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Published in: BMC Musculoskeletal Disorders 1/2014

Open Access 01-12-2014 | Study protocol

Neuromuscular training and muscle strengthening in patients with patellofemoral pain syndrome: a protocol of randomized controlled trial

Authors: Nayra Deise dos Anjos Rabelo, Bruna Lima, Amir Curcio dos Reis, André Serra Bley, Liu Chiao Yi, Thiago Yukio Fukuda, Leonardo Oliveira Pena Costa, Paulo Roberto Garcia Lucareli

Published in: BMC Musculoskeletal Disorders | Issue 1/2014

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Abstract

Background

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition, particularly among women. Patients with PFPS usually experience weakness in the gluteal muscles, as well as pain and impaired motor control during activities of daily living. Strengthening the hip muscles is an effective way of treating this disorder. Neuromuscular training has also been identified as a therapeutic tool, although the benefits of this intervention in patients with PFPS patients remain inconclusive.

Design

This is a protocol of randomized controlled trial with a blind assessor. Thirty-four women with a clinical diagnosis of PFPS participated. These participants were allocated into two groups (experimental and control). The experimental group performed twelve sessions to strengthen the knee extensors, hip abductor and lateral rotator muscles in association with neuromuscular training of the trunk and lower extremities. The control group performed the same number of sessions to strengthen the muscles of the hip and knee. The primary outcome was functional capacity (Anterior Knee Pain Scale – AKPS) at 4 weeks. Pain intensity, muscle strength and kinematic changes were also measured during the step down test after four weeks of intervention. Follow up assessments were conducted after three and six months to assess functional capacity and pain. The effects of the treatment (i.e. between-group differences) were calculated using mixed linear models.

Discussion

The present study was initiated on the 1st of April 2013 and is currently in progress. The results of this study may introduce another effective technique of conservative treatment and could guide physical therapists in the clinical decision-making process for women with PFPS.

