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Surplus Value of Hip Adduction in Leg-Press Exercise in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial

CY Song, PT, MS, is a PhD student, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
YF Lin, MD, PhD, is Orthopedic Surgeon, Department of Orthopedics, West Garden Hospital, Taipei, Taiwan.
TC Wei, PT, MS, is Physical Therapist, Yeong-An Clinic, Taipei, Taiwan.
DH Lin, MD, is Orthopedic Surgeon, Department of Orthopedics, En Chu Kong Hospital, Taipei, Taiwan.
TY Yen, PT, MS, is Physical Therapist, Yeong-An Clinic.
MH Jan, PT, MS, is Associate Professor, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F, No. 17, Xuzhou Rd, Zhongzheng District, Taipei 100, Taiwan, Republic of China.

Address all correspondence to Ms Jan at: mhjan{at}ntu.edu.tw

Background: A common treatment for patients with patellofemoral pain syndrome (PFPS) is strength (force-generating capacity) training of the vastus medialis oblique muscle (VMO). Hip adduction in conjunction with knee extension is commonly used in clinical practice; however, evidence supporting the efficacy of this exercise is lacking.

Objective: The objective of this study was to determine the surplus effect of hip adduction on the VMO.

Design: This study was a randomized controlled trial.

Setting: The study was conducted in a kinesiology laboratory.

Participants: Eighty-nine patients with PFPS participated.

Intervention: Participants were randomly assigned to 1 of 3 groups: hip adduction combined with leg-press exercise (LPHA group), leg-press exercise only (LP group), or no exercise (control group). Training consisted of 3 weekly sessions for 8 weeks.

Measurements: Ratings of worst pain as measured with a 100-mm visual analog scale (VAS-W), Lysholm scale scores, and measurements of VMO morphology (including cross-sectional area [CSA] and volume) were obtained before and after the intervention.

Results: Significant improvements in VAS-W ratings, Lysholm scale scores, and VMO CSA and volume were observed after the intervention in both exercise groups, but not in the control group. Significantly greater improvements for VAS-W ratings, Lysholm scale scores, and VMO volume were apparent in the LP group compared with the control group. There were no differences between the LP and LPHA groups for any measures.

Limitations: Only the VMO was examined by ultrasonography. The resistance level for hip adduction and the length of intervention period may have been inadequate to induce a training effect.

Conclusions: Similar changes in pain reduction, functional improvement, and VMO hypertrophy were observed in both exercise groups. Incorporating hip adduction with leg-press exercise had no impact on outcome in patients with PFPS.

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