The immediate effect of lumbopelvic manipulation on EMG of vasti and gluteus medius in athletes with patellofemoral pain syndrome: A randomized controlled trial

• Lubmopelvic manipulation improved the EMG activity of vastus medialis and gluteus medius.
• Improvement was observed in step-down test and pain intensity after manipulation.
• Lumbopelvic manipulation might be considered in the management of PFPS.

ObjectiveTo evaluate the immediate effect of lubmopelvic manipulation on EMG activity of vastus medialis, vastus lateralis and gluteus medius as well as pain and functional performance of athletes with patellofemoral pain syndrome.DesignRandomized placebo-controlled trial.MethodsTwenty eight athletes with patellofemoral pain syndrome were randomly assigned to two groups. One group received a lubmopelvic manipulation at the side of the involved knee while the other group received a sham manipulation. EMG activity of the vasti and gluteus medius were recorded before and after manipulation while performing a rocking on heel task. The functional abilities were evaluated using two tests: step-down and single-leg hop. Additionally, the pain intensity during the functional tests was assessed using a visual analog scale.ResultsThe onset and amplitude of EMG activity from vastus medialis and gluteus medius were, respectively, earlier and higher in the manipulation group compared to the sham group. There were no significant differences, however, between two groups in EMG onset of vastus lateralis. While the scores of one-leg hop test were similar for both groups, significant improvement was observed in step-down test and pain intensity in the manipulation group compared to the sham group.ConclusionsLubmopelvic manipulation might improve patellofemoral pain and functional level in athletes with patellofemoral pain syndrome. These effects could be due to the changes observed in EMG activity of gluteus medius and vasti muscles. Therefore, the lubmopelvic manipulation might be considered in the rehabilitation protocol of the athletes with patellofemoral pain syndrome.