods; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010147:Pain Measurement; D046788:Patellofemoral Pain Syndrome / Q000534:rehabilitation*; D011446:Prospective Studies; D055070:Resistance Training / Q000379:methods*; D057185:Sedentary Behavior; D055815:Young Adult