臺灣博碩士論文加值系統

髕股骨疼痛症候群(PFPS)通常是因為股內側肌和股外側肌的功能失衡所致。然而在臨床實驗中尚未確定將髖內收肌與動態閉鎖運動鏈運動相結合是否會影響下 肢肌肉電位訊號需要更多研究證明，本研究目的是探討髖內收動態閉鎖鏈運動治療對髕股骨疼痛症候群患者股內側肌的影響。試驗徵召16位髕股骨疼痛症候群受測者(13位女性及3位男性)，並將受測者隨機分派至髖內收下蹲運動組以及下蹲運動組二組，以無線肌電圖系統、無線動作分析系統以及Noraxon MyoResearch 3軟體分別記錄在下蹲、下蹲夾球、上下樓梯三項測驗對肌電訊號、VMO/VL肌電比值以及肌肉電位起動時間程度評比。研究結果：執行下蹲動作中，髖內收下蹲運動組的VMO/VL比值以及下蹲運動組的股內側肌訓練前、後有顯著差異(p<.05)；執行下蹲夾球動作中，髖內收下蹲運動組的髖內收肌、VMO/VL比值、股內側肌電位啟動時間以及下蹲運動組的股內側肌訓練前、後有顯著差異(p<.05)；在上下樓梯動作中，下蹲運動組的下樓梯髖內收肌訓練前、後有顯著差異(p<.05)。結果發現髖內收下蹲運動組並沒有選擇性加強股內側肌，為了訓練肌肉力量，下蹲運動訓練對於股四頭肌的股內側肌力量比髖內收下蹲運動更有效。由研究結果得知，髖內收下蹲運動組以及下蹲運動組二組之訓練成果不盡相同，相關研究結果將可以提供未來在髖內收下蹲動作與下蹲動作之運動預測及復健設計之參考。

Patellofemoral pain syndrome (PFPS) was commonly due to the functional imbalance of the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles. Moreover, in clinical practices, it has not been determined if combining hip adductor (ADD) with a dynamic closed chain exercise affects the activity of the lower limbs’ electromyography. Therefore, the purpose of this study was to investigate the effects of dynamic closed kinetic chain exercise combining with hip adduction on the VMO muscle in patients with PFPS. Sixteen patients with PFPS (13 females and 3 males) were recruited, and they were randomly divided into to two treatment groups: Squat with hip adduction exercise group (Squat-HA) and squat exercise group (Squat-NHA). All subjects were asked to perform the squat exercise, squat with hip adduction exercise and up and down the stairs exercise before and after 8-week training program. An electromyography system (Noraxon DTS, U.S.A) was applied to measure the electric activities of muscles including vastus medialis oblique (VMO), vastus lateralis (VL) and hip adductor (ADD). The relevant data processing was used the software of Noraxon MyoResearch 3.The results showed that during squat exercise test, the magnitude of VMO/VL ratio pre-after training was significant difference for squat-HA group and the VMO muscle for squat-NHA group (p<.05). During squat with hip adduction exercise test, the magnitude of the ADD muscle, VMO/VL ratio and VMO’s onset time pre-after training were significant difference for squat-HA group and the VMO muscle for squat-NHA group (p<.05). During up and down the stairs exercise test, the magnitude of the ADD muscle pre-after training was significant difference for squat-NHA group (p<.05).Research result showed squat with hip adduction exercise can’t more increase the VMO muscle of the quadriceps. To training muscle strength, squat exercise was more effective for promoting the VMO muscle strength of the quadriceps than squat with hip adduction exercise.According to the research results, the exercise training results of the Squat-HA group and the Squat-NHA group are not the same, and research results will provide future reference for the prediction and rehabilitation design of squat with hip adduction and squat exercise.

