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Altered hip and trunk muscle function in individuals with patellofemoral pain
  1. Sallie M Cowan (s.cowan{at}unimelb.edu.au)
  1. Rehabilitation Sciences Research Centre, The School of Physiotherapy, The University of Melbourne, Australia
    1. Kay M Crossley (k.crossley{at}unimelb.edu.au)
    1. Department of Mechanical Engineering and The School of Physiotherapy, University of Melbourne, Australia
      1. Kim L Bennell (k.bennell{at}unimelb.edu.au)
      1. Centre for Health Exercise and Sports Medicine, The School of Physiotherapy, University of Melbourne, Australia

        Abstract

        Objective: The purpose of this study was to investigate the role of hip muscles in PFP, specifically by investigating neuromotor control, strength and range of motion of the hip muscles.

        Design: cross-sectional.

        Setting: University laboratory.

        Patients: Ten participants diagnosed with PFP and 27 asymptomatic controls were recruited, using standard inclusion and exclusion criteria.

        Main outcome measures: Electromyographic activity of the vasti and anterior gluteus medius were recorded using surface electrodes and posterior gluteus medius using fine wire electrodes while the participant completed a stair stepping task. Hip strength and trunk side flexion strength was assessed using a hand held dynamometer and hip range of motion with an inclinometer. Pain and disability measures were recorded for the PFP participants.

        Results: When individuals with PFP completed the stair stepping task there was a delay in activation of both anterior and posterior gluteus medius (p<0.02) and an alteration in vasti control (p=0.001). In addition trunk side flexion strength was significantly less (29%) in individuals with PFP (p=0.03).

        Conclusion: This study provides evidence that trunk side flexion strength and neuromotor control of the gluteus medius are affected in people with PFP. This study also confirms the presence of a delayed vastus medialis obliquus relative to vastus lateralis, providing further evidence underpinning the importance of retraining the vasti function in patients with PFP.

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