Abdelmohsen Azza Mohammed, Nabil Abd El-Maboud Bassam Ahmed
Assistant Professor of Biomechanics, Biomechanics Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Lecturer in Biomechanics Department, Faculty of Physical Therapy, October 6 University, 6th of October City, Egypt.
Physiother Res Int. 2025 Oct;30(4):e70093. doi: 10.1002/pri.70093.
Patellofemoral pain syndrome (PFPS) is a prevalent condition among physically active females and is often associated with reduced hip and knee muscle strength, altered biomechanics, and pain-related disability. Weight-bearing exercise programs may enhance neuromuscular control and functional outcomes, but their effects on multiple objective and subjective measures have not been comprehensively studied in this population. Therefore, the main purpose of this study was to investigate the effect of the weight-bearing exercise for better balance (WEBB) program on isokinetic hip and knee muscle strength, pain intensity, pain sensitivity, and disability in females with PFPS.
A randomized controlled trial (RCT) was conducted on 30 females with clinically diagnosed PFPS. Participants were randomly allocated to either an experimental group (n = 15), receiving 8 weeks of a supervised WEBB program, or a control group (n = 15), did not receive any intervention. Outcomes included nine dependent variables: isokinetic peak torque of hip and knee muscles (flexors, extensors, abductors, adductors, knee flexors, knee extensors) measured by Biodex Isokinetic Dynamometer, pain intensity evaluated by Visual Analogue Scale (VAS), pressure pain threshold (PPT) measured by digital algometer, and disability assessed by Oswestry Disability Index (ODI). Measurements were taken at baseline and after 8 weeks of the WEBB program.
Within the experimental group, significant improvements were observed after performing the WEBB program across all nine measured outcomes (p < 0.05), including increases in isokinetic strength, reductions in pain intensity, elevated PPT values, and decreased ODI scores. Between-group comparisons revealed statistically significant improvements in several variables favoring the experimental group post intervention. Specifically, there were statistically significant increases in isokinetic strength of hip flexors, hip adductors, knee flexors, and knee extensors in addition to a significant reduction in pain intensity and functional disability (p < 0.05). However, the other variables including isokinetic strength of hip extensors, hip abductors and ODI scores did not show any statistically significant differences between groups (p > 0.05).
The introduced WEBB program demonstrated significant within-group improvements in all measures of muscular strength, pain, and disability in females with PFPS. While between-group differences were evident in some outcomes, further studies are warranted to explore the long-term and differential effects on specific muscle groups and functional indices.
The study was registered at https://clinicaltrials.gov/.
髌股疼痛综合征（PFPS）在身体活跃的女性中很常见，通常与髋部和膝部肌肉力量减弱、生物力学改变以及疼痛相关的功能障碍有关。负重锻炼计划可能会增强神经肌肉控制和功能结果，但尚未对该人群中其对多种客观和主观指标的影响进行全面研究。因此，本研究的主要目的是调查负重锻炼以改善平衡（WEBB）计划对患有PFPS的女性等速髋部和膝部肌肉力量、疼痛强度、疼痛敏感性和功能障碍的影响。
对30名临床诊断为PFPS的女性进行了一项随机对照试验（RCT）。参与者被随机分配到实验组（n = 15），接受为期8周的有监督的WEBB计划，或对照组（n = 15），不接受任何干预。结果包括九个因变量：通过Biodex等速测力计测量的髋部和膝部肌肉（屈肌、伸肌、外展肌、内收肌、膝部屈肌、膝部伸肌）的等速峰值扭矩，通过视觉模拟量表（VAS）评估的疼痛强度，通过数字痛觉计测量的压力疼痛阈值（PPT），以及通过Oswestry功能障碍指数（ODI）评估的功能障碍。在基线时以及WEBB计划8周后进行测量。
在实验组中，在执行WEBB计划后，所有九个测量结果均观察到显著改善（p < 0.05），包括等速力量增加、疼痛强度降低、PPT值升高和ODI评分降低。组间比较显示，干预后几个变量在有利于实验组方面有统计学显著改善。具体而言，除了疼痛强度和功能障碍显著降低外（p < 0.05），髋部屈肌、髋部内收肌、膝部屈肌和膝部伸肌的等速力量有统计学显著增加。然而，包括髋部伸肌、髋部外展肌的等速力量和ODI评分在内的其他变量在组间未显示任何统计学显著差异（p > 0.05）。
引入的WEBB计划在患有PFPS的女性的所有肌肉力量、疼痛和功能障碍测量指标上均显示出组内显著改善。虽然在一些结果中组间差异明显，但仍需要进一步研究来探索对特定肌肉群和功能指标的长期和差异影响。
