Correlation of lower limb muscles strength and flexibility with pain and function in females with Patellofemoral Pain

authors:

avatar Atefe Omidi , avatar Fateme Esfandiarpour , * , avatar Afshin Rezazade , avatar Shahla Zahednejad


how to cite: Omidi A, Esfandiarpour F, Rezazade A, Zahednejad S. Correlation of lower limb muscles strength and flexibility with pain and function in females with Patellofemoral Pain. koomesh. 2017;19(3):e152900. 

Abstract

Introduction: Reduced strength and flexibility of lower limb muscles have been proposed as contributing factors to Patellofemoral Pain (PFP). However, relationship of muscle strength and flexibility with pain and function in people with PFP is not well recognized, yet. The purpose of this study was to investigate the correlation of lower limb muscles strength and flexibility with pain and function in females with PFP. Materials and Methods: In this cross-sectional study 35 females with PFP and 35 matched healthy females participated. Muscle strength, muscle flexibility, and pain were assessed using a dynamometer, an inclinometer, and visual analog scale, respectively. In this account,Kujalla questionnaire and step-down test were used to determine the function. The data were analyzed using an independent t -test, Pearson correlation test and stepwise regression. Results: There were significantly lower strength of the knee extensors, the knee flexors, the hip abductors and lateral rotators in the PFP group as compared to the healthy group (P

References

  • 1.

    Brody LT, Thein JM. Nonoperative treatment for patellofemoral pain. J Orthop Sports Phys Ther 1998; 28: 336-344.

  • 2.

    Piva SR, Fitzgerald GK, Irrgang JJ, Fritz JM, Wisniewski S, McGinty GT, et al. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil 2009; 90: 285-295.

  • 3.

    Thome R. A comprehensive treatment approach for patellofemoral pain syndrome in young women. Phys Ther 1997; 77: 1690-1703.

  • 4.

    Thome R, Augustsson J, Karlsson J. Patellofemoral pain syndrome. Sports Med 1999; 28: 245-262.

  • 5.

    Powers CM, Bolgla LA, Callaghan MJ, Collins N, Sheehan FT. Patellofemoral pain: proximal, distal, and local factors2nd iternational research retreat, august 31september 2, 2011, Ghent, Belgium. J Orthop Sports Phys Ther 2012; 42.

  • 6.

    Piva SR, Goodnite EA, Childs JD. Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2005; 35: 793-801.

  • 7.

    Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic risk factors for the development of anterior knee pain in an athletic oopulation A two-year prospective study. Am J Sports Med 2000; 28: 480-489.

  • 8.

    Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther 2003; 33: 671-676.

  • 9.

    Bolgla LA, Malone TR, Umberger BR, Uhl TL. Hip strength and hip and knee kinematics during stair descent in females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2008; 38: 12-18.

  • 10.

    Powers CM, Perry J, Hsu A, Hislop HJ. Are patellofemoral pain and quadriceps femoris muscle torque associated with locomotor function? Phys Ther 1997; 77: 1063-1075.

  • 11.

    Kwon O, Yun M, Lee W. Correlation between intrinsic patellofemoral pain syndrome in young adults and lower extremity biomechanics. J Phys Ther Sci 2014; 26: 961-964.

  • 12.

    Messier SP, Davis SE, Curl WW, Lowery RB, Pack RJ. Etiologic factors associated with patellofemoral pain in runners. Med Sci Sports Exerc 1991; 23: 1008-1015.

  • 13.

    Rathleff CR, Baird WN, Olesen JL, Roos EM, Rasmussen S, Rathleff MS. Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain - A cross-sectional population-based study. PLoS One 2013; 8: e79153.

  • 14.

    Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome the joint undertaking to monitor and prevent ACL injury (JUMP-ACL) cohort. Am J Sports Med 2009; 37: 2108-2116.

  • 15.

    Almeida GPL, Carvalho e Silva APdMC, Frana FJR, Magalhes MO, Burke TN, Marques AP. Does anterior knee pain severity and function relate to the frontal plane projection angle and trunk and hip strength in women with patellofemoral pain? J Bodyw Mov Ther 2015; 19: 558-564.

  • 16.

    Long-Rossi F, Salsich GB. Pain and hip lateral rotator muscle strength contribute to functional status in females with patellofemoral pain. Physiother Res Int 2010; 15: 57-64.

