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Hossein Rabieifar1, Hoda Niknam *2, Khosro Khademi Kalantari2, Seyyed Morteza Kazemi3, Mahsa Farajabdollahi1
1- Student Research Committee, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Physiotherapy Research Center, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Department of Orthopedics, School of Medicine Bone, Akhtar Hospiatl, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Physiotherapy Research Center, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Department of Orthopedics, School of Medicine Bone, Akhtar Hospiatl, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract: (50 Views)
Background: Patellofemoral pain syndrome (PFPS) commonly presents with pain localized to the anterior aspect of the knee and is often associated with impaired hip muscle function. Strengthening of the gluteus medius is frequently recommended in rehabilitation programs for PFPS. Electromyographic (EMG) biofeedback may enhance neuromuscular activation during exercise; however, its additional clinical benefits remain unclear.
Purpose: To compare the effects of gluteus medius neuromuscular training with EMG biofeedback and conventional strengthening exercises on pain intensity and functional status in individuals with PFPS.
Method: In this assessor-blinded randomized controlled trial, 32 individuals with PFPS were randomly assigned using a coin-toss method to either an experimental group (EMG biofeedback plus gluteus medius strengthening) or a control group (gluteus medius strengthening alone). The experimental group additionally performed functional tasks (walking, step-up, step-down, side step-up, and side step-down) with real-time EMG biofeedback. Both groups also received the same standardized physiotherapy program over 10 treatment sessions performed three times per week. Pain intensity was measured by a visual analogue scale (VAS) at pre-intervention |(baseline), post-intervention, and a 1-month follow-up. Functional status was evaluated by KOOS questionnaire at baseline and post-intervention. The data were subjected to a two-way mixed repeated-measures ANOVA.
Results: Twenty-nine participants completed the study (experimental, n = 15; control, n = 14). Pain significantly decreased in both groups following the intervention and remained improved at one-month follow-up (main effect of time, p < 0.001). Functional status measured by the KOOS also improved significantly in both groups after treatment (main effect of time, p < 0.001). No significant between-group differences were observed following the addition of EMG biofeedback to gluteus medius strengthening (time × group interaction and main effect of group: p > 0.05, Partial η² ≤ 0.02).
Conclusion: Both rehabilitation programs were associated with improvements in pain and functional status in individuals with PFPS. Because both groups received the same standardized physiotherapy modalities, these findings should be interpreted cautiously. Adding EMG biofeedback-assisted neuromuscular training did not provide additional short-term clinical benefits beyond gluteus medius strengthening alone.
Purpose: To compare the effects of gluteus medius neuromuscular training with EMG biofeedback and conventional strengthening exercises on pain intensity and functional status in individuals with PFPS.
Method: In this assessor-blinded randomized controlled trial, 32 individuals with PFPS were randomly assigned using a coin-toss method to either an experimental group (EMG biofeedback plus gluteus medius strengthening) or a control group (gluteus medius strengthening alone). The experimental group additionally performed functional tasks (walking, step-up, step-down, side step-up, and side step-down) with real-time EMG biofeedback. Both groups also received the same standardized physiotherapy program over 10 treatment sessions performed three times per week. Pain intensity was measured by a visual analogue scale (VAS) at pre-intervention |(baseline), post-intervention, and a 1-month follow-up. Functional status was evaluated by KOOS questionnaire at baseline and post-intervention. The data were subjected to a two-way mixed repeated-measures ANOVA.
Results: Twenty-nine participants completed the study (experimental, n = 15; control, n = 14). Pain significantly decreased in both groups following the intervention and remained improved at one-month follow-up (main effect of time, p < 0.001). Functional status measured by the KOOS also improved significantly in both groups after treatment (main effect of time, p < 0.001). No significant between-group differences were observed following the addition of EMG biofeedback to gluteus medius strengthening (time × group interaction and main effect of group: p > 0.05, Partial η² ≤ 0.02).
Conclusion: Both rehabilitation programs were associated with improvements in pain and functional status in individuals with PFPS. Because both groups received the same standardized physiotherapy modalities, these findings should be interpreted cautiously. Adding EMG biofeedback-assisted neuromuscular training did not provide additional short-term clinical benefits beyond gluteus medius strengthening alone.
Keywords: Patellofemoral Pain Syndrome, Anterior Knee Pain, Hip Abductor Muscles, Electromyographic Biofeedback, Exercise Therapy
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