human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / AIM The role of hip muscles in the rehabilitation of patellofemoral pain syndrome has recently received interest . The aim of this study was to compare the efficiencies of hip exercises alongside knee exercises versus only knee exercises on pain , function , and isokinetic muscle strength in patients with this syndrome . MATERIAL S AND METHODS Fifty-five young female patients ( mean age : 34.1 ± 6.2 years ; mean BMI : 25.9 ± 3.9 kg/m2 ) with patellofemoral pain syndrome were included . The patients were r and omized into groups of hip- and -knee exercises and knee-only exercise programs for 6 weeks with a total of 30 sessions at the clinic . Both groups were evaluated before therapy , after 6 weeks of a supervised exercise program , and after 6 weeks of an at-home exercise program . The outcome measures were muscle strength , pain , and both subjective and objective function . RESULTS The improvements of the patients in the hip- and -knee exercise group were better than in patients of the knee-only exercise group in terms of scores of pain relief ( P < 0.001 ) and functional gain ( P = 0.002 ) after 12 weeks . CONCLUSION We suggest additional hip-strengthening exercises to patients with patellofemoral pain syndrome in order to decrease pain and increase functional status Patello-femoral pain syndrome ( PFPS ) is a common knee joint disability . The integration of hip soft tissue regimens are not always emphasized , although current literature implies that there is a significant relationship between the two and there is a lack of r and omized clinical trials to substantiate this relationship in clinical practice . A r and omized controlled assessor blinded trial was design ed to explore different rehabilitation programs related to PFPS . The study was conducted at RAZIEL institute of physical therapy , Netania , Israel with a total of 30 consecutive patients ( mean age 35y ) , diagnosed with PFPS . All patients were r and omly allocated into 3 groups . Group I conventional knee rehabilitation program . Included quadriceps strengthening and Trans Electric Neuromuscular Stimulation ( TENS ) . Group II hip oriented rehabilitation program . included stretching , Hip external rotators strengthening and TENS . Group III a combination of the two above programs .  Pain and function were documented on initial of the program and again 3 weeks later , on the completion . Pain was assessed by a numeric visual analogue scale ( VAS ) ; function was assessed by Patello-femoral joint evaluation scale ( PFJES ) ( 0 - 100 points ) . At end of trial , all groups showed significant improvements in VAS and PFJES ( p<0.0001 ) ; these improvements did not vary significantly between the 3 groups . The conclusions were that the explored different rehabilitation programs showed a similar beneficial effect STUDY DESIGN R and omized controlled trial . OBJECTIVES To determine if adding hip-strengthening exercises to a conventional knee exercise program produces better long-term outcomes than conventional knee exercises alone in women with patellofemoral pain syndrome ( PFPS ) . BACKGROUND Recent studies have shown that a hip-strengthening program reduces pain and improves function in individuals with PFPS . However , there are no clinical trials evaluating long-term outcomes of this type of program compared to conventional knee-strengthening and -stretching exercises . METHODS Fifty-four sedentary women between 20 and 40 years of age , with a diagnosis of unilateral PFPS , were r and omly assigned knee exercise ( KE ) or knee and hip exercise ( KHE ) .  The women in the KE group ( n = 26 ; mean age , 23 years ) performed a 4-week conventional knee-stretching and -strengthening program . The women in the KHE group ( n = 28 ; mean age , 22 years ) performed the same exercises as those in the KE group , as well as strengthening exercises for the hip abductors , lateral rotators , and extensors . An 11-point numeric pain rating scale , the Lower Extremity Functional Scale , the Anterior Knee Pain Scale , and a single-hop test were used as outcome measures at baseline ( pretreatment ) and 3 , 6 , and 12 months posttreatment . RESULTS At baseline , demographic , pain , and functional assessment data were similar between groups . Those in the KHE group had a higher level of function and less pain at 3 , 6 , and 12 months compared to baseline ( P<.05 ) . In contrast , the KE group had reduced pain only at the 3- and 6-month