Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Biomechanics

Background: Despite the fact that patients with patellofemoral pain syndrome (PFPS) have hip and knee muscle weakness that causes dynamic lower extremity malalignment, few studies that compare among the biomechanical effects of combined hip and knee, isolated hip and isolated knee strengthening exercises in these patients. Purpose: This study aimed to compare the effect of three different exercise programs on pain level, Kujala questionnaire scale, Q angle, femoral anteversion angle (FAA), and knee extensors{u2019}, hip abductors{u2019} and external rotators{u2019} peak torques (PT) in patients with PFPS. The programs involve isolated hip strengthening, isolated knee strengthening and stretching, and combined hip and knee exercises. Results: 3x2 Mixed Design MANOVA revealed that there was a significant increase in the mean values of the hip abductors{u2019} PT in addition to a significant decline in the mean values of the Q angle and FAA in group (A) compared with group (C) after three weeks of exercises (p<0.05). Additionally, there was a significant decline in the pain level in group (C) compared with groups (A) and (B) after three weeks of exercises (p<0.05). Conclusion: The combined hip and knee exercise program is more effective in reducing anterior knee pain compared with the isolated hip and knee exercise programs in patients with PFPS. However, the isolated hip strengthening program is more effective in increasing the hip abductors{u2019} PT and reducing the Q angle and FAA compared with the combined hip and knee exercise program in these patients.

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