Carryover effect of hip and knee exercises program on functional performance in individuals with patellofemoral pain syndrome.
Hamada Ahmed Hamada, Amira Hussein Draz, Ghada Mohamed Koura and 1 others
PMID 28878459WHAT IT FOUND
The two starting orders did not differ overall.
Both groups improved hop distance and Kujala scores over 8 weeks. Hip-first ended with higher Kujala scores; knee-first ended with longer hops.
Key findings
01Both groups showed significant increases in hop test distance and Kujala scores at 4 weeks and at 8 weeks compared with baseline.
02At 8 weeks, the hip-first group had higher Kujala scores than the knee-first group, while the knee-first group had longer hop distances than the hip-first group.
03The overall difference between the two starting orders was not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 30 patients were studied, all with unilateral patellofemoral pain and aged 18 to 35 years, so it may not apply to older patients, bilateral pain, or other knee problems. The trial compared two active exercise sequences and had no controlled follow-up period after treatment, so long-term effects and natural improvement cannot be separated. Patients performed the exercises in non-weight-bearing positions, while the hop test and Kujala questionnaire reflect weight-bearing function. The authors note that future studies should use weight-bearing strengthening exercises and more measures of muscle performance. The Discussion's attribution of hop improvement to hip exercises and Kujala improvement to knee exercises is an interpretation, not a directly tested comparison.
The easy way to misread this
Do not read the hip-first group's higher Kujala score or the knee-first group's longer hop distance as proof that one exercise type caused the gain. Both groups received hip strengthening, knee strengthening, and stretching, and the overall difference between starting orders was not significant.