Med Sci Monit. 2026 Oct 13;32:e953994. doi: 10.12659/MSM.953994.
ABSTRACT
BACKGROUND Patellofemoral pain syndrome (PFPS) often stems from neuromuscular imbalances, particularly vastus medialis obliques (VMO) dysfunction impairing patellar tracking. Research is shifting toward integrated rehabilitation strategies, such as combining hip adduction with squats to enhance VMO recruitment. MATERIAL AND METHODS Thirty participants with PFPS were randomized to traditional squatting (SQU, n=15) or squatting with hip adduction (SQU-HA, n=15) for an 8-week home-based program with identical stretching. SQU-HA squeezed a Swiss ball during squats. Fifteen healthy individuals served as a reference group (RG). Outcome measures assessed before and after intervention included Q-angle, patellar tilt, clinical scales (visual analog scale [VAS], patellofemoral pain severity scale [PSS]), and electromyographic parameters (VMO, vastus lateralis [VL], adductor [ADD] amplitudes, onset times, VMO/VL ratio, and VMO-VL onset difference). RESULTS Both PFPS groups showed significant improvements in VAS and PSS after intervention, with greater VAS improvement in the SQU-HA group (P<0.01). Within-group analysis showed reduced patellar tilt in the SQU-HA group (P=0.003); between-group comparison did not reach statistical significance (P=0.217). Muscle activation onset sequences shifted from an abnormal pattern, in which VL activation preceded VMO and ADD activation, to a more typical pattern, in which VMO activation preceded VL and ADD activation. This shift was particularly evident in the SQU-HA group, whose activation pattern resembled that of the RG after intervention. Only VMO-VL onset difference, VMO/VL ratio, and Q-angle were correlated with clinical outcomes (P<0.05). CONCLUSIONS An 8-week SQU-HA program demonstrates promising short-term improvements in VMO-related neuromuscular measures and pain reduction for patients with PFPS. This accessible motor re-education strategy serves as a practical, home-based approach to patellofemoral rehabilitation.
PMID:42864886 | DOI:10.12659/MSM.953994