follow-ups ( P<.05 ) , without any changes in Lower Extremity Functional Scale , Anterior Knee Pain Scale , or hop testing ( P>.05 ) through the course of the study . Compared to the KE group , the KHE group had less pain and better function at 3 , 6 , and 12 months posttreatment ( P<.05 ) . For the Lower Extremity Functional Scale , the between-group difference in change scores from baseline at 3 , 6 , and 12 months posttreatment favored the KHE group by 22.0 , 22.0 , and 20.8 points , respectively . CONCLUSION Knee-stretching and -strengthening exercises supplemented by hip posterolateral musculature-strengthening exercises were more effective than knee exercises alone in improving long-term function and reducing pain in sedentary women with PFPS STUDY DESIGN R and omized clinical trial . OBJECTIVE To investigate the influence of strengthening the hip abductor and lateral rotator musculature on pain and function of females with patellofemoral pain syndrome ( PFPS ) . BACKGROUND Hip muscle weakness in women athletes has been the focus of many recent studies and is suggested as an important impairment to address in the conservative treatment of women with PFPS . However , it is still not well established if strengthening these muscles is associated with clinical improvement in pain and function in sedentary females with PFPS . METHODS Seventy females ( average±SD age , 25±07 years ) , with a diagnosis of unilateral PFPS , were distributed r and omly into 3 groups : 22 females in the knee exercise group , who received a conventional treatment that emphasized stretching and strengthening of the knee musculature ; 23 females in the knee and hip exercise group , who performed exercises to strengthen the hip abductors and external rotators in addition to the same exercises performed by those in the knee exercise group ; and of the 25 females who did not receive any treatment . The females of the nontreatment group ( control ) were instructed to maintain their normal daily activities . An 11-point numerical pain rating scale ( NPRS ) was used to assess pain during stair ascent and descent . The lower extremity functional scale ( LEFS ) and the anterior knee pain scale ( AKPS ) were used to assess function . The single-limb single hop test was also used as a functional outcome to measure preintervention and 4-week postintervention function . RESULTS The 3 groups were homogeneous prior to treatment in respect to demographic , pain , and functional scales data . Both the knee exercise and the knee and hip exercise groups showed significant improvement in the LEFS , the AKPS , and the NPRS , when compared to the control group ( P<.05 and P<.001 , respectively ) . But , when we considered minimal clinical ly important differences , only the knee and hip exercise group demonstrated mean improvements in AKPS and pain scores that were large enough to be clinical ly meaningful . For the single-limb single hop test , both groups receiving an intervention showed greater improvement than the control group , but there was no difference between the 2 interventions ( P>.05 ) . CONCLUSION Rehabilitation programs focusing on knee strengthening exercises and knee strengthening exercises supplemented by hip strengthening exercises were both effective in improving function and reducing pain in sedentary women with PFPS .  Improvements of pain and function were greater for the group that performed the hip strengthening exercises , but the difference was significant only for pain rating while descending stairs . LEVEL OF EVIDENCE Therapy , level 1b- STUDY DESIGN R and omized clinical trial . OBJECTIVES To compare the effects of functional stabilization training ( FST ) versus st and ard training on knee pain and function , lower-limb and trunk kinematics , trunk muscle endurance , and eccentric hip and knee muscle strength in women with patellofemoral pain . BACKGROUND A combination of hip- and knee-strengthening exercise may be more beneficial than quadriceps strengthening alone to improve pain and function in individuals with patellofemoral pain . However , there is limited evidence of the effectiveness of these exercise programs on the biomechanics of the lower extremity . METHODS Thirty-one women were r and omized to either the FST group or st and ard-training group .  