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Can we replace exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in women with patellofemoral pain? A randomized controlled trial [with consumer summary]
Pompeo KD, da Rocha ES, Melo MA, de Oliveira NT, Oliveira DF, Sonda FC, dos Santos PF, Rodrigues R, Baroni BM, Vaz MA
Physical Therapy in Sport 2022 Nov;58:1-7
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To verify the effects of replacing exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in a rehabilitation program for patellofemoral pain (PFP). Design: Randomized Controlled Trial. Participants: Fifty women with PFP. METHODS: PFP participants were randomized into the standard rehabilitation group (SRG, n = 25) or distal exercise group (DEG, n = 25). Knee pain, patient-reported function, dynamic knee valgus and muscle strength were measured at baseline and after six and twelve weeks of the program start. RESULTS: SRG and DEG presented similar responses to rehabilitation (except for muscle strengthening). Knee pain reduced after 6 weeks (SRG: -37.7%, ES = 1.23; DEG: -30%, ES = 0.93) and 12 weeks (SRG: -47.4%, ES = 1.53; DEG: -43.3%, ES = 1.46). Patient-reported function improved after 6 weeks (SRG: +7.3%, ES = 0.45; DEG: +3.8%, ES = 0.22) and 12 weeks (SRG: +14.1%, ES = 0.80; DEG: +8.8%, ES = 0.50). Dynamic knee valgus reduced after 12 weeks (SRG: -29.7%, ES = 0.38; DEG: -34.5%, ES = 0.32). Both groups experienced increases in knee extension strength (SRG: +9%, ES = 0.28; DEG: +6%, ES = -0.29), but only SRG had strength gains for hip abduction (+10%, ES = 0.36) and extension (+11%, ES = 0.44). CONCLUSION: Exercises targeted on core/hip muscles can be replaced by exercises targeted on leg/foot muscles in a lower limb exercise-based rehabilitation program for women with PFP. CLINICAL TRIAL REGISTRATION: NCT03663595.

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