Hip Muscle Strength and Endurance in Females with Patellofemoral Pain: A Systematic Review with Meta-analysis.

Authors: Van Cant J, Pineux C, Pitance L, Feipel V

Patellofemoral pain (PFP) is a common knee condition experienced by adolescents and young adults, seen particularly in women. Clinicians and researchers need to understand how proximal, local, or distal factors may influence the development of PFP and affect individuals once they have developed PFP. Proximal factors are the focus of recent studies and the purpose of this systematic review was to determine if females with PFP have hip muscle strength or endurance deficits when compared to their unaffected leg and to comparison groups.  The authors included ten cross-sectional studies in this review. Concerning isometric strength, pooled data reported deficits in hip abduction, extension, external rotation, and flexion; but no deficit in adduction and internal rotation when compared with healthy controls. When compared with the unaffected side, deficits in hip abduction were reported in two studies and deficit in extension and external rotation in one study.  Studies with isokinetic strength evaluation reported deficit in abductors, but contradictory results for extensors and rotators in females with PFPS. Finally, one study reported hip endurance deficit in extension and one found no significant differences in hip endurance compared to control subjects.  Therefore, the authors concluded that the results of this systematic review confirm that females with PFPS have deficit in hip muscle strength compared with healthy controls and the unaffected side but are contradictory concerning endurance.

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