中文摘要 I
英文摘要 II
致 謝 IV
目 錄 V
表目錄 VIII
圖目錄 IX
第一章 緒論 1
1.1研究背景與動機 1
1.2研究目的 2
1.3研究架構 3
1.4研究限制 5
第二章 文獻探討 6
2.1髕股骨疼痛症候群 6
2.2髕股關節之構造及生物力學 7
2.2.1髕股關節功用 7
2.2.2髕股關節之作用力與壓力 9
2.2.3髕股關節之股四頭肌重要性 9
2.3髕股骨疼痛症候群臨床診斷與評估 11
2.3.1肌肉電位訊號 11
2.3.2步態特徵 13
2.3.3 Q角度 14
2.3.4髕骨疼痛症候群疼痛嚴重評估 16
2.4髕股骨疼痛症候群治療與運動處方 17
2.4.1閉鎖運動鏈運動和開放運動鏈運動 17
2.4.2下蹲運動訓練 19
2.4.3髖內收運動訓練 20
2.5 小結 21
第三章 研究方法 22
3.1受測者 22
3.2 實驗設計 24
3.2.1自變項 24
3.2.2依變項 24
3.2.3控制變因 27
3.3實驗設備 28
3.3.1主要硬體設備 28
3.3.2主要軟體設備 29
3.4實驗流程 30
3.5資料分析與處理 37
第四章 研究結果 38
4.1受測者基本資料 38
4.2髖內收下蹲運動組及下蹲運動組在下蹲動作之評估 39
4.2.1髖內收下蹲運動組及下蹲運動組在下蹲動作前後測之影響 39
4.2.2髖內收下蹲運動組及下蹲運動組在下蹲動作前、後測變異數分析 41
4.3髖內收下蹲運動組及下蹲運動組在下蹲夾球動作之評估 44
4.3.1髖內收下蹲運動組及下蹲運動組在下蹲夾球動作前、後測影響 44
4.3.2髖內收下蹲運動組及下蹲運動組在下蹲夾球動作前、後測變異數分析 46
4.4髖內收下蹲運動組及下蹲運動組在上下樓梯動作之評估 50
4.4.1髖內收下蹲運動組及下蹲運動組在上下樓梯動作前、後測影響 50
4.4.2髖內收下蹲運動組及下蹲運動組在上下樓梯前、後測變異數分析 52
4.5啟動時間對髖內收下蹲運動組及下蹲運動組之影響 54
4.5.1髖內收下蹲運動組及下蹲運動組在下蹲動作的啟動時間前、後測影響54
4.5.2髖內收下蹲運動組及下蹲運動組在下蹲夾球動作的啟動時間前、後測影響 55
第五章 討論 57
5.1髖內收下蹲運動組及下蹲運動組在下蹲動作前後測之影響 57
5.2髖內收下蹲運動組及下蹲運動組在下蹲夾球動作前後測之影響 58
5.3髖內收下蹲運動組及下蹲運動組在上下樓梯動作前後測之影響 59
5.4啟動時間對髖內收下蹲運動組及下蹲運動組之影響 60
第六章 結論與建議 61
6.1結論 61
6.2建議 63
參考文獻 64
附 錄 一 79
附 錄 二 84

1.Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA (2002). Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil, 81:807-813.
2.Amis AA (2007). Current concepts on anatomy and biomechanics of patellar stability. Sports Med Arthrosc, 15:48-56.
3.Andriacchi TP, Andersson GB, Fermier RW, Stern D, Galante JO (1980). A study of lower-limb mechanics during stair-climbing. J Bone Joint Surg, 62:749-757.
4.Asplund DJ, Hall SJ (1995). Kinematics and myoelectric activity during stair-climbing ergometry. J Orthop Sports Phys Ther, 22:247-253.
5.Aglietti P, Insall JN, Cerulli G (1983). Patellar pain and incongruence. I : Measurements of incongruence. Clin Orthop Relat Res, 176:217-224.
6.Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A (2010). Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports, 20:725-730.
7.Boling M, Padua D, Blackburn JT, Petschauer M, Hirth C (2006). Hip adduction does not affect VMO EMG amplitude or VMO : VL ratios during a dynamic squat exercise. J Sport Rehabil, 15:195-205.