Trial registration

Current Controlled Trials NCT01804608.
Appendix
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Literature
1.
go back to reference Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD: A retrospective case–control analysis of 2002 running injuries. Br J Sports Med. 2002, 36: 95-101. 10.1136/bjsm.36.2.95.CrossRefPubMedPubMedCentral Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD: A retrospective case–control analysis of 2002 running injuries. Br J Sports Med. 2002, 36: 95-101. 10.1136/bjsm.36.2.95.CrossRefPubMedPubMedCentral
2.
go back to reference Wood L, Muller S, Peat G: The epidemiology of patellofemoral disorders in adulthood: a review of routine general practice morbidity recording. Prim Health Care Res Dev. 2011, 12: 157-164. 10.1017/S1463423610000460.CrossRefPubMed Wood L, Muller S, Peat G: The epidemiology of patellofemoral disorders in adulthood: a review of routine general practice morbidity recording. Prim Health Care Res Dev. 2011, 12: 157-164. 10.1017/S1463423610000460.CrossRefPubMed
3.
go back to reference Cesarelli M, Bifulco P, Bracale M: Study of the control strategy of the quadriceps muscles in anterior knee pain. Rehabil Eng. 2000, 8 (3): 330-341. 10.1109/86.867875.CrossRef Cesarelli M, Bifulco P, Bracale M: Study of the control strategy of the quadriceps muscles in anterior knee pain. Rehabil Eng. 2000, 8 (3): 330-341. 10.1109/86.867875.CrossRef
4.
go back to reference Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G: Intrinsic risk factors for the development of anterior knee pain in an athletic population a two-year prospective study. Am J Sports Med. 2000, 28 (4): 480-489.PubMed Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G: Intrinsic risk factors for the development of anterior knee pain in an athletic population a two-year prospective study. Am J Sports Med. 2000, 28 (4): 480-489.PubMed
5.
go back to reference Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J: Deficits in neuromuscular control of the trunk predict knee injury risk a prospective biomechanical-epidemiologic study. Am J Sports Med. 2007, 35 (7): 1123-1130. 10.1177/0363546507301585.CrossRefPubMed Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J: Deficits in neuromuscular control of the trunk predict knee injury risk a prospective biomechanical-epidemiologic study. Am J Sports Med. 2007, 35 (7): 1123-1130. 10.1177/0363546507301585.CrossRefPubMed
6.
go back to reference Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, Willson JD, Earl-Boehm JE, Davis IS, Powers CM, McConnell J, 11 Crossley KM: Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014, 48: 411-414. 10.1136/bjsports-2014-093450.CrossRefPubMed Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, Willson JD, Earl-Boehm JE, Davis IS, Powers CM, McConnell J, 11 Crossley KM: Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014, 48: 411-414. 10.1136/bjsports-2014-093450.CrossRefPubMed
7.
go back to reference Cowan SM, Crossley KM, Bennell KL: Altered hip and trunk muscle function in individuals with patellofemoral pain. Br J Sports Med. 2009, 43: 584-588. 10.1136/bjsm.2008.053553.CrossRefPubMed Cowan SM, Crossley KM, Bennell KL: Altered hip and trunk muscle function in individuals with patellofemoral pain. Br J Sports Med. 2009, 43: 584-588. 10.1136/bjsm.2008.053553.CrossRefPubMed
8.
go back to reference Willson JD, Davis IS: Lower extremity strength and mechanics during jumping in women with patellofemoral pain. J Sport Rehabil. 2009, 18: 76-90.PubMed Willson JD, Davis IS: Lower extremity strength and mechanics during jumping in women with patellofemoral pain. J Sport Rehabil. 2009, 18: 76-90.PubMed
9.
go back to reference Magalhaes E, Fukuda TY, Sacramento SN, Forgas A, Cohen M, Abdalla RJ: A Comparison of hip strength between sedentary females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2010, 40 (10): 641-647. 10.2519/jospt.2010.3120.CrossRefPubMed Magalhaes E, Fukuda TY, Sacramento SN, Forgas A, Cohen M, Abdalla RJ: A Comparison of hip strength between sedentary females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2010, 40 (10): 641-647. 10.2519/jospt.2010.3120.CrossRefPubMed
10.
