EFFECT OF A CLOSED KINETIC CHAIN EXERCISE PROTOCOL ON PATELLOFEMORAL SYNDROME REHABILITATION

The purpose of this study was to verify the efficacy of quadriceps femoris muscle strengthening exercises in a closed kinetic chain (CKC) in the treatment of patellofemoral syndrome (PFS). The following elements were evaluated: pain, knee functional injury level, Q angle and electromyographic activity of the vastus medialis and vastus lateralis muscles during isometric contractions. The 10 PFS patients performed quadriceps femoris strengthening exercises using a leg-press with progressive increase in resistance during eight weeks, twice a week. The data collected were analyzed by the Wilcoxon test (&#945

Physical therapy in patellofemoral syndrome patients: comparison of open and closed kinetic chain exercises

Este estudo teve como objetivo comparar a eficácia do fortalecimento muscular na recuperação funcional da síndrome fêmoro-patelar (SFP). Foram selecionadas 20 mulheres com SFP divididas em dois grupos: o Grupo 1 (G1) realizou fortalecimento do músculo quadríceps femoral em cadeia cinética aberta (CCA) e o Grupo 2 (G2) em cadeia cinética fechada (CCF), durante oito semanas com freqüência de duas vezes semanais. Foi avaliada a dor, capacidade funcional, flexibilidade, encurtamento dos músculos isquiotibiais, ângulo Q e eletromiografia (EMG) dos músculos vasto medial (VM) e vasto lateral (VL) durante extensão isométrica da perna. Antes e após o tratamento, as variáveis foram analisadas pelo teste de Wilcoxon, e entre os grupos pelo teste t para amostras independentes ou Anova de Friedman ou Manova (a<0,05). Após o tratamento, os resultados mostram que houve melhora da capacidade funcional, encurtamento dos músculos isquiotibiais e flexibilidade. Porém, somente o G1 apresentou diminuição da intensidade da dor e aumento da atividade EMG do músculo VL, enquanto ambos não modificaram o ângulo Q. Os dados sugerem que os tratamentos baseados no fortalecimento do músculo quadríceps femoral possibilitaram melhoras importantes nos principais sinais e sintomas apresentados pelas pacientes, não havendo diferenças evidentes entre os realizados em CCA e CCF.The aim of this study was to compare the efficacy of muscular strengthening in the functional recovery of patellofemoral syndrome (PFS) patients. Twenty female patients with PFS were divided into two groups: Group 1 (G1) performing quadriceps femoris strengthening exercises in open kinetic chain (OKC) and Group 2 (G2) in closed kinetic chain (CKC), twice a week for eight weeks. Pain, functional capacity, flexibility, hamstring tightness, Q angle and electromyography (EMG) were measured for vastus medialis (VM) and vastus lateralis (VL) muscles during isometric leg extension. The data obtained before and after treatment were analyzed by Wilcoxon test, and the data between groups by t-test for independent samples or Friedman Anova or Manova (á<0.05). After treatment, the results showed a significant improvement in terms of functional capacity, hamstring tightness and flexibility. However, only G1 showed decreased pain and improved EMG activity of VL muscle, while both groups showed unchanged Q angles. These data suggest that treatments based on exercises for quadriceps femoris strengthening produced improvements on a number of PFS signals and symptoms, with no evidences of differences between OKC and CKC exercises