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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 April;179(4):213-23

DOI: 10.23736/S0393-3660.19.04072-5


language: English

The effects of closed and open kinetic chain exercise on strength and onset timing of hip musculature and dynamic knee valgus in women

Kelsi WOOD 1, William BERG 1 , Nick SALCEDO 2, Mark WALSH 1, Kelsey BILLER 1

1 Department of Kinesiology and Health, Miami University, Oxford, OH, USA; 2 Mercy Hospital Outpatient Rehabilitation Services, Fairfield, OH, USA

BACKGROUND: The most common type of overuse knee pain in women is patellofemoral pain syndrome (PFP), and it has been associated with decreases in hip strength. This experiment evaluated the potential of closed kinetic chain (CKC) exercise and open kinetic chain (OKC) exercise to act as a preventative strategy for PFP.
METHODS: Participants were randomly assigned to one of three groups; an 8-week, 24 session CKC exercise intervention (N.=10), an 8-week, 24 session OKC exercise intervention (N.=10), and a control group (C) (N.=10). Pre and posttests included assessment of: 1) peak torque in hip extension, abduction and external rotation (eccentric and concentric); 2) EMG recording of gluteus medius (GMed) during a drop jump and stair accent and decent; 3) dynamic knee valgus during a single-leg squat and stair accent and decent.
RESULTS: Overall, there was a trend for both interventions, OKC and CKC, to improve hip strength compared to the control group (25%, 24.7% and 2.1%, respectively). However, there were minimal differences between interventions. In four of the 12 peak torque measures (eccentric hip flexion and internal rotation, and concentric hip internal and external rotation), strength gains by the CKC group significantly exceeded those of the control group, whereas the OKC group exceeded the control group on just two measures (concentric hip internal and external rotation).
CONCLUSIONS: Neither training intervention significantly increased gluteal contribution, nor had any effect on GMed onset or dynamic knee valgus during in functional activities. The interventions were likely of too low an intensity to have meaningful therapeutic effects.

KEY WORDS: Patellofemoral pain syndrome; Knee joint; Muscle strength; Electromyography

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