go back to reference Magalhães E, Silva APMCC, Sacramento SN, Martin RL, Fukuda TY: Isometric strength ratios of the hip musculature in females with patellofemoral pain: a comparison to pain free controls. J Strength Cond Res. 2013, 27 (8): 2165-2170. 10.1519/JSC.0b013e318279793d.CrossRefPubMed Magalhães E, Silva APMCC, Sacramento SN, Martin RL, Fukuda TY: Isometric strength ratios of the hip musculature in females with patellofemoral pain: a comparison to pain free controls. J Strength Cond Res. 2013, 27 (8): 2165-2170. 10.1519/JSC.0b013e318279793d.CrossRefPubMed
11.
go back to reference Nakagawa TH, Moriya TU, Maciel CD, Serrão FV: Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2012, 42 (6): 491-501. 10.2519/jospt.2012.3987.CrossRefPubMed Nakagawa TH, Moriya TU, Maciel CD, Serrão FV: Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2012, 42 (6): 491-501. 10.2519/jospt.2012.3987.CrossRefPubMed
12.
go back to reference Lankhorst NE, Bierma-zeinstra SMA, Middelkoop MV: Risk factors for patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther. 2012, 42 (2): 81-A12. 10.2519/jospt.2012.3803.CrossRefPubMed Lankhorst NE, Bierma-zeinstra SMA, Middelkoop MV: Risk factors for patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther. 2012, 42 (2): 81-A12. 10.2519/jospt.2012.3803.CrossRefPubMed
13.
go back to reference Pappas E, Wong-Tom WM: Prospective predictors of patellofemoral pain syndrome: a systematic review with meta-analysis. Sports Health. 2012, 4 (2): 115-120. 10.1177/1941738111432097.CrossRefPubMedPubMedCentral Pappas E, Wong-Tom WM: Prospective predictors of patellofemoral pain syndrome: a systematic review with meta-analysis. Sports Health. 2012, 4 (2): 115-120. 10.1177/1941738111432097.CrossRefPubMedPubMedCentral
14.
go back to reference Fukuda TY, Rossetto FM, Magalhães E, Bryk FF, Lucareli PRG, Carvalho NAA: Short-term effects of Hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial. J Orthop Sports Phys Ther. 2010, 40 (11): 736-742. 10.2519/jospt.2010.3246.CrossRefPubMed Fukuda TY, Rossetto FM, Magalhães E, Bryk FF, Lucareli PRG, Carvalho NAA: Short-term effects of Hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial. J Orthop Sports Phys Ther. 2010, 40 (11): 736-742. 10.2519/jospt.2010.3246.CrossRefPubMed
15.
go back to reference Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B: Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Br J Sports Med. 2009, 43 (3): 169-171.CrossRefPubMed Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B: Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Br J Sports Med. 2009, 43 (3): 169-171.CrossRefPubMed
16.
go back to reference Earl JE, Hoch AZ: A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med. 2011, 39 (1): 154-163. 10.1177/0363546510379967.CrossRefPubMed Earl JE, Hoch AZ: A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med. 2011, 39 (1): 154-163. 10.1177/0363546510379967.CrossRefPubMed
17.
go back to reference Brody LT, Thein JM: Nonoperative treatment for at ell of em oral pain. J Orthop Sports Phys Ther. 1998, 28 (5): 337-344.CrossRef Brody LT, Thein JM: Nonoperative treatment for at ell of em oral pain. J Orthop Sports Phys Ther. 1998, 28 (5): 337-344.CrossRef
18.
go back to reference Meira EP, Brumitt J: Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health. 2011, 3 (5): 455-465. 10.1177/1941738111415006.CrossRefPubMedPubMedCentral Meira EP, Brumitt J: Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health. 2011, 3 (5): 455-465. 10.1177/1941738111415006.CrossRefPubMedPubMedCentral
19.
go back to reference Salsich GB1, Graci V, Maxam DE: The effects of movement pattern modification on lower extremity kinematics and pain in women with patellofemoral pain. J Orthop Sports Phys Ther. 2012, 42 (12): 1017-1024. 10.2519/jospt.2012.4231.CrossRefPubMedPubMedCentral Salsich GB1, Graci V, Maxam DE: The effects of movement pattern modification on lower extremity kinematics and pain in women with patellofemoral pain. J Orthop Sports Phys Ther. 2012, 42 (12): 1017-1024. 10.2519/jospt.2012.4231.CrossRefPubMedPubMedCentral
20.
go back to reference Hewett BT, Myer GD MS, Ford K: Decrease in neuromuscular control about the knee with maturation in female athletes. J Bone Joint Surg. 2004, 86 (8): 1601-1608.PubMed Hewett BT, Myer GD MS, Ford K: Decrease in neuromuscular control about the knee with maturation in female athletes. J Bone Joint Surg. 2004, 86 (8): 1601-1608.PubMed
21.
