Evidence map›Paper›PMID 39006111›Full record

ArticleArchives of rehabilitation research and clinical translation2024

Combined Hip and Knee Strengthening Compared With Knee Strengthening for Individuals With Lateral Patellar Dislocation: A Single-blind, Superiority, Randomized Controlled Trial.

Lucas Simões Arrebola, Toby O Smith, Vanessa Gonçalves Coutinho de Oliveira, Pedro Rizzi de Oliveira, Paloma Yan Lam Wun, Rogério Teixeira de Carvalho, Carlos Eduardo Pinfildi

Abstract read
In one paragraph

Article in Archives of rehabilitation research and clinical translation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lucas Simões ArrebolaDepartment of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo, Brazil.
Toby O SmithNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
Vanessa Gonçalves Coutinho de OliveiraDepartment of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo, Brazil.
Pedro Rizzi de OliveiraDepartment of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo, Brazil.
Paloma Yan Lam WunPhysical Therapy Department, Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo, Brazil.
Rogério Teixeira de CarvalhoDepartment of Orthopaedics, Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo, Brazil.
Carlos Eduardo PinfildiDepartment of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To investigate whether a combined hip and knee muscle strengthening program is superior to a knee strengthening program for people after lateral patellar dislocation (LPD). Design: Single-blind, superiority, randomized controlled trial with 48 weeks follow-up. Setting: Physiotherapy out-patient clinic. Participants: Forty individuals aged 16 or older, with a history of non-traumatic LPD were randomized to a knee-based strengthening (KBSG) or quadriceps and hip strengthening exercise (HQSG) program (N=40). Inclusion criteria included a positive apprehension sign, pain on palpation along the medial retinaculum, and J sign. Exclusion criteria included restricted range of motion (<90° knee flexion), and traumatic or postsurgical LPD. Interventions: Concealed randomization was performed using random permuted blocks of size 4. Individuals received their corresponding exercise program according to randomization and group allocation: knee-based strengthening (n=20) or combined hip and quadriceps strengthening (n=20) twice weekly for 8 weeks over 16 appointments. Main Outcome Measures: Primary outcome was the Lysholm Knee Score. Secondary outcomes included Numerical Pain Ratings Scale (NPRS) at rest and during effort, Norwich Patellar Instability Score (NPIS), Kujala Anterior Knee Pain Scale (AKPS), Lower Extremity Functional Scale (LEFS), 4 domains of the WHOQOL-Bref, and recurrence rate. Patient-reported outcome measures were assessed from the baseline to 48 weeks. Assessments were performed by a physiotherapist who was blinded to the group allocation. Data were analyzed by using a repeated-measures ANOVA model with Tukey's post hoc test after an intention-to-treat principle. Results: At the primary time-point of 8 weeks, there were no substantial between-group differences in the Lysholm Knee Score: mean difference=-6.8 (95% CI -14.3 to 3.7); NPIS: mean difference=23.5 (95% CI 5.6 to 41.3); AKPS: mean difference=-1.54 (95% CI -8.6 to 5.6), NPRS at rest and during effort (mean difference=0.32 (95% CI -0.37 to 1); and mean difference=0.68 (95% CI -0.9 to 1.86); LEFS mean difference=-1.08 (95% CI -5.9 to 2.4), WHOQOL-Bref domains (physical health: mean difference=-0.12, (95% CI -1.26 to 1.02); psychological: mean difference=-0.32 (95% CI -2.04 to 1.4); social relations: mean difference=-0.7 (95% CI -2.2 to 0.82); environment: mean difference=0.44 (95% CI -1 to 1.9), and recurrence rate ( Conclusion: This study indicates that combined hip and knee muscle strengthening is not superior to knee-based strengthening for LPD treatment. The limitations stemming from the underpowered nature of the trial must be acknowledged, concerning the potential oversight of moderate intervention effects.

Indexed as

Clinical trialConservative treatmentPatellar dislocationRehabilitationResistance training

Identifiers

PMID39006111
PMCPMC11240038

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.