8.Bizzini M, Childs JD, Piva SR, Delitto A (2003). Systematic review of the quality of randomized controlled trials for patellofemoral pain syndrome. J Orthop Sports Phys Ther, 33:4-20.
9.Bolgla LA, Boling MC (2011). An update for the conservative management of patellofemoral pain syndrome : a systematic review of the literature from 2000 to 2010. Int J Sports Phys Ther, 6:112-125.
10.Basmajian JV, Blumenstein R (1980). Electrode placement in EMG biofeedback. Baltimore, Md : Williams & Wilkins.
11.Brattström H (1964). Shape of the intercondylar groove normally and in recurrent dislocation of patella. Acta Orthop Scand Suppl, 68:1-148.
12.Bynum EB, Barrack RL, Alexander AH (1995). Open versus closed chain kinetic exercises after anterior cruciate ligament reconstruction : a prospective randomized study. Am J Sports Med, 23:401-406.
13.Brownstein BA, Lamb RL, Mangine RE (1985). Quadriceps torque and integrated electromyography. J Orthop Sports Phys Ther, 6:309-314.
14.Brunet ME, Stewart GW (1989). Patellofemoral rehabilitation. Clin Sports Med, 8:319-329.
15.Beck JL, Wildermuth BP (1985). The female athlete’s knee. Clin Sports Med, 4: 345-366.
16.Bose K, Kanagasuntheram R, Osman MBH (1980). Vastus medialis oblique : an anatomical and physiological study. Orthopedics, 3:880-883.
17.Crossley K, Bennell K, Green S, Cowan S, McConnell J (2002). Physical therapy for patellofemoral pain : a randomized, double-blinded, placebo-controlled trial. Am J Sports Med, 30:857-865.
18.Crossley KM, Cowan SM, Bennell KL, McConnell J (2004). Knee flexion during stair ambulation is altered in individuals with patellofemoral pain. J Orthop Res, 22:267-274.
19.Cutbill JW, Ladly KO, Bray RC, Thorne P , Verhoef M (1997). Anterior knee pain : a review. Clin J Sport Med, 7:40-45.
20.Collado H, Fredericson M (2010). Patellofemoral pain syndrome. Clin Sports Med, 29:379-398.
21.Callaghan MJ, McCarthy CJ, Oldham JA (2001). Electromyographic fatigue characteristics of the quadriceps in patellofemoral pain syndrome. Man Ther, 6:27-33.
22.Cavazzuti L, Merlo A, Orlandi F, Campanini I (2010). Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Gait Posture, 32:290-295.
23.Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J (2001). Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil, 82:183-189.
24.Chesworth BM, Culham EG, Tata GE, Peat M (1989). Validation of outcome measures in patients with patellofemoral syndrome. J Orthop Sports Phys Ther, 10:302-308.
25.Callaghan MJ, Oldham JA (1996). The role of quadriceps exercise in the treatment of patellofemoral pain syndrome. Sports Med, 21:384-391.
26.Coqueiro KRR, Bevilaqua-Grossi D, Bérzin F, Soares AB, Candolo C, Monteiro-Pedro V (2005). Analysis on the activation of the VMO and VLL muscles during semisquat exercises with and without hip adduction in individuals with patellofemoral pain syndrome. J Electromyogr Kinesiol, 15:596-603.
27.Cerny K (1995). Vastus medialis oblique/vastus lateralis muscle activity ratios for selected exercises in persons with and without patellofemoral pain syndrome. Phys Ther, 75:672-683.
28.Choi B, Kim M, Jeon HS (2011). The effects of an isometric knee extension with hip adduction (KEWHA) exercise on selective VMO muscle strengthening. J Electomyogr Kinesiol, 21:1001-1016.
29.Devereaux MD, Lachmann SM (1984). Patello-femoral arthralgia in athletes attending a Sports Injury Clinic. Br J Sports Med, 18:18-21.
30.DeHaven KE, Lintner DM (1986). Athletic injuries : comparison by age, sport, and gender. Am J Sports Med, 14:218-224.
31.Dehaven KE, Dolan WA, Mayer PJ (1979). Chondromalacia patellae in athletes : Clinical presentation and conservative management. Am J Sports Med, 7:5-11.
