18, 19, 21, 22 and 23 It is plausible that significant improvements in pain intensity and health status after the 8-week hip strengthening intervention could have been the result of changes in hip and knee biomechanics during functional activities.31, 33, 34, 35, 36 and 37 Consistent with this hypothesis, Earl,31 Mascal,33 and colleagues have previously demonstrated changes in hip and knee biomechanics after hip strengthening programs. Previous studies have suggested that persons with PFP limit the use of the quadriceps in an attempt to decrease patellofemoral joint loading.38 and 39 This suggests that quadriceps
atrophy in this population may be the result of pain as opposed to the cause of PFP. Given that quadriceps function is important for normative patellofemoral joint mechanics, restoration of quadriceps strength would appear to be important in this PFT�� clinical trial population. However, an argument could be made that hip strengthening may address the underlying cause of abnormal patellofemoral joint loading, whereas quadriceps strengthening may be addressing the symptom of pain. Further research is necessary to test this hypothesis. Our study sample consisted
of a relatively small, homogeneous group of patients with moderate to severe impairments. This may limit the generalizability Cell Cycle inhibitor of our findings to other PFP populations. Additionally, the exercises chosen may have influenced the results obtained. For example, the use of non–weight-bearing terminal knee extension (30°–0°) has been reported to increase patellofemoral joint reaction force and stress.40 It is possible that superior results may have been obtained if patients performed this exercise at lesser knee flexion angles (ie, 90°–45°). However, all exercises were performed using a resistance that did not elicit pain. Finally, the partial squat exercise used in the quadriceps group was performed in weight-bearing. As such, it is
possible that hip strength gains occurred in this group. An 8-week program of posterolateral hip muscle Interleukin-2 receptor strengthening was more effective in improving pain and health status in persons with PFP than a quadriceps strengthening program. The observed improvements were maintained at 6-month follow-up. Our results support the use of hip strengthening as a viable rehabilitation approach for persons with PFP. a. Hygenic Corp, 1245 Home Ave, Akron, OH 44310. “
“Restoring motor function after stroke is an important factor for increasing independence in daily activities.1 and 2 A challenge in rehabilitation is identifying the main determinants of functional ability and the potential for recovery. This is of paramount importance to guide the planning of therapy goals, to manage the expectations of patients and their cargivers, and for organization of rehabilitation services.