Neuromuscular training and muscle strengthening in patients with patellofemoral pain syndrome: a protocol of randomized controlled trial

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition, particularly among women. Patients with PFPS usually experience weakness in the gluteal muscles, as well as pain and impaired motor control during activities of daily living. Strengthening the hip muscles is an effective way of treating this disorder. Neuromuscular training has also been identified as a therapeutic tool, although the benefits of this intervention in patients with PFPS patients remain inconclusive.Design: This is a protocol of randomized controlled trial with a blind assessor. Thirty-four women with a clinical diagnosis of PFPS participated. These participants were allocated into two groups (experimental and control). the experimental group performed twelve sessions to strengthen the knee extensors, hip abductor and lateral rotator muscles in association with neuromuscular training of the trunk and lower extremities. the control group performed the same number of sessions to strengthen the muscles of the hip and knee. the primary outcome was functional capacity (Anterior Knee Pain Scale - AKPS) at 4 weeks. Pain intensity, muscle strength and kinematic changes were also measured during the step down test after four weeks of intervention. Follow up assessments were conducted after three and six months to assess functional capacity and pain. the effects of the treatment (i.e. between-group differences) were calculated using mixed linear models.Discussion: the present study was initiated on the 1st of April 2013 and is currently in progress. the results of this study may introduce another effective technique of conservative treatment and could guide physical therapists in the clinical decision-making process for women with PFPS.Univ Nove Julho, Dept Rehabil Sci, Human Mot Anal Lab, São Paulo, BrazilUniversidade Federal de São Paulo, BR-11060000 São Paulo, BrazilIrmandade Santa Casa Misericordia, São Paulo, BrazilUniv Cidade São Paulo, Masters & Doctoral Programs Phys Therapy, São Paulo, BrazilGeorge Inst Global Hlth, Musculoskeletal Div, Sydney, NSW, AustraliaUniversidade Federal de São Paulo, BR-11060000 São Paulo, BrazilWeb of Scienc

Índice de incapacitação das lombalgias em motoristas de caminhão

Introdução: As lombalgias são causas de morbidade e incapacidade na realização de atividades de vida diária. Motoristas de caminhão apresentam risco aumentado de desenvolvimento da lombalgia em razão das demandas mecânico-posturais características da profissão. Objetivo: Investigar o nível de interferência das lombalgias nas atividades de vida diária de motoristas de caminhão. Métodos: Foi realizado um estudo transversal, no qual foram entrevistados 30 motoristas de caminhão, do sexo masculino, com idade entre 25 e 35 anos e com mais de cinco anos de experiência na profissão. Apenas os indivíduos que referiram dor lombar crônica, persistente há mais de três meses, foram instruídos a responder o questionário sobre o índice de incapacitação de Oswestry para dor lombar, com intuito de classificar os níveis de interferência das lombalgias nas atividades de vida diária. Resultados: Vinte e nove motoristas de caminhão atenderam aos critérios de inclusão do estudo (média de idade 31,83±3,63 anos, tempo de experiência 8,93±2,4 anos e média de 13,66±2,47 horas diárias de trabalho). Vinte e dois motoristas (75,86%) apresentavam incapacidade mínima (score 8,45±6,58) e sete (24,14%), incapacidade moderada (score 27,14±6,3). Conclusão: Apenas 24,14% da amostra estudada apresentou incapacidade moderada, interferindo assim na realização de atividades de vida diária, tais como: problemas ao sentar, levantar peso e ficar de pé

Time course of the ground reaction force during the propulsion phase of the single leg hop test (SLHT).

<p>Fz(t) – normalized vertical ground reaction force; IPP – initial propulsion phase; EPP – end propulsion phase; TP – duration of the propulsion phase; PKFa – Peak Knee Flexion Angle; G – gravitational force acting on the human body (G = m.g, where m is the mass of the subject and g is the gravitational acceleration).</p

Subject instrumentation.

<p>1. Electromyography (EMG) – electrode placement and subjects performed a maximum voluntary isometric contraction (MVIC); 2. Kinematic – marker placement; 3. Kinetic; 4. Motion capture during SLTHT – EMG, Kinematic and Kinetic data were captured simultaneously; 5. The propulsion phase was analysed.</p

Surface electromyography during a maximum voluntary isometric contraction (MVIC).

<p>Positioning of the subjects performing a MVIC for the gluteus maximus (A), biceps femoris (B), gluteus medius (C) and vastus lateralis (D), against a fixed resistance.</p

Comparison of kinematic data, peak joint angles (°), kinetic data, internal joint moments (Nm/Kg) and EMG data, eccentric phase muscle activation (% MVIC) between patellofemoral pain group and control group during propulsion phase for SLTHT.

<p>Data expressed as mean (standard deviation).</p><p>*Negative value: ipsilateral trunk lean. Abbreviations: SLTHT =  single-leg triple-hop test.</p