32.Decker MJ, Torry MR, Wyland DJ, Sterett WI, Richard Steadman J (2003). Gender differences in lower extremity kinematics, kinetics and energy absorption during landing. Clin Biomech (Bristol, Avon), 18:662-669.
33.Dunbar CC, Robertson RJ, Baun R, Blandin MF, Metz K, Burdett R, Goss FL (1992). The validity of regulating exercise intensity by ratings of perceived exertion. Med Sci Sports Exerc, 24:94-99.
34.Dixit S, Difiori JP, Burton M, Mines B (2007). Management of patellofemoral pain syndrome. Am Fam Physician, 75:194-202.
35.Dillon PZ, Updyke WF, Allen WC (1983). Gait analysis with reference to chondromalacia patellae. J Orthop Sports Phys Ther, 5:127-131.
36.Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA (1978). Studies with pain rating scales. Ann Rheum Dis, 37:378-381.
37.Doucette SA, Child DD (1996). The effect of open and closed chain exercise and knee joint position on patella tracking in lateral patellar compression syndrome. J Orthop Sports Phys Ther, 23:104-110.
38.Earl JE, Vetter CS (2007). Patellofemoral pain. Phy Med Rehabil Clin N Am, 18:439-458.
39.Earl JE, Schmitz RJ, Arnold BL (2001). Activation of the VMO and VL during dynamic mini-squat exercises with and without isometric hip adduction. J Electromyogr Kinesiol, 11:381-386.
40.Emami MJ, Ghahramani MH, Abdinejad F, Namazi H (2007). Q-angle : an invaluable parameter for evaluation of anterior knee pain. Arch Iran Med, 10: 24-26.
41.Eng JJ, Pierrynowski MR (1993). Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. Phys Ther, 73:62-70.
42.Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR (1998). Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Med Sci Sports Exerc, 30:556-569.
43.Escamilla RF, Flesig GS, Lowry TM, Barrentine SW, Andrews JR (2001). A three-dimensional biomechanical analysis of the squat during varying stance widths. Med Sci Sports Exerc, 33:984-998.
44.Fredericson M, Powers CM (2002). Practical management of patellofemoral pain. Clin J Sport Med, 12:36-38.
45.Ficat RP, Hungerford DS (1977). Disorders of the patello-femoral joint. Baltimore, Md : Williams & Wilkins.
46.France L, Nester C (2001). Effect of errors in the identification of anatomical landmarks on the accuracy of Q angle values. Clin Biomech, 16:710-713.
47.Fulkerson JP (2002). Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med ,30:447-456.
48.Giles LS, Webster KE, McClelland JA, Cook J (2013). Does quadriceps atrophy exist in individuals with patellofemoral pain? A systematic literature review with meta-analysis. J Orthop Sports Phy Ther, 43:766-776.
49.Gerbino PG, Griffin ED, d’Hemecourt PA, Kim T, Kocher MS, Zurakowski D, Micheli LJ (2006). Patellofemoral pain syndrome : evaluation of location and intensity of pain. Clin J Pain, 22:154-159.
50.Grelsamer RP, Weinstein CH (2001). Applied biomechanics of the patella. Clin Orthpd Relat Res, 389:9-14.
51.Grelsamer RP, Klein JR(1998). The biomechanics of the patellofemoral joint. J Orthop Sports Phys Ther, 28:286-298.
52.Goh JC, Lee PY, Bose K (1995). A cadaver study of the function of the oblique part of vastus medialis. J Bone Joint Surg, 77:225-231.
53.Gilleard W, McConnell J, Parsons D (1998). The effect of patellar taping on the onset of vastus medialis obliquus and vastus lateralis muscle activity in persons with patellofemoral pain. Phys Ther, 78:25-32.
54.Ghoussayni S, Stevens C, Durham, S, Ewins D (2004). Assessment and validation of a simple automated method for the detection of gait events and intervals. Gait Posture, 20:266-272.