go back to reference Noehren B, Scholz J, Davis I: The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011, 45: 691-696. 10.1136/bjsm.2009.069112.CrossRefPubMed Noehren B, Scholz J, Davis I: The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011, 45: 691-696. 10.1136/bjsm.2009.069112.CrossRefPubMed
22.
go back to reference Willyv RW, Scholz JP, Davis IS: Mirror gait retraining for the treatment of patellofemoral pain in female runners. Clin Biomech. 2012, 27: 1045-1051. 10.1016/j.clinbiomech.2012.07.011.CrossRef Willyv RW, Scholz JP, Davis IS: Mirror gait retraining for the treatment of patellofemoral pain in female runners. Clin Biomech. 2012, 27: 1045-1051. 10.1016/j.clinbiomech.2012.07.011.CrossRef
23.
go back to reference Baldon RM, Serrão FV, Scattone SR: Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2014, 44 (4): 240-A8. 10.2519/jospt.2014.4940.CrossRef Baldon RM, Serrão FV, Scattone SR: Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2014, 44 (4): 240-A8. 10.2519/jospt.2014.4940.CrossRef
24.
go back to reference Powers CM: The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003, 33: 640-646. Powers CM: The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003, 33: 640-646.
25.
go back to reference Bolgla LA, Malone TR, Umberger BR, Uhl TL: Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. Int J Orthop Sports Phys Ther. 2011, 6 (4): 285-296. Bolgla LA, Malone TR, Umberger BR, Uhl TL: Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. Int J Orthop Sports Phys Ther. 2011, 6 (4): 285-296.
26.
go back to reference Nakagawa TH, Muniz TB, de Marche Baldon R, Dias Maciel C, de Menezes Reiff RB, Serrão FV: The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil. 2008, 22: 1051-1060. 10.1177/0269215508095357.CrossRefPubMed Nakagawa TH, Muniz TB, de Marche Baldon R, Dias Maciel C, de Menezes Reiff RB, Serrão FV: The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil. 2008, 22: 1051-1060. 10.1177/0269215508095357.CrossRefPubMed
27.
go back to reference Kraemer WJ, Adams K, Cafarelli E, Dudley GA, Dooly C, Feigenbaum MS, Fleck SJ, Franklin B, Fry AC, Hoffman JR, Newton RU, Potteiger J, Stone MH, Ratamess NA, Triplett-McBride T: American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002, 34: 364-380.CrossRefPubMed Kraemer WJ, Adams K, Cafarelli E, Dudley GA, Dooly C, Feigenbaum MS, Fleck SJ, Franklin B, Fry AC, Hoffman JR, Newton RU, Potteiger J, Stone MH, Ratamess NA, Triplett-McBride T: American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002, 34: 364-380.CrossRefPubMed
28.
go back to reference Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG: Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther. 2003, 33: 677-685. 10.2519/jospt.2003.33.11.677.CrossRefPubMed Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG: Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther. 2003, 33: 677-685. 10.2519/jospt.2003.33.11.677.CrossRefPubMed
29.
go back to reference Powers CM: The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010, 40 (2): 42-51. 10.2519/jospt.2010.3337.CrossRefPubMed Powers CM: The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010, 40 (2): 42-51. 10.2519/jospt.2010.3337.CrossRefPubMed
30.
go back to reference da Cunha RA, Costa LO, Hespanhol Junior LC, Pires RS, Kujala UM, Lopes AD: Translation, cross-cultural adaptation and clinimetric testing of instruments used to assess patients with patellofemoral pain syndrome in the Brazilian population. J Orthop Sports Phys Ther. 2013, 43 (5): 332-339. 10.2519/jospt.2013.4228.CrossRefPubMed da Cunha RA, Costa LO, Hespanhol Junior LC, Pires RS, Kujala UM, Lopes AD: Translation, cross-cultural adaptation and clinimetric testing of instruments used to assess patients with patellofemoral pain syndrome in the Brazilian population. J Orthop Sports Phys Ther. 2013, 43 (5): 332-339. 10.2519/jospt.2013.4228.CrossRefPubMed
31.
go back to reference Fukuda TY, Melo WP, Zaffalon BM, Rossetto FM, Magalhães E, Bryk FF, Martin RL: Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up. J Orthop Sports Phys Ther. 2012, 42: 823-830. 10.2519/jospt.2012.4184.CrossRefPubMed Fukuda TY, Melo WP, Zaffalon BM, Rossetto FM, Magalhães E, Bryk FF, Martin RL: Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up. J Orthop Sports Phys Ther. 2012, 42: 823-830. 10.2519/jospt.2012.4184.CrossRefPubMed
32.