  • 17.

    Nakagawa TH, Baldon RdM, Muniz TB, Serro FV. Relationship among eccentric hip and knee torques, symptom severity and functional capacity in females with patellofemoral pain syndrome. Phys There Sport 2011; 12: 133-139.

  • 18.

    Juhakoski R, Tenhonen S, Anttonen T, Kauppinen T, Arokoski JP. Factors affecting self-reported pain and physical function in patients with hip osteoarthritis. Arch Phys Med Rehabil 2008; 89: 1066-1073.

  • 19.

    Etemadi M, Asadi Z, Hedayati R, Salavati M, Aminian far A. Effects of the surface instability degrees on dynamic postural stability in anterior knee pain patients and healthy subjects. Koomesh 2013; 15: 67-77.

  • 20.

    Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil 2004; 85: 815-822.

  • 21.

    Chesworth BM, Culham EG, Tata GE, Peat M. Validation of outcome measures in patients with patellofemoral syndrome 1. J Orthop Sports Phys Ther 1989; 10: 302-308.

  • 22.

    Negahban H, Pouretezad M, Yazdi MJ, Sohani SM, Mazaheri M, Salavati M, et al. Persian translation and validation of the Kujala Patellofemoral Scale in patients with patellofemoral pain syndrome. Disabil Rehabil 2012; 34: 2259-2263.

  • 23.

    Loudon JK, Wiesner D, Goist-Foley HL, Asjes C, Loudon KL. Intrarater reliability of functional performance tests for subjects with patellofemoral pain syndrome. J Athl Train 2002; 37: 256-261.

  • 24.

    Gagnon D, Nadeau S, Gravel D, Robert J, Blanger D, Hilsenrath M. Reliability and validity of static knee strength measurements obtained with a chair-fixed dynamometer in subjects with hip or knee arthroplasty. Arch Phys Med Rehabil 2005; 86: 1998-2008.

  • 25.

    Bolgla LA, Malone TR, Umberger BR, Uhl TL. Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. Int J Sports Phys Ther 2011; 6: 285.

  • 26.

    Piva SR, Fitzgerald K, Irrgang JJ, Jones S, Hando BR, Browder DA, Childs JD. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC Musculoskelet Disord 2006; 7: 33.

  • 27.

    Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry: FA Davis; 2009, 211.

  • 28.

    Weber JC, Lamb DR. Statistics and research in physical education: Mosby Distributed by Kimpton; 1970.

  • 29.

    Duffey MJ, Martin DF, Cannon DW, Craven T, Messier SP. Etiologic factors associated with anterior knee pain in distance runners. Med Sci Sports Exerc 2000; 32: 1825-1832.

  • 30.

    Bokaee F, Nasseri N, Mazaheri H, Fakhari Z, Jalaee S. Strengths of lower extremity and lower trunk muscles in females with patellofemoral pain syndrome. Koomesh 2010; 12: 22-30.

  • 31.

    Agre J, Magness J, Hull S, Wright K, Baxter T, Patterson R, Stradel L. Strength testing with a portable dynamometer: reliability for upper and lower extremities. Arch Phys Med Rehabil 1987; 68: 454-458.

  • 32.

    Wikholm JB, Bohannon RW. Hand-held dynamometer measurements: tester strength makes a difference. J Orthop Sports Phys Ther 1991; 13: 191-198.

  • 33.

    Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med 2013; 47: 193-206.

  • 34.

    Pappas E, Wong-Tom WM. Prospective predictors of patellofemoral pain syndrome a systematic review with meta-analysis. Sports Health 2012; 4: 115-120.

  • 35.

    Smith AD, Stroud L, McQueen C. Flexibility and anterior knee pain in adolescent elite figure skaters. J Pediatr Orthop 1991; 11: 77-82.

  • 36.

    Hudson Z, Darthuy E. Iliotibial band tightness and patellofemoral pain syndrome: A case-control study. Manual Ther 2009; 14: 147-151.

  • 37.

    Jensen R, Hystad T, Baerheim A. Knee function and pain related to psychological variables in patients with long-term patellofemoral pain syndrome. J Orthop Sports Phys Ther 2005; 35: 594-600.##.