55.Green ST (2005). Patellofemoral syndrome. J Bodyw Mov Ther, 9:16-26.
56.Grabiner MD, Koh RJ, Miller GF (1991). Fatigue rates of the vastus medialis oblique and vastus lateralis during static and dynamic knee extension. J Orthop Res, 9:391-397.
57.Hyong IH (2015). Effects of squats accompanied by hip joint adduction on the selective activity of the vastus medialis oblique. J Phys Ther Sci, 27:1979-1981.
58.Horton MG, Hall TL (1989). Quadriceps femoris muscle angle : normal values and relationships with gender and selected skeletal measures. Phys Ther , 69:897-901.
59.Herrington L, Payton CJ (1997). Effects of corrective taping of the patella on patients with patellofemoral pain. Physiotherapy, 83:566-572.
60.Herrington L, Pearson S (2006). Does level of load affect relative activation levels of vastus medialis oblique and vastus lateralis? J Electromyogr Kinesiol, 16:379-383.
61.Herrington L (2013). Does the change in Q angle magnitude in unilateral stance differ when comparing asymptomatic individuals to those with patellofemoral pain? Phys Ther Sport, 14:94-97.
62.Hubbard JK, Sampson HW, Elledge JR (1998). The vastus medialis oblique muscle and its relationship to patellofemoral joint deterioration in human cadavers. J Orthop Sports Phys Ther, 28:384-391.
63.Hehne HJ (1990). Biomechanics of the patellofemoral joint and its clinical relevance. Clin Orthop:73-85.
64.Harms-Ringdahl K, Carlsson AM, Ekholm J, Raustorp A, Svensson T, Toresson HG (1986). Pain assessment with different intensity scales in response to loading of joint structures. Pain, 27:401-411.
65.Harrison E, Quinney H, Magee D, Sheppard MS, McQuarrie A (1995). Analysis of outcome measures used in the study of patellofemoral pain syndrome. Physiother Can, 47:264-272.
66.Hungerford DS, Barry M (1979). Biomechanics of the patellofemoral joint. Clin Orthop Relat Res, 144:9-15.
67.Huberti HH, Hayes WC (1984). Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg Am, 66:715-724.
68.Hanten WP, Schulthies SS (1990). Exercise effect on electromyographic activity of the vastus medialis oblique and vastus lateralis muscles. Phys Ther, 70:561-565.
69.Hodges PW, Richardson CA (1993). The influence of isometric hip adduction on quadriceps femoris activity. Scand J Rehabil Med, 25:57-62.
70.Irish SE, Millward AJ, Wride J, Haas BM, Shum GL (2010). The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. J Strength Cond Res, 24:1256-1262.
71.Insall J (1982). Current concepts review: patellar pain. J Bone Joint Surg Am, 64:147-152.
72.Jan MH, Lin DH, Lin JJ, Lin CH, Cheng CK, Lin YF (2009). Differences in sonographic characteristics of the vastus medialis obliquus between patients with patellofemoral pain syndrome and healthy adults. Am J Sports Med, 37:1743-1749.
73.Kramer PG (1986). Patella malalignment syndrome: rationale to reduce excessive lateral pressure. J Orthop Sports Phys Ther, 8:301-309.
74.Karst GM, Jewett PD (1993). Electromyographic analysis of exercises proposed for differential activation of medial and lateral quadriceps femoris muscle components. Phys Ther, 73:286-295.
75.Koh EK, Lee KH, Jung DY (2011). The effect of isometric hip adduction and abduction on the muscle activities of the vastus medialis oblique and vastus lateralis during leg squat exercise. Korean J Sport Biomechanies, 21:361-368.
76.LaBella C (2004). Patellofemoral pain syndrome : evaluation and treatment. Prim Care, 31:977-1003.
77.Lieb FJ, Perry J (1968). Quadriceps function : an anatomical and mechanical study using amputated limbs. J Bone Joint Surg, 50:1535-1548.
78.Lin F, Wang G, Koh JL, Hendrix RW, Zhang LQ (2004). In vivo and noninvasive three-dimensional patellar tracking induced by individual heads of quadriceps. Med Sci Sports Exer, 36:93-101.