Patients attended a baseline assessment session , followed by an 8-week intervention , and were reassessed at the end of the intervention and at 3 months after the intervention . Assessment measures were a 10-cm visual analog scale for pain , the Lower Extremity Functional Scale , and the single-leg triple-hop test . A global rating of change scale was used to measure perceived improvement . Kinematics were assessed during the single-leg squat . Outcome measures also included trunk endurance and eccentric hip and knee muscle strength assessment . RESULTS The patients in the FST group had less pain at the 3-month follow-up and greater global improvement and physical function at the end of the intervention compared to those in the st and ard-training group . Lesser ipsilateral trunk inclination , pelvis contralateral depression , hip adduction , and knee abduction , along with greater pelvis anteversion and hip flexion movement excursions during the single-leg squat , were only observed in the FST group after the intervention . Only those in the FST group had greater eccentric hip abductor and knee flexor strength , as well as greater endurance of the anterior , posterior , and lateral trunk muscles , after training . CONCLUSION An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was more beneficial in improving pain , physical function , kinematics , and muscle strength compared to a program of quadriceps-strengthening exercises alone CONTEXT Patellofemoral pain ( PFP ) is the most common injury in running and jumping athletes . R and omized controlled trials suggest that incorporating hip and core strengthening ( HIP ) with knee-focused rehabilitation ( KNEE ) improves PFP outcomes . However , no r and omized controlled trials have , to our knowledge , directly compared HIP and KNEE programs . OBJECTIVE To compare PFP pain , function , hip- and knee-muscle strength , and core endurance between KNEE and HIP protocol s after 6 weeks of rehabilitation . We hypothesized greater improvements in ( 1 ) pain and function , ( 2 ) hip strength and core endurance for patients with PFP involved in the HIP protocol , and ( 3 ) knee strength for patients involved in the KNEE protocol . DESIGN R and omized controlled clinical trial . SETTING Four clinical research laboratories in Calgary , Alberta ; Chicago , Illinois ; Milwaukee , Wisconsin ; and Augusta , Georgia . PATIENTS OR OTHER PARTICIPANTS Of 721 patients with PFP screened , 199 ( 27.6 % ) met the inclusion criteria ( 66 men [ 31.2 % ] , 133 women [ 66.8 % ] , age = 29.0 ± 7.1 years , height = 170.4 ± 9.4 cm , weight = 67.6 ± 13.5 kg ) . INTERVENTION(S ) Patients with PFP were r and omly assigned to a 6-week KNEE or HIP protocol . MAIN OUTCOME MEASURE(S ) Primary variables were self-reported visual analog scale and Anterior Knee Pain Scale measures , which were conducted weekly . Secondary variables were muscle strength and core endurance measured at baseline and at 6 weeks . RESULTS Compared with baseline , both the visual analog scale and the Anterior Knee Pain Scale improved for patients with PFP in both the HIP and KNEE protocol s ( P < .001 ) , but the visual analog scale scores for those in the HIP protocol were reduced 1 week earlier than in the KNEE group . Both groups increased in strength ( P < .001 ) , but those in the HIP protocol gained more in hip-abductor ( P = .01 ) and -extensor ( P = .01 ) strength and posterior core endurance ( P = .05 ) compared with the KNEE group . CONCLUSIONS Both the HIP and KNEE rehabilitation protocol s produced improvements in PFP , function , and strength over 6 weeks . Although outcomes were similar , the HIP protocol result ed in earlier resolution of pain and greater overall gains in strength compared with the KNEE protocol OBJECTIVE To compare the efficacy of posterolateral hip muscle strengthening versus quadriceps strengthening in reducing pain and improving health status in persons with patellofemoral pain ( PFP ) . DESIGN Comparative control trial . SETTING Rehabilitation facility . PARTICIPANTS Persons with a diagnosis of PFP ( N=36 ; 18 men , 18 women ) . INTERVENTIONS Patients were alternately assigned to a posterolateral hip muscle strengthening group ( 9 men and 9 women ) or a quadriceps strengthening group ( 9 men and 9 women ) . The posterolateral hip muscle strengthening group performed hip abductor and external rotator strengthening exercises , whereas the quadriceps strengthening group performed quadriceps strengthening exercises ( 3 times a week for 8wk ) . MAIN OUTCOME MEASURES Pain ( visual analog scale [ VAS ] ) and health status ( Western Ontario McMaster Universities 
    Output:
    
agent
