KNEE VALGUS ANGLE AND HIP STRENGTH IN FEMALES WITH AND WITHOUT PATELLOFEMORAL PAIN SYNDROME DURING TWO FUNCTIONAL TESTS

E.K. Ganatsiou^1,2, N. Kitsouli^1,2, E. Lagouvardou^1,2, K. Vassis^1,2, M. Ntoulias², I. Poulis^1,2

¹School of Health Sciences, University of Thessaly, Faculty of Physiotherapy, Lamia, Greece, ²Human Performance and Rehabilitation Laboratory, Faculty of Physiotherapy, Lamia, Greece

Background: In recent years, there has been an increase of interest in the role of hip muscle function in the development and management of Patellofemoral Pain Syndrome (PFPS). The weakening of these muscles is believed to promote valgus knee moments or result in a gluteus medius gait. These deviations could increase the Q-angle, which would change the patella's tracking, put more pressure on the patellofemoral joint, and finally result in knee pain. Therefore, muscular weakness around the hip may be a significant aspect to take into account in the conservative management of PFPS.

Purpose: The purpose of the study was to compare hip eccentric strength measured in an isokinetic dynamometer and hip kinematics (as defined by the 2D frontal plane projection angle) in Single-Leg Squat (SLS) and Single-Leg Landing (SLL) functional tests in female subjects with PFPS to matched controls.

Methods: 17 asymptomatic individuals and 19 PFPS patients participated in the study. Isokinetic unilateral concentric and eccentric hip abductor mean peak moment (MPM) was assessed isokinetically at 60°/s. Functional performance was assessed using SLS and SLL tests. The Dynamic Knee Valgus (DKV) was performed at the maximum tibiofemoral angle of the frontal plane through the SLS and SLL performances using the Kinovea application.

Results: No differences were found between groups in DKV in both SLL and SLS functional tests and between groups in isokinetic values of concentric abduction MPM at 60°/s (p = .802) and eccentric abduction MPM at 60°/s (p =.769).

Conclusions: Our results indicate that early PFPS does not appear to be significantly associated with hip abduction strength asymmetry. PFPS seems to be multifactorial in its etiology therefore, further studies to understand the interaction between these impairments and to determine if subgroups of patients with PFPS exist are also warranted.

Implications: Contrary to the main body of research our study may not suggest that hip strengthening focusing on eccentric or concentric action should be incorporated into the rehabilitation programs for females with PFPS. Clinicians should consider different solutions like incorporating neuromuscular training exercises to reduce DKV.

Funding acknowledgements: This research received no external funding.

Keywords:
Anterior knee pain
Hip abductors
Dynamic knee valgus

Topics:
Musculoskeletal
Musculoskeletal: lower limb
Sport & sports injuries

Did this work require ethics approval? Yes

Institution: School of Health Sciences, University of Thessaly

Committee: Research Ethics Committee of Department of Physiotherapy

Ethics number: 75/20-04-2022