Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial

Abstract Background Patellofemoral pain syndrome (PFPS) is a common disorder affecting the lower extremity. This study aimed to compare the effects of functional strength training (FST) and standard strength training (SST) in PFPS patients. Methods Forty college students (aged 18–30 years) with PFPS...

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Main Authors: Zheyu Xiong, Wei Zheng, Haiwen Wang, Yuan Gao, Chengshuo Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-05482-z
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author Zheyu Xiong
Wei Zheng
Haiwen Wang
Yuan Gao
Chengshuo Wang
author_facet Zheyu Xiong
Wei Zheng
Haiwen Wang
Yuan Gao
Chengshuo Wang
author_sort Zheyu Xiong
collection DOAJ
description Abstract Background Patellofemoral pain syndrome (PFPS) is a common disorder affecting the lower extremity. This study aimed to compare the effects of functional strength training (FST) and standard strength training (SST) in PFPS patients. Methods Forty college students (aged 18–30 years) with PFPS and no exercise habits were randomized into FST group (n = 20) and SST group (n = 20). FST group underwent six weeks of lower extremity training focused on functional adaptations, whereas SST group focus on lower extremity strength training. Function (Kujala Patellofemoral Scale, KPS), pain (visual analog scale, VAS), peak joint angles of hip, knee, and ankle, along with muscle activation (step-down test) of Vastus medialis, Vastus lateralis, Biceps femoris, Semitendinosus, Gluteus maximus, and Gluteus medius were assessed at baseline and after intervention. Results FST outperformed SST in pain reduction (p = 0.026) and function (p = 0.006) post-intervention. The FST group also showed increased hip flexion (p < 0.001), gluteus maximus activation (p < 0.001), and reduced knee valgus (p = 0.032), while SST group exhibited greater knee flexion (p = 0.008), and higher activation of the lateral femoral (p < 0.001) and semitendinosus (p < 0.001). Conclusion Interventions focused on functional adaptations result in differential kinematic and muscle activation changes that may result in greater improvements in pain and knee function than lower limb muscle strengthening alone. Trial registration chictr.org.cn. NO: ChiCTR2400087664. Date 01/08/2024.
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spelling doaj-art-7e7cd23964b44691b167e2f39d1c1d022025-01-19T12:32:49ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-012011910.1186/s13018-025-05482-zEffects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trialZheyu Xiong0Wei Zheng1Haiwen Wang2Yuan Gao3Chengshuo Wang4Institute of Sport, Exercise & Health, Tianjin University of SportInstitute of Sport, Exercise & Health, Tianjin University of SportDepartment of Physical Education and Research, China University of Mining and Technology- BeijingInstitute of Sport, Exercise & Health, Tianjin University of SportInstitute of Sport, Exercise & Health, Tianjin University of SportAbstract Background Patellofemoral pain syndrome (PFPS) is a common disorder affecting the lower extremity. This study aimed to compare the effects of functional strength training (FST) and standard strength training (SST) in PFPS patients. Methods Forty college students (aged 18–30 years) with PFPS and no exercise habits were randomized into FST group (n = 20) and SST group (n = 20). FST group underwent six weeks of lower extremity training focused on functional adaptations, whereas SST group focus on lower extremity strength training. Function (Kujala Patellofemoral Scale, KPS), pain (visual analog scale, VAS), peak joint angles of hip, knee, and ankle, along with muscle activation (step-down test) of Vastus medialis, Vastus lateralis, Biceps femoris, Semitendinosus, Gluteus maximus, and Gluteus medius were assessed at baseline and after intervention. Results FST outperformed SST in pain reduction (p = 0.026) and function (p = 0.006) post-intervention. The FST group also showed increased hip flexion (p < 0.001), gluteus maximus activation (p < 0.001), and reduced knee valgus (p = 0.032), while SST group exhibited greater knee flexion (p = 0.008), and higher activation of the lateral femoral (p < 0.001) and semitendinosus (p < 0.001). Conclusion Interventions focused on functional adaptations result in differential kinematic and muscle activation changes that may result in greater improvements in pain and knee function than lower limb muscle strengthening alone. Trial registration chictr.org.cn. NO: ChiCTR2400087664. Date 01/08/2024.https://doi.org/10.1186/s13018-025-05482-zPatellofemoral Pain SyndromeExercise TherapyStrength trainingBiomechanics
spellingShingle Zheyu Xiong
Wei Zheng
Haiwen Wang
Yuan Gao
Chengshuo Wang
Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial
Journal of Orthopaedic Surgery and Research
Patellofemoral Pain Syndrome
Exercise Therapy
Strength training
Biomechanics
title Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial
title_full Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial
title_fullStr Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial
title_full_unstemmed Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial
title_short Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial
title_sort effects of functional strength training on pain function and lower extremity biomechanics in patients with patellofemoral pain syndrome a randomized clinical trial
topic Patellofemoral Pain Syndrome
Exercise Therapy
Strength training
Biomechanics
url https://doi.org/10.1186/s13018-025-05482-z
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