title: Individuals With Patellofemoral Pain Have Less Hip Flexibility Than Controls Regardless of Treatment Outcome.
abstract: OBJECTIVE
  To examine differences in hip flexibility before and after a 6-week muscle strengthening program between those with patellofemoral pain (PFP) and healthy controls.
  
  
  METHODS
  Single-blind, multicentered, randomized controlled trial.
  
  
  METHODS
  Four clinical research laboratories.
  
  
  METHODS
  Physically active individuals (199 PFP and 38 controls).
  
  
  METHODS
  Patellofemoral pain and control subjects were randomized into either a hip-focused or a knee-focused muscle strengthening treatment program.
  
  
  METHODS
  Pain-visual analog scale (centimeter), function-Anterior Knee Pain Scale (points), flexibility-passive goniometry (degrees): hip adduction (HADD), hip external rotation (HER), hip internal rotation (HIR), total hip rotation (HROT), hip extension (HEXT) were measured before and after the muscle strengthening treatment program.
  
  
  RESULTS
  Subjects with patellofemoral pain who successfully completed the treatment program (n = 153) had 65%, 25%, 18%, and 12% less HADD, HER, HROT, and HIR ranges of motion (ROMs), respectively, than controls (P < 0.05). Patellofemoral pain subjects who did not successfully complete the program (n = 41) had 134%, 31%, 22%, and 13% less HADD, HER, HROT, and HIR ROMs, respectively, than controls (P < 0.05). All subjects increased their HIR, HROT, and HEXT ROMs pretest to posttest (P < 0.05), but by less than 2 degree.
  
  
  CONCLUSIONS
  Individuals with PFP had less hip flexibility than controls regardless of treatment outcome or time. After the 6-week muscle strengthening program, and regardless of treatment success, PFP and control subjects experienced a small but clinically insignificant improvement in hip flexibility.
  
  
  CONCLUSIONS
  Hip ROM should be considered as a targeted area of focus in a rehabilitation program for physically active individuals with PFP.
authors.affiliation: *Department of Kinesiology & Nutrition, University of Illinois at Chicago, Chicago, Illinois; †Department of Kinesiology: Integrated Health Care and Performance Unit, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; ‡Department of Physical Therapy, Georgia Regents University, Augusta, Georgia; §Faculty of Kinesiology, University of Calgary, Calgary, Canada; and ¶Faculties of Kinesiology and Nursing, University of Calgary, Calgary, Canada.
authors.forename: Karrie L
authors.initials: KL
authors.lastname: Hamstra-Wright
authors.forename: Jennifer
authors.initials: J
authors.lastname: Earl-Boehm
authors.forename: Lori
authors.initials: L
authors.lastname: Bolgla
authors.forename: Carolyn
authors.initials: C
authors.lastname: Emery
authors.forename: Reed
authors.initials: R
authors.lastname: Ferber
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000503:physiopathology*; D053587:Arthrometry, Articular; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D057071:Patellofemoral Joint / Q000293:injuries*; D055070:Resistance Training; D017211:Treatment Failure; D055815:Young Adult