Saturday, March 7, 2009

Hip joint muscle strength In PFPS

Proximal joint stability leads to controlled execution of distal joint motions & functions. Hence decreased hip strength may be associated with poor control of lower extremity motion during weight-bearing activities, leading to abnormal Patellofemoral motions and pain.

Studies exploring the presence of hip strength impairments in subjects with PFPS have reported conflicting results.

In a cross-sectional (female only study) Robinson RL et al investigated whether females seeking physical therapy treatment for unilateral patellofemoral pain syndrome (PFPS) exhibit deficiencies in hip strength compared to a control group.

Sample & method:

1. 20 aged 12 to 35 years, participated in the study. Ten subjects with unilateral PFPS were compared to 10 control subjects with no known knee pathologies.
2. Hip abduction, extension, and external rotation strength were tested using a handheld dynamometer.
3. A limb symmetry index (LSI) was used to quantify physical performance for all tests.

Result & conclusion:
1. The symptomatic limbs of subjects with PFPS exhibited impairments in hip strength for all variables tested.
2. LSI values in subjects with PFPS (range, 71%-79%) were significantly lower than those in control subjects (range, 93%-101%) (P< or =".007)." p =" .007)," p=" .004)" style="font-weight: bold;">Females aged 12 to 35 presenting with unilateral PFPS demonstrate significant impairments in hip strength compared to control subjects.

My suggestion for Clinicians:

Folks in case of a PFJ dysfunction (I am generalizing, please check)

1. Check the Lumbar spine (manipulate for a asymmetric movement assuring for a symmetrical Lumbo-pelvic mechanism)- see the Blogs down in this context
2. Strength training of hip musculature.

Reference:

J Orthop Sports Phys Ther. 2007 May;37(5):232-8.

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