Dataset Information

Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial.

ABSTRACT:

Background

Strong evidence supports the proximal combined with quadriceps strengthening for patellofemoral pain (PFP) rehabilitation. However, most reported rehabilitation programs do not follow specific exercise prescription recommendations or do not provide adequate details for replication in clinical practice. Furthermore, people with PFP have power deficits in hip and knee muscles and it remains unknown whether the addition of power exercises would result in superior or more consistent outcomes. Therefore, this study is designed to verify whether the benefits of a rehabilitation program addressing proximal and knee muscles comprising power and strength exercises are greater than those of a program consisting of strength exercises only.

Method

This study will be a randomized controlled trial that will be conducted at university facilities. A minimum of 74 people with PFP between the ages of 18 and 45 years will be included. The experimental group will engage in a 12-week resistance training program focusing on proximal and knee muscles using power and strength exercises. The control group will engage in a 12-week resistance training program focusing on proximal and knee muscles using strength exercises only. Primary outcomes will be pain intensity and physical function; and secondary outcomes will be kinesiophobia, self-reported improvement, quality of life, peak hip and knee torque, and hip and knee rate of force development. The primary outcomes will be evaluated at baseline, and after 6 weeks, 12 weeks, 3 months, 6 months, and 1 year. The secondary outcomes will be evaluated at baseline and immediately after the interventions. Therapists and participants will not be blinded to group allocation.

Discussion

This randomized clinical trial will investigate if adding power exercises to a progressive resistance training may lead to more consistent outcomes for PFP rehabilitation. The study will provide additional knowledge to support rehabilitation programs for people with PFP.

Trial registration

ClinicalTrials.gov NCT03985254. Registered on 26 August 2019.

SUBMITTER: de Vasconcelos GS

PROVIDER: S-EPMC8572497 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial.

de Vasconcelos Gabriela Souza GS Nunes Guilherme Silva GS Barton Christian John CJ Munhoz Raquel Fantinelli RF da Silva Maria Eduarda Chinotti Batista MECB Pisani Giulia Keppe GK Luz Bruna Calazans BC Serrão Fábio Viadanna FV

Trials 20211106 1

<h4>Background</h4>Strong evidence supports the proximal combined with quadriceps strengthening for patellofemoral pain (PFP) rehabilitation. However, most reported rehabilitation programs do not follow specific exercise prescription recommendations or do not provide adequate details for replication in clinical practice. Furthermore, people with PFP have power deficits in hip and knee muscles and it remains unknown whether the addition of power exercises would result in superior or more consiste ...[more]

PMID: 34742328

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Project description:BackgroundHip and knee strengthening exercises are implemented in rehabilitation of patellofemoral pain patients, but typically use high loads (70% of 1 repetition maximum). This may lead to increased patellofemoral joint stress. Low load training (20-30% of 1 repetition maximum) with blood flow restriction could allow for exercise strength benefits to proximal and distal muscles with reduced joint stress and by promoting hypoalgesia.AimThe aim of this study was to compare hip and knee focused exercises with and without blood flow restriction in adults with patellofemoral pain for short term effectiveness.DesignA randomized observed-blind controlled trial.SettingMusculoskeletal laboratories of the European University Cyprus, Nicosia, Cyprus.Population60 volunteer patients, 18-40 years of age with patellofemoral pain.MethodsParticipants were randomly assigned to (1 reference group) hip and knee strengthening at (70% of 1 repetition maximum) or (2 experimental group) Strengthening with blood flow restriction at (30% of 1 repetition maximum at 70% of limb occlution pressure). Treatments took place 3 times per week for 4weeks and outcomes were assessed at baseline, end of treatment and at 2-month follow-up. The primary outcome was the Kujala Anterior Knee Pain Scale and secondary outcomes were worst and usual pain, pain with Single leg Squats, the maximum pain free flexion angle, the Tampa Scale of kinesiophobia, the Pain Catastrophizing Scale and isometric strength of knee extensors, hip extensors and hip abductors.ResultsNo difference were found for the main outcome of this study between groups. There was a significant effect of time for all outcome measures in both groups. Between group differences showed a significant difference for isometric strength of Knee extensor values at 2 month follow-up F(1,58)=5.56, P=0.02, partial η2=0.09, 459.4 (412.13, 506.64) vs. 380.68 (333.42, 427.93) and in worst pain post-treatment F(1,58)=5.27, P=0.02, partial η2=0.08, 0.76 (0.48, 1.04) vs. reference group 1.30 (0.91, 1.68) with significantly better scores in the blood flow restriction group.ConclusionsBlood flow restriction exercises of the hip and knee musculature used in this study were as effective as usual exercises of Hip and knee musculature in reducing symptoms in the short term. They also indicated greater increases in strength and reduction of worst pain post-treatment.Clinical rehabilitation impactFurther research is needed to investigate the dose response relationship with longer follow-ups.

Project description:BackgroundPersistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction.ObjectiveThe purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function.DesignAn assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted.SettingThe study will be conducted in a community setting.ParticipantsThe participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA.InterventionParticipants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention.MeasurementsOutcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks.LimitationsA self-reported diagnosis of persistent hip pain will be used.ConclusionsThe findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision.

Project description:BACKGROUND:In the early phase after a total knee arthroplasty (TKA), patients experience multi-level weakness in the operated leg, which is caused primarily by reduced central nervous system (CNS) activation failure of the muscles - especially the knee extensors (quadriceps muscle). Whether similar levels of neuromuscular activity of the muscles in the operated leg, elicited during strength training exercises in machines, can be reached during strength training exercises in more simple forms is unknown. Many clinicians are faced with the problem of not having strength training equipment at their institution or having to prescribe simple strength training exercises for home-based training. Therefore, the purpose of this study was to determine which strength training exercises that activated the muscles in the operated leg the most after TKA. The hypothesis was that strength training exercises performed in machines would elicit higher levels of voluntary peak quadriceps and hamstring muscle activity than strength training exercises performed in more simple forms, using elastic bands or the patients' own body weight. METHODS:A cross-sectional electromyographic study investigated voluntary peak muscle activity in the operated leg during 6 different strength training exercises. Twenty-four patients, who received a TKA 4 to 8 weeks earlier, performed the exercises in a randomized order, using a pre-determined loading of 10 RM (repetition maximum). Voluntary peak muscle activity (%EMGmax) was calculated for the quadriceps and hamstring muscles for each exercise. RESULTS:Knee extensions with elastic band showed significantly higher voluntary peak quadriceps muscle activity than knee extensions in machine (93.3 vs. 74.9; mean difference, 18.3 %EMGmax [95% confidence interval (CI), 11.7 to 24.9]; P < 0.0001). Similarly, one-legged squat (and sit to stand) elicited higher voluntary peak quadriceps muscle activity than leg press in machine (86.7 vs. 66.8; mean difference, 19.9 %EMGmax [95% CI, 14.8 to 25.0]; P < 0.0001). CONCLUSIONS:Strength training exercises in more simple forms elicited higher voluntary peak quadriceps muscle activity than strength training exercises in machines early after TKA. Consequently, simple home-based strength training exercises using e.g. elastic bands or the patients' own bodyweight should be considered to alleviate muscle strength losses early after TKA. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT01708980 .

Dataset Information

Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial.

Background

Method

Discussion

Trial registration

Publications

Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial.

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