Hip Strengthening Compared With Quadriceps Strengthening in Conservative Treatment of Patients With Patellofemoral Pain: A Critically Appraised Topic

Clinical Scenario: Patellofemoral pain is a common injury that affects both athletic and sedentary populations. Clinicians may treat patellofemoral pain more effectively through a comprehensive understanding of the most effective exercise protocols. Clinical Question: In patients with patellofemoral pain, are hip abductor and external rotator muscle strengthening exercises more effective in reducing pain and improving patient-reported function compared with isolated quadriceps strengthening? Summary of Key Findings: A comprehensive and systematic database search was conducted for studies of level 2 evidence or higher. The search yielded 253 studies; of these studies, four randomized control trials and one comparative control trial fit the inclusion and exclusion criteria. A combination of quadriceps and hip strengthening exercises or hip strengthening exercises alone reduced pain and improved patient-reported function compared with quadriceps strengthening alone. Clinical Bottom Line: There is strong evidence to support the use of hip strengthening or hip strengthening combined with quadriceps strengthening in the treatment of patellofemoral pain to decrease pain and improve patient reported function. Strength of Recommendation: The Strength of Recommendation Taxonomy recommends a grade of A for level 1 evidence with consistent patient-oriented findings