Fortalecimento muscular de quadril e joelho é superior ao fortalecimento isolado de joelho para redução da dor e melhora da atividade em indivíduos com síndrome da dor patelofemoral: uma revisão sistemática

Abstract

Introduction: Question: In people with patellofemoral pain syndrome, does hip and knee strength training increase strength, reduce pain and improve activity? Is it more effective than knee strength training alone? Are any benefits maintained beyond the intervention period? Design: Systematic review of randomised or controlled trials. Participants: Adults with patellofemoral pain syndrome. Intervention: Hip and knee strength training. Outcome measures: Muscle strength, pain intensity and activity. Results: Fourteen trials involving 673 participants were included. The mean PEDro score was 5.8 (range 3 to 8), showing moderate methodological quality. Random effects meta-analyses showed that hip and knee strength training decreased pain (MD -3.3, 95% CI -5.6 to -1.1), and improved activity (SMD 1.4, 95% CI 0.03 to 2.8), compared with nothing/placebo. In addition, hip and knee strength training showed to be superior to knee strength training alone for decreasing pain (MD -1.5, 95% CI -2.3 to -0.8), and improving activity (SMD 0.7, 95% CI 0.2 to 1.3). Results were maintained beyond the intervention period, with moderate-to-large effect sizes. There were no significant changes in strength. Conclusions: Hip and knee strength training, delivered three times a week, for six weeks, showed to be effective and superior to knee strength training alone for decreasing pain and improving activity in people with patellofemoral pain syndrome with moderate-to-high levels of pain intensity. The current evidence is insufficient to support or refute the efficacy of the strength training on muscle strength. Review Registration: PROSPERO (CRD42015027762).