title: Evaluating eccentric hip torque and trunk endurance as mediators of changes in lower limb and trunk kinematics in response to functional stabilization training in women with patellofemoral pain.
abstract: BACKGROUND
  Altered movement patterns of the trunk and lower limbs have been associated with patellofemoral pain (PFP). It has been assumed that increasing the strength of the hip and trunk muscles would improve lower limb and trunk kinematics in these patients. However, evidence in support of that assumption is limited.
  
  
  OBJECTIVE
  To determine whether increases in the strength of hip muscles and endurance of trunk muscles in response to functional stabilization training will mediate changes in frontal plane lower limb kinematics in patients with PFP.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Thirty-one female athletes were randomized to either a functional stabilization training group that emphasized strengthening of the trunk and hip muscles or a standard training group that emphasized stretching and quadriceps strengthening. Patients attended a baseline assessment session, followed by 8 weeks of intervention, and were then reassessed at the end of the intervention period. The potential mediators that were evaluated included eccentric torque of hip muscles and endurance of the trunk muscles. The outcome variables were the lower limb and trunk kinematics in the frontal plane assessed during a single-legged squat task.
  
  
  RESULTS
  The eccentric strength of the gluteus muscles showed a mediation effect ranging from 18% to 32% on changes to frontal plane kinematics (decreased ipsilateral trunk inclination, pelvis contralateral depression, and hip adduction excursions) observed in the functional stabilization training group after intervention.
  
  
  CONCLUSIONS
  Although the mediation effects were small, the results suggest that improvements in the strength of the gluteus muscles can influence the frontal plane movement patterns of the lower limb and trunk in women with PFP.
  
  
  CONCLUSIONS
  Patients with PFP might benefit from strengthening of the hip muscles to improve frontal plane lower limb and trunk kinematics during functional tasks.
authors: Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil.
authors: Rodrigo de Marche
authors: Rde M
authors: Baldon
authors: Department of Physical Therapy University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Sara Regina
authors: SR
authors: Piva
authors: Department of Physical Therapy University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Rodrigo
authors: R
authors: Scattone Silva
authors: Department of Physical Therapy University of Pittsburgh, Pittsburgh, Pennsylvania, USA fserrao@ufscar.br.
authors: Fábio Viadanna
authors: FV
authors: Serrão
mesh_terms: D056352:Athletes; D001696:Biomechanical Phenomena; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006615:Hip / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000502:physiology; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology; D046788:Patellofemoral Pain Syndrome / Q000503:physiopathology* / Q000628:therapy; D010388:Pelvis / Q000502:physiology; D019415:Torque; D060726:Torso / Q000502:physiology*
keywords: biomechanics; clinical assessment; injury prevention; knee; patella; rehabilitation