go back to reference Andrews AW, Thomas MW, Bohannon RW: Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys Ther. 1996, 76: 248-259.PubMed Andrews AW, Thomas MW, Bohannon RW: Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys Ther. 1996, 76: 248-259.PubMed
33.
go back to reference Bohannon RW: Hand-held compared with isokinetic dynamometry for measurement of static knee extension torque (parallel reliability of dynamometers). Clin Phys Physiol Meas. 1990, 11: 217-222. 10.1088/0143-0815/11/3/004.CrossRefPubMed Bohannon RW: Hand-held compared with isokinetic dynamometry for measurement of static knee extension torque (parallel reliability of dynamometers). Clin Phys Physiol Meas. 1990, 11: 217-222. 10.1088/0143-0815/11/3/004.CrossRefPubMed
34.
go back to reference Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O: Scoring of patellofemoral disorders. Arthroscopy. 1993, 9: 159-163. 10.1016/S0749-8063(05)80366-4.CrossRefPubMed Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O: Scoring of patellofemoral disorders. Arthroscopy. 1993, 9: 159-163. 10.1016/S0749-8063(05)80366-4.CrossRefPubMed
35.
go back to reference Davis IIIRB, Õunpuu S, Tyburski D, Gage JR: A gait analysis data collection and reduction technique. Hum Mov Sci. 1991, 10: 575-587. 10.1016/0167-9457(91)90046-Z.CrossRef Davis IIIRB, Õunpuu S, Tyburski D, Gage JR: A gait analysis data collection and reduction technique. Hum Mov Sci. 1991, 10: 575-587. 10.1016/0167-9457(91)90046-Z.CrossRef
36.
go back to reference Kadaba MP, Ramakrishnan HK, Wootten ME: Measurement of lower extremity kinematics during level walking. J Orthop Res. 1990, 8: 383-392. 10.1002/jor.1100080310.CrossRefPubMed Kadaba MP, Ramakrishnan HK, Wootten ME: Measurement of lower extremity kinematics during level walking. J Orthop Res. 1990, 8: 383-392. 10.1002/jor.1100080310.CrossRefPubMed
37.
go back to reference Earl JE, Monteiro SK, Snyder KR: Differences in lower extremity kinematics between a bilateral drop-vertical jump and a single-leg step-down. J Orthop Sports Phys Ther. 2007, 37: 245-252. 10.2519/jospt.2007.2202.CrossRefPubMed Earl JE, Monteiro SK, Snyder KR: Differences in lower extremity kinematics between a bilateral drop-vertical jump and a single-leg step-down. J Orthop Sports Phys Ther. 2007, 37: 245-252. 10.2519/jospt.2007.2202.CrossRefPubMed
38.
go back to reference Mascal CL, Landel R, Powers CM: Management of patellofemoral pain targeting Hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther. 2003, 33: 642-660.CrossRef Mascal CL, Landel R, Powers CM: Management of patellofemoral pain targeting Hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther. 2003, 33: 642-660.CrossRef
39.
go back to reference Souza RB, Powers CM: Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys The. 2009, 39 (1): 12-19. 10.2519/jospt.2009.2885.CrossRef Souza RB, Powers CM: Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys The. 2009, 39 (1): 12-19. 10.2519/jospt.2009.2885.CrossRef
40.
go back to reference Tonley JC, Yun , SM MPT, Kochevar RJ, DYE JA, Farrokhi S, Powers CM: Treatment of an individual with piriformis syndrome focusing on Hip muscle strengthening and movement reeducation. A Case Report J Orthop Sports Phys Ther. 2011, 40 (2): 103-111.CrossRef Tonley JC, Yun , SM MPT, Kochevar RJ, DYE JA, Farrokhi S, Powers CM: Treatment of an individual with piriformis syndrome focusing on Hip muscle strengthening and movement reeducation. A Case Report J Orthop Sports Phys Ther. 2011, 40 (2): 103-111.CrossRef
41.
go back to reference LaBella CR, Huxford MR, Smit TL, Preseason JC: Neuromuscular exercise program reduces sports-related knee pain in female adolescent athletes. Clin Pediatr. 2009, 48: 327-330.CrossRef LaBella CR, Huxford MR, Smit TL, Preseason JC: Neuromuscular exercise program reduces sports-related knee pain in female adolescent athletes. Clin Pediatr. 2009, 48: 327-330.CrossRef
Metadata
Title
Neuromuscular training and muscle strengthening in patients with patellofemoral pain syndrome: a protocol of randomized controlled trial
Authors
Nayra Deise dos Anjos Rabelo
Bruna Lima
Amir Curcio dos Reis
André Serra Bley
Liu Chiao Yi
Thiago Yukio Fukuda
Leonardo Oliveira Pena Costa
Paulo Roberto Garcia Lucareli
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2014
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-15-157

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