Refining Home-Based Squat Training: The Role of Hip Adduction in Improving Neuromuscular Control for Clinically Diagnosed Patellofemoral Pain Syndrome.
Chia-Ling Chen, Sui-Foon Lo, Min-Chi Chiu et al.
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In 30 seconds
This randomized controlled trial compared an 8-week home-based squat program with and without hip adduction in 30 participants with clinically diagnosed patellofemoral pain syndrome (PFPS); both groups also performed identical stretching. Both groups improved on pain and patellofemoral pain severity scales, while the hip-adduction group had greater improvement in visual analog scale pain scores (P<0.01). Its muscle-activation sequence also shifted toward VMO activation preceding vastus lateralis activation, resembling the healthy reference group. Reduced patellar tilt was observed within the hip-adduction group, but the between-group difference was not statistically significant.
Key findings
- Both PFPS groups improved on visual analog scale pain and patellofemoral pain severity scores after the intervention.
- Visual analog scale pain improvement was greater with squats plus hip adduction than with traditional squats (P<0.01).
- Patellar tilt decreased within the hip-adduction group (P=0.003), but the between-group comparison was not significant (P=0.217).
- After training, muscle activation shifted toward VMO preceding vastus lateralis activation, particularly in the hip-adduction group.
Why it matters
The findings suggest that adding hip adduction to home-based squats may influence pain and neuromuscular activation in PFPS. The observed activation changes offer a potential rationale for this exercise variation, while the nonsignificant between-group result for patellar tilt cautions against assuming broader biomechanical benefit. The study provides short-term evidence relevant to rehabilitation approaches that combine hip and knee muscle control.
What to keep in mind
The intervention lasted 8 weeks and included only 30 participants with PFPS, limiting conclusions about longer-term outcomes and the precision or generalisability of between-group effects.