Effectiveness of knee exercises versus combined knee and hip exercises in treatment of patellofemoral pain: A randomized clinical trial

Abstract

Introduction: Previous studies suggest that hip muscle weakness may contribute to patellofemoral pain (PFP). Accordingly, addition of hip strengthening exercises to conventional knee exercises was recommended for treatment of PFP. However, evidence to support superior efficacy of additional hip exercises in treatment of PFP is limited. This study compared the clinical efficacy of knee exercises versus combined knee and hip exercises in females with PFP. Materials and Methods: In this randomized clinical trial 60 females with PFP were randomly assigned into two groups: “the knee exercises” and “the knee and hip exercises”. Participants performed progressive therapeutic exercises 3 times a week for 4 weeks. Pain, muscle strength (the knee extensors, the hip abductors and the hip external rotators) and physical function were evaluated before and after treatment interventions using Visual Analogue Scale (VAS), a dynamometer, and step-down test, respectively. Results: Both groups showed significant improvements in pain, function, and the knee extensor, hip abductor and hip external rotator muscles strength after the interventions (P0.05). Conclusion: Four weeks of either knee exercises or combined knee and hip exercises significantly improve function and reduce pain in women with PFP. Addition of hip strengthening exercises to conventional knee exercises was not associated with superior treatment outcomes.