79.Larsson LE, Odenrick P, Sandlund B, Weitz P, Oberg PA (1980). The phases of the stride and their interaction in human gait. Scand J Pehabil Med 12:107-112.
80.Laprade J, Culham E, Brouwer B (1998). Comparison of five isometric exercises in the recruitment of the vastus medialis oblique in persons with and without patellofemoral pain syndrome. J Orthop Sports PhysTher, 27:197-204.
81.Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE (2001). A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech, 16:438-445.
82.Mohr KJ, Kvitne RS, Pink MM, Fideler B, Perry J (2003). Electromyography of the quadriceps in patellofemoral pain syndrome with patellar subuxation. Clin Orthop Relat Res, 415:261-271.
83.Mirzabeigi E, Jordan C, Gronley JK, Rockowitz NL, Perry J (1999). Isolation of the vastus medialis oblique muscle during exercise. Am J Sports Med, 27:50-53.
84.Makhsous M, Lin F, Koh JL, Nuber GW, Zhang LQ (2004). In vivo and noninvasive load sharing among the vasti in patellar malalignment. Med Sci Sports Exerc, 36:1768-1775.
85.Nadeau S, Gravel D, Hebert LF, Arsenault AB, Lepage Y (1997). Gait study of patients with patellofemoral pain syndrome. Gait Posture, 5:21-27.
86.Nakagawa TH, Muniz TB, Baldon Rde M, Dias Maciel C, de Menezes Reiff RB, Serrao FV (2008). The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome : a randomized controlled pilot study. Clin Rehabil, 22:1051-1060.
87.Oakes JL, McCandless P, Selfe J (2009). Exploration of the current evidence base for the incidence and prevalence of patellofemoral pain syndrome. Phys apy Rev, 14:382-387.
88.Olerud C, Berg P (1984). The variation of the Q angle with different positions of the foot. Clin Orthop Relat Res, 191:162-165.
89.Powers CM (2010). The influence of abnormal hip mechanics on knee injury : a biomechanical perspective. J Orthop Sports Phys Ther, 40:42-51.
90.Powers CM (2003). The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: A theoretical perspective. J Orthop Sports Phys Ther, 33:639-646.
91.Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG (2003). Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella : a preliminary study. J Orthop Sports Phys Ther, 33:677-685.
92.Pappas IP, Popovic MR, Keller T, Dietz V, Morari M (2001). A reliable gait phase detection system. IEEE Trans, Rehabil, Eng, 9:113-125.
93.Perry J, Burnfield J (1992). Gait Analysis : Normal and Pathological Function. Thorofare, NJ, SlackInc.
94.Price DD, McGrath PA, Rafii A, Buckingham B (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17:45-56.
95.Quilty B, Tucker M, Campbell R, Dieppe P (2003). Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement : randomized controlled trial. J Rheumatol, 30: 1311-1317.
96.Reid DC (1993). The myth, mystic and frustration of anterior knee pain. Clin J Sport Med, 3:139-143.
97.Reynolds L , Levin TA , Medeiros JM , Adler NS , Hallum A (1983). EMG activity of the vastus medialis oblique and the vastus lateralis in their role in patellar alignment. Am J Phys Med, 62:61-70.
98.Raimondo RA, Ahmad CS, Blankevoort L, April EW, Grelsamer RP, Henry JH (1998). Patellar stabilization : a quantitative evaluation of the vastus medialis obliquus muscle. Orthopedics, 21:791-795.
99.Sakai N, Luo ZP, Rand JA, An KN (2000). The influence of weakness in the vastus medialis oblique muscle on the patellofemoral joint : an in vitro biomechanical study. Clin Biomech, 15:335-339.
100.Sykes K, Wong YM (2003). Electrical activity vastus medialis oblique muscle in straight leg raise exercise with different angle of hip rotation. Physiotherapy 89:423-430.
