Primerjava učinkov vadbe za izboljšanje zmogljivosti mišic kolka ali kolena pri pacientih s patelofemoralnim bolečinskim sindromom - pregled literature : diplomsko delo

Močnik, Domen (author), Palma, Polona (mentor), Vauhnik, Renata (reviewer)

Uvod: Patelofemoralni bolečinski sindrom (PFBS) je eden najpogostejših vzrokov bolečine v sprednjem delu kolena, ki se pojavlja predvsem pri telesno aktivni populaciji in pomembno vpliva na funkcijsko sposobnost posameznikov. Zanj je značilna retropatelarna ali peripatelarna bolečina brez jasno opredeljenih strukturnih sprememb, pri čemer na njegov nastanek lahko vpliva več biomehanskih in mišičnih dejavnikov. Kljub dokazanim pozitivnim učinkom vadbe na zmanjšanje bolečine in izboljšanje funkcije ostaja nejasno, ali je učinkovitejši pristop, usmerjen v krepitev mišic kolena ali kolka. Namen: Namen diplomskega dela je bil s pregledom literature analizirati prednosti vadbe za krepitev mišičnih skupin kolčnega sklepa v primerjavi s krepitvijo mišic kolenskega sklepa pri pacientih s PFBS. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom znanstvene literature. Iskanje je potekalo v podatkovni zbirki PubMed s ključnimi besedami: patellofemoral, knee, hip. V pregled so bile vključene randomizirane nadzorovane raziskave, ki so primerjale vadbo za mišice kolenskega in kolčnega sklepa pri pacientih s PFBS. Rezultati: V končno analizo je bilo vključenih šest randomiziranih nadzorovanih raziskav, v katerih je sodelovalo 639 preiskovancev s PFBS, pri katerih so simptomi trajali najmanj en mesec. Rezultati kažejo, da sta tako vadba za krepitev mišic kolenskega sklepa kot tudi vadba za krepitev mišic kolčnega sklepa privedli do statistično značilnega zmanjšanja bolečine ter izboljšanja funkcije in mišične jakosti. V štirih raziskavah med vadbenimi pristopi niso bile ugotovljene statistično značilne razlike, z izjemo dveh raziskav, kjer je bila vadba za mišice kolka ali kombinirana vadba za mišice kolena in kolka učinkovitejša predvsem pri zmanjševanju bolečine. Razprava in zaključek: Na podlagi pregleda literature lahko zaključimo, da tako vadba za krepitev mišic kolenskega sklepa kot tudi kolčnega sklepa učinkovito zmanjša bolečino ter izboljša funkcijo in mišično jakost pri pacientih s PFBS, pri čemer ni bila ugotovljena jasna prednost enega vadbenega pristopa pred drugim. Mišice kolčnega sklepa imajo pomembno vlogo pri nadzoru položaja spodnjega uda, saj preprečujejo prekomerno addukcijo in notranjo rotacijo med funkcionalnimi nalogami. Rezultati posameznih raziskav kažejo, da je lahko vadba za mišice kolka učinkovitejša v zgodnji fazi rehabilitacije pri zmanjševanju bolečine. V klinični praksi je zato smiselno vključevanje krepitve mišic kolka v programe za rehabilitacijo PFBS.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, patelofemoralni bolečinski sindrom, krepitev mišic, mišična jakost, kolk, koleno
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [D. Močnik]
• Year: 2026
• Number of pages: IX, 26 str.
• PID: 20.500.12556/RUL-183277
• UDC: 615.8
• COBISS.SI-ID: 281127171
• Publication date in RUL: 10.06.2026

Secondary language

• Language: English
• Title: Comparison of the effects of exercises aimed at improving hip or knee muscle performance in patients with patellofemoral pain syndrome: literature review : diploma work

Abstract

Introduction: Patellofemoral pain syndrome (PFPS) is one of the most common causes of anterior knee pain, predominantly affecting physically active individuals and significantly impacting functional ability. It is characterized by retropatellar or peripatellar pain without clearly defined structural changes, and its development can be influenced by various biomechanical and muscular factors. Despite the documented positive effects of exercise on pain reduction and functional improvement, it remains unclear whether strengthening of the knee or hip musculature is the more effective approach. Purpose: The purpose of this thesis was to analyze, through a literature review, the advantages of hip muscle strengthening compared to knee muscle strengthening in patients with PFPS. Methods: A descriptive method was used, based on a review of scientific literature. The literature search was conducted in the PubMed database using the keywords: patellofemoral, knee, hip. Randomized controlled trials comparing knee and hip strengthening exercises in patients with PFPS were included in the review. Results: A total of six randomized controlled trials involving 639 patients with PFPS, with symptoms lasting at least one month, were included in the final analysis. The results indicate that both knee and hip strengthening exercises led to statistically significant reductions in pain and improvements in function and muscle strength. In four studies, no statistically significant differences were found between the two approaches, although two studies reported greater effectiveness of hip or combined training, particularly in reducing pain. Discussion and conclusion: Based on the reviewed literature, both knee and hip strengthening exercises are effective in reducing pain and improving function and muscle strength in patients with PFPS, with no clear superiority of one approach, indicating comparable effectiveness. Hip joint muscles play an important role in controlling the position of the lower limb, as they prevent excessive adduction and internal rotation during functional tasks. Results of individual studies suggest that hip strengthening may be more effective in the early phase of rehabilitation for pain reduction. Therefore, incorporating hip strengthening into rehabilitation programs for PFPS is recommended in clinical practice.

• Keywords: diploma theses, physiotherapy, patellofemoral pain syndrome, muscle strengthening, muscle strength, hip, knee