Date of Graduation

2008

Document Type

Thesis

Degree Type

MS

Committee Chair

Michelle A. Sandrey

Abstract

Objective: To evaluate the methodological quality of the studies in the current literature that focus on the exercises for the vastus medialis oblique. Data Sources: Pubmed (1950- 2008), MEDLINE(1976-2008), CINAHL (1982-2008), Cochrane (1999-2008), SPORTDiscus (1985-2008), Science Direct, PEDro (1999-2008), Scirius (1920-2008), and Google Scholar were searched using the terms quadriceps, vastus medialis, patellofemoral, EMG, and biofeedback. Second, the term quadriceps was combined with each of the following words: exercises, biofeedback, patellofemoral, and EMG. In addition the term vastus medialis were combined with each of the following words: exercises, patellofemoral, EMG, biofeedback, and vastus lateralis. Third, the citations were cross-referenced from studies to include literature not found in the original search. Study Selection: Studies were selected based on the following inclusion and exclusion criteria. The inclusion criteria included articles written in the English language or an English translation, randomized clinical trials, must have VMO, quadriceps, or patellofemoral pain in the title and abstract. The exclusion criteria were articles not written in the English language or have an English translation, no ACL rehabilitation, and no literature reviews. Data Extraction: Both investigators underwent training which included a tutorial of the PEDro scale, a review of all the listed criteria with explanations, and took three practice evaluations via the PEDro website. Once the training was completed, both investigators evaluated the studies. All of the studies that met the inclusion criteria were evaluated using the PEDro scale. If the investigators had any discrepancies with the PEDro score for a study, they discussed the differences. After discussing the differences, both investigators came to an agreement. Finally, the agreed scored were recorded for each study.

Data Synthesis: The data synthesis section included four parts: study quality, studies with patellofemoral pain syndrome subjects, studies with healthy subjects, and studies with both patellofemoral pain syndrome subjects and healthy subjects. The fourteen studies that were used varied in the subject population, location of the study, type of exercises, inclusion/exclusion criteria, and the methodological quality. Conclusions: Fourteen studies met the inclusion criteria and were evaluated using the PEDro scale. The methodological quality of the studies ranged from three to nine. The studies with the higher PEDro scores can be used to make rehabilitation programs to strengthen the VMO. There is still controversy in the literature as to which exercises recruit more muscle fibers of the VMO. The use of biofeedback will increased the muscle activity of the VMO sooner, but a rehabilitation program without biofeedback will still increase the muscle activity of the VMO. Medial rotation of the hip during knee extensions have shown to be more effective than knee extension with lateral rotation hip rotation, but during a wall slide or step-up hip placement did not affect the muscle fibers recruited of the VMO. If standardization was used in the studies, one might be better able to conclude that one exercise is better than the rest to recruit muscle fibers of the VMO.

Download

Share

COinS