Closed Kinetic Chain exercises with or without additional hip strengthening exercises in management of Patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) is a prevalent musculoskeletal pain condition, particularly in females. Decreased hip muscle strength has been implicated as a contributing factor. Isolated open kinetic chain hip abductors and lateral rotators exercises were added by many authors to the rehabilitation program. However, Closed Kinetic Chain (CKC) exercises focusing on hip and knee muscles were not investigated if they can produce similar effect of hip strengthening and decreasing pain without the need of isolated exercises for hip musculature. The authors’ aim in the study was to determine the effect of a CKC exercises program with or without additional hip strengthening exercises on pain and hip abductors and lateral rotators peak torque. The study thirty two patients, aged eighteen to thirty years, with patellofemoral pain syndrome, referred to the outpatient physical therapy clinic of the faculty of physical therapy, Cairo university. The patients were randomly put into one of two groups: CKC group and CKC with hip muscles strengthening exercises as a control (CO) group. Treatment was given 3 times/week, for 6 weeks. Patients were evaluated pre- and post-treatment for their pain severity using VAS, function of knee joint using Kujala questionnaire, hip abductors and external rotators concentric/eccentric peak torque. There were significant improvements in pain, function and hip muscles peak torque in both groups (P<0.05). However, there was no statistically significant difference between groups in hip muscles torque (P<0.05) but pain and function improvements were significantly greater in the CO group (P<0.05).

They concluded that six weeks CKC program focusing on knee and hip strengthening has similar effect in improving hip muscles torque in patients with PFPS as a CKC exercises with additional hip strengthening exercises. However, adding isolated hip strengthening exercises had the advantage of greater pain relief. They suggest that CKC exercises with additional hip strengthening may be more beneficial in decreasing pain in PFPS than CKC exercises alone.

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