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Effectiveness of the open and closed kinetic chain exercises in the treatment of the patellofemoral pain syndrome

The aim of this study was to analyze the therapeutic effects of the open kinetic chain (OKC) and closed kinetic chain (CKC) exercises to treat the patellofemoral syndrome (PFSD). For this, 24 volunteers, bearers of the PFSD were randomly divided in two groups: group I (n = 12) performed the OKC exercises; group II (n = 12) performed the CKC exercises. Both groups were submitted to eight consecutive weeks of treatment consisting of three weekly sessions performed in alternate days. To analyze the activation pattern of the vastus medialis oblique (VMO) and the vastus lateralis (VL) muscles, the electromyographic signals (EMG) were collected using bipolar surface electrodes quantified by the root mean square (RMS) normalized by the maximal voluntary isometric contraction of the quadriceps. The pain intensity and the functionality of the volunteers were assessed using scales. The analysis of the amounts of the VMO/VL ratio in both groups I and II showed no significant differences as to the pre- and post-treatment times in the concentric (p > 0.05) and eccentric (p > 0.05) phases of the OKC and CKC exercises. Despite of this, the VMO muscle presented a lower activation rate compared to the VL in the eccentric phase of the CKC exercise. It was found significant increases in the functionality (p < 0.05), and a reduction in the pain intensity (p < 0.05) between the pre- and post-treatment times in both groups, but group II showed higher amounts compared to group I in both variables. The results found in this study suggest that according to the conditions of the trial, the OKC and CKC exercises provoke no changes in the patterns of the EMG activation in the VMO and VL muscles. However, they promoted an improvement in the functionality and a reduction in the pain intensity after the eight week intervention, and the CKC exercises presented better performances than OKC exercises.

Knees; Electromyography; Exercise; Functional recovery


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