Meta‐analyses showed no significant changes in strength for any of the interventions . •
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / AIM The role of hip muscles in the rehabilitation of patellofemoral pain syndrome has recently received interest . The aim of this study was to compare the efficiencies of hip exercises alongside knee exercises versus only knee exercises on pain , function , and isokinetic muscle strength in patients with this syndrome . MATERIAL S AND METHODS Fifty-five young female patients ( mean age : 34.1 ± 6.2 years ; mean BMI : 25.9 ± 3.9 kg/m2 ) with patellofemoral pain syndrome were included . The patients were r and omized into groups of hip- and -knee exercises and knee-only exercise programs for 6 weeks with a total of 30 sessions at the clinic . Both groups were evaluated before therapy , after 6 weeks of a supervised exercise program , and after 6 weeks of an at-home exercise program . The outcome measures were muscle strength , pain , and both subjective and objective function . RESULTS The improvements of the patients in the hip- and -knee exercise group were better than in patients of the knee-only exercise group in terms of scores of pain relief ( P < 0.001 ) and functional gain ( P = 0.002 ) after 12 weeks . CONCLUSION We suggest additional hip-strengthening exercises to patients with patellofemoral pain syndrome in order to decrease pain and increase functional status Patello-femoral pain syndrome ( PFPS ) is a common knee joint disability . The integration of hip soft tissue regimens are not always emphasized , although current literature implies that there is a significant relationship between the two and there is a lack of r and omized clinical trials to substantiate this relationship in clinical practice . A r and omized controlled assessor blinded trial was design ed to explore different rehabilitation programs related to PFPS . The study was conducted at RAZIEL institute of physical therapy , Netania , Israel with a total of 30 consecutive patients ( mean age 35y ) , diagnosed with PFPS . All patients were r and omly allocated into 3 groups . Group I conventional knee rehabilitation program . Included quadriceps strengthening and Trans Electric Neuromuscular Stimulation ( TENS ) . Group II hip oriented rehabilitation program . included stretching , Hip external rotators strengthening and TENS . Group III a combination of the two above programs .  Pain and function were documented on initial of the program and again 3 weeks later , on the completion . Pain was assessed by a numeric visual analogue scale ( VAS ) ; function was assessed by Patello-femoral joint evaluation scale ( PFJES ) ( 0 - 100 points ) . At end of trial , all groups showed significant improvements in VAS and PFJES ( p<0.0001 ) ; these improvements did not vary significantly between the 3 groups . The conclusions were that the explored different rehabilitation programs showed a similar beneficial effect STUDY DESIGN R and omized controlled trial . OBJECTIVES To determine if adding hip-strengthening exercises to a conventional knee exercise program produces better long-term outcomes than conventional knee exercises alone in women with patellofemoral pain syndrome ( PFPS ) . BACKGROUND Recent studies have shown that a hip-strengthening program reduces pain and improves function in individuals with PFPS . However , there are no clinical trials evaluating long-term outcomes of this type of program compared to conventional knee-strengthening and -stretching exercises . METHODS Fifty-four sedentary women between 20 and 40 years of age , with a diagnosis of unilateral PFPS , were r and omly assigned knee exercise ( KE ) or knee and hip exercise ( KHE ) .  The women in the KE group ( n = 26 ; mean age , 23 years ) performed a 4-week conventional knee-stretching and -strengthening program . The women in the KHE group ( n = 28 ; mean age , 22 years ) performed the same exercises as those in the KE group , as well as strengthening exercises for the hip abductors , lateral rotators , and extensors . An 11-point numeric pain rating scale , the Lower Extremity Functional Scale , the Anterior Knee Pain Scale , and a single-hop test were used as outcome measures at baseline ( pretreatment ) and 3 , 6 , and 12 months posttreatment . RESULTS At baseline , demographic , pain , and functional assessment data were similar between groups . Those in the KHE group had a higher level of function and less pain at 3 , 6 , and 12 months compared to baseline ( P<.05 ) . In contrast , the KE group