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J Sport Rehabil. 2016 Feb;25(1):23-30. doi: 10-1123/jsr.2014-0245. Epub 2015 Mar 11.

The Effects of a Multimodal Rehabilitation Program on Symptoms and Ground-Reaction Forces in Runners With Patellofemoral Pain Syndrome.

Author information

1
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada.

Abstract

CONTEXT:

Patellofemoral pain (PFP) is one of the most frequent running-related injuries. However, few interventions taking into consideration the specificity of running have been shown to be effective in runners with PFP.

OBJECTIVE:

To evaluate the effects of a multimodal rehabilitation program including lower-limb-strengthening/ motor-control exercises, advice on running biomechanics, and symptoms management on symptoms, strength, and ground-reaction forces in runners with PFP.

DESIGN:

Pre- to post- quasi-experimental.

SETTING:

Gait-analysis laboratory and private physical therapy clinic.

PARTICIPANTS:

21 runners with PFP (34.1 ± 6.0 y old, symptoms duration 38.1 ± 45.5 mo).

INTERVENTION:

An 8-wk multimodal rehabilitation program including lower-limb- and core-strengthening and motor-control exercises, as well as advice on running gait and symptoms management.

MAIN OUTCOME MEASURES:

The Activities of Daily Living Scale of the Knee Outcome Survey (KOS-ADLS) questionnaire and visual analog scales for usual pain (VAS-U), worst pain (VAS-W), and pain during running (VAS-R) were used to assess changes in symptoms and function. Vertical ground-reaction forces (VGRF) during running and lower-limb isometric strength were also measured.

RESULTS:

Statistically and clinically significant improvements (P < .001) were reported on KOS-ADLS (+17.8 pts), VAS-U (-19.2 pts), VAS-W (-28.7 pts), and VAS-R (-32.2 pts) after the intervention. No significant changes in isometric strength were observed. The instantaneous vertical loading rate was decreased after the intervention (P = .002), and this reduction was correlated with changes in KOS-ADLS scores (P = .028).

CONCLUSION:

This multimodal intervention was successful in reducing pain and improving function of runners with PFP. However, no significant changes in lower-limb strength were observed. It appears that changes in VGRF combined with appropriate training advice could explain the clinical outcomes.

PMID:
25760965
DOI:
10-1123/jsr.2014-0245
[Indexed for MEDLINE]

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