had reduced pain only at the 3- and 6-month follow-ups ( P<.05 ) , without any changes in Lower Extremity Functional Scale , Anterior Knee Pain Scale , or hop testing ( P>.05 ) through the course of the study . Compared to the KE group , the KHE group had less pain and better function at 3 , 6 , and 12 months posttreatment ( P<.05 ) . For the Lower Extremity Functional Scale , the between-group difference in change scores from baseline at 3 , 6 , and 12 months posttreatment favored the KHE group by 22.0 , 22.0 , and 20.8 points , respectively . CONCLUSION Knee-stretching and -strengthening exercises supplemented by hip posterolateral musculature-strengthening exercises were more effective than knee exercises alone in improving long-term function and reducing pain in sedentary women with PFPS STUDY DESIGN R and omized clinical trial . OBJECTIVE To investigate the influence of strengthening the hip abductor and lateral rotator musculature on pain and function of females with patellofemoral pain syndrome ( PFPS ) . BACKGROUND Hip muscle weakness in women athletes has been the focus of many recent studies and is suggested as an important impairment to address in the conservative treatment of women with PFPS . However , it is still not well established if strengthening these muscles is associated with clinical improvement in pain and function in sedentary females with PFPS . METHODS Seventy females ( average±SD age , 25±07 years ) , with a diagnosis of unilateral PFPS , were distributed r and omly into 3 groups : 22 females in the knee exercise group , who received a conventional treatment that emphasized stretching and strengthening of the knee musculature ; 23 females in the knee and hip exercise group , who performed exercises to strengthen the hip abductors and external rotators in addition to the same exercises performed by those in the knee exercise group ; and of the 25 females who did not receive any treatment . The females of the nontreatment group ( control ) were instructed to maintain their normal daily activities . An 11-point numerical pain rating scale ( NPRS ) was used to assess pain during stair ascent and descent . The lower extremity functional scale ( LEFS ) and the anterior knee pain scale ( AKPS ) were used to assess function . The single-limb single hop test was also used as a functional outcome to measure preintervention and 4-week postintervention function . RESULTS The 3 groups were homogeneous prior to treatment in respect to demographic , pain , and functional scales data . Both the knee exercise and the knee and hip exercise groups showed significant improvement in the LEFS , the AKPS , and the NPRS , when compared to the control group ( P<.05 and P<.001 , respectively ) . But , when we considered minimal clinical ly important differences , only the knee and hip exercise group demonstrated mean improvements in AKPS and pain scores that were large enough to be clinical ly meaningful . For the single-limb single hop test , both groups receiving an intervention showed greater improvement than the control group , but there was no difference between the 2 interventions ( P>.05 ) . CONCLUSION Rehabilitation programs focusing on knee strengthening exercises and knee strengthening exercises supplemented by hip strengthening exercises were both effective in improving function and reducing pain in sedentary women with PFPS .  Improvements of pain and function were greater for the group that performed the hip strengthening exercises , but the difference was significant only for pain rating while descending stairs . LEVEL OF EVIDENCE Therapy , level 1b- STUDY DESIGN R and omized clinical trial . OBJECTIVES To compare the effects of functional stabilization training ( FST ) versus st and ard training on knee pain and function , lower-limb and trunk kinematics , trunk muscle endurance , and eccentric hip and knee muscle strength in women with patellofemoral pain . BACKGROUND A combination of hip- and knee-strengthening exercise may be more beneficial than quadriceps strengthening alone to improve pain and function in individuals with patellofemoral pain . However , there is limited evidence of the effectiveness of these exercise programs on the biomechanics of the lower extremity . METHODS Thirty-one women were r and omized to either the FST group or st and ard-training group .  Patients attended a baseline assessment session , followed by an 8-week intervention , and were reassessed at the end of the intervention and at 3 months after the intervention . Assessment measures were a 10-cm visual analog scale for pain , the Lower Extremity Functional Scale , and the single-leg triple-hop test . A global rating of change scale was used to measure perceived improvement . Kinematics were assessed during the single-leg squat . Outcome measures also included trunk endurance and eccentric hip and knee muscle strength assessment . RESULTS The patients in the FST group had less pain at the 3-month follow-up and greater global improvement and physical function at the end of the intervention compared to those in the st and ard-training group . Lesser ipsilateral trunk inclination , pelvis contralateral depression , hip adduction , and knee abduction , along with greater pelvis anteversion and hip flexion movement excursions during the single-leg squat , were only observed in the FST group after the intervention . Only those in the FST group had greater eccentric hip abductor and knee flexor strength , as well as greater endurance of the anterior , posterior , and lateral trunk muscles , after training . CONCLUSION An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was more beneficial in improving pain , physical function , kinematics , and muscle strength compared to a program of quadriceps-strengthening exercises alone CONTEXT Patellofemoral pain ( PFP ) is the most common injury in running and jumping athletes . R and omized controlled trials suggest that incorporating hip and core strengthening ( HIP ) with knee-focused rehabilitation ( KNEE ) improves PFP outcomes . However , no r and omized controlled trials have , to our knowledge , directly compared HIP and KNEE programs . OBJECTIVE To compare PFP pain , function , hip- and knee-muscle strength , and core endurance between KNEE and HIP protocol s after 6 weeks of rehabilitation . We hypothesized greater improvements in ( 1 ) pain and function , ( 2 ) hip strength and core endurance for patients with PFP involved in the HIP protocol , and ( 3 ) knee strength for patients involved in the KNEE protocol . DESIGN R and omized controlled clinical trial . SETTING Four clinical research laboratories in Calgary , Alberta ; Chicago , Illinois ; Milwaukee , Wisconsin ; and Augusta , Georgia . PATIENTS OR OTHER PARTICIPANTS Of 721 patients with PFP screened , 199 ( 27.6 % ) met the inclusion criteria ( 66 men [ 31.2 % ] , 133 women [ 66.8 % ] , age = 29.0 ± 7.1 years , height = 170.4 ± 9.4 cm , weight = 67.6 ± 13.5 kg ) . INTERVENTION(S ) Patients with PFP were r and omly assigned to a 6-week KNEE or HIP protocol . MAIN OUTCOME MEASURE(S ) Primary variables were self-reported visual analog scale and Anterior Knee Pain Scale measures , which were conducted weekly . Secondary variables were muscle strength and core endurance measured at baseline and at 6 weeks . RESULTS Compared with baseline , both the visual analog scale and the Anterior Knee Pain Scale improved for patients with PFP in both the HIP and KNEE protocol s ( P < .001 ) , but the visual analog scale scores for those in the HIP protocol were reduced 1 week earlier than in the KNEE group . Both groups increased in strength ( P < .001 ) , but those in the HIP protocol gained more in hip-abductor ( P = .01 ) and -extensor ( P = .01 ) strength and posterior core endurance ( P = .05 ) compared with the KNEE group . CONCLUSIONS Both the HIP and KNEE rehabilitation protocol s produced improvements in PFP , function , and strength over 6 weeks . Although outcomes were similar , the HIP protocol result ed in earlier resolution of pain and greater overall gains in strength compared with the KNEE protocol OBJECTIVE To compare the efficacy of posterolateral hip muscle strengthening versus quadriceps strengthening in reducing pain and improving health status in persons with patellofemoral pain ( PFP ) . DESIGN Comparative control trial . SETTING Rehabilitation facility . PARTICIPANTS Persons with a diagnosis of PFP ( N=36 ; 18 men , 18 women ) . INTERVENTIONS Patients were alternately assigned to a posterolateral hip muscle strengthening group ( 9 men and 9 women ) or a quadriceps strengthening group ( 9 men and 9 women ) . The posterolateral hip muscle strengthening group performed hip abductor and external rotator strengthening exercises , whereas the quadriceps strengthening group performed quadriceps strengthening exercises ( 3 times a week for 8wk ) . MAIN OUTCOME MEASURES Pain ( visual analog scale [ VAS ] ) and health status ( Western Ontario McMaster Universities 
    Output:
    