101.Souza DR, Gross MT (1991). Comparison of vastus medialis obliquus : vastus lateralis muscle integrated electromyographic ratios between healthy subjects and patients with patellofemoral pain. Phys Ther, 71:310-320.
102.Salsich GB, Brechter JH, Powers CM (2001). Lower extremity kinetics during stair ambulation in patients with and without patellofemoral pain. Clin Biomech, 16:906-912.
103.Scott J, Huskisson EC (1976). Graphic representation of pain. Pain, 2:175-184.
104.Stratford P (1982). The validation of outcome measures in patients fulfilling the clinical diagnostic criteria of chondromalacia patellae. Annual Congress of the Canadian Physiotherapy Association, June, Halifax, Novia Scotia.
105.Stendotter A, Hodges P, Mellor R, Sundelin G, Häger-Ross C (2003). Quadriceps activation in closed and in open kinetic chain exercise. Med Sci Sports Exerc, 35: 2043-2047.
106.Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB (1996). A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther, 24:136-142.
107.Stensdotter AK, Hodges P, Ohberg F, Häger-Ross C (2007). Quadriceps EMG in open and closed kinetic chain tasks in women with patellofemoral pain. J Motor Behav, 39:194-202.
108.Schoenfeld BJ (2010). Squatting kinematics and kinetics and their application to exercise performance. J Strength Cond Res, 24:3497-3506.
109.Saeterbakken AH, Fimland MS (2013). Muscle force output and electromyographic activity in squats with various unstable surfaces. J Strength Cond Res, 27:130-136.
110.Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP (2006). The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med, 34:630-636.
111.Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD (2002). A retrospective case-control analysis of 2002 running injuries. J Sports Med, 36:95-101.
112.Thomee R (1997). A comprehensive treatment approach for patellofemoral pain syndrome in young women. Phys Ther, 77:1690-1703.
113.Thomee R, Augustsson J, Karlsson J (1999). Patellofemoral pain syndrome : a review of current issues. Sports Med, 28:245-262.
114.Thomee R, Grimby G, Wright BD, Linacre JM (1995). Rasch analysis of Visual Analog Scale measurements before and after treatment of Patellofemoral Pain Syndrome in women. Scand J Rehabil Med, 27:145-151.
115.Tecklenburg K, Dejour D, Hoser C, Fink C (2006). Bony and cartilaginous anatomy of the patellofemoral joint. Knee Surg Sports Traumatol Arthrosc, 14:235-240.
116.Taskiran E, Dinedurga Z, Yagiz A, Uludag B, Ertekin C, Lok V (1998). Effect of the vastus medialis obliquus on the patellofemoral joint. Knee Surg Sports Traumatol Arthrosc, 6:173-180.
117.Timm KE (1998). Randomized controlled trial of Protonics on patellar pain, position, and function. Med Sci Sports Exer, 30:665-670.
118.Tang SFT, Chen CK, Hsu R, Chou SW, Hong WH, Lew HL (2001). Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome : an electromyographic study. Arch Phys Med Rehabil, 82:1441-1445.
119.Waryasz GR, McDermott AY (2008). Patellofemoral pain syndrome (PFPS) : a systematic review of anatomy and potential risk factors. Dyn Med 7:9.
120.Winter DA (1980). Overall principle of lower limb support during stance phase of gait. J Biomech, 13:923-927.
121.Witvrouw E, Werner S, Mikkelsen C, Van Tiggelen D, Vanden Berghe L (2005). Clinical classifiaction of patellofemoral pain syndrome : guidelines for non-operative treatment. Knee Surg Sports Traumatol Arthrosc, 13:122-130.
122.Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G (2000). Intrinsic risk factors for the development of anterior knee pain in an athletic population : a two-year prospective study. Am J Sports Med, 28:480-489.
123.Wilk KE, Reinold MM (2001). Principles of patellofemoral rehabilitation. Sports Med Arthosc, 9:325-336.
124.Zijsltra W, Aminian K (2007). Mobility assessment in older people : New possibilities and challenges. Eur. J. Aging, 4:3-12.
125.Zakaria D, Harburn KL, Kramer JF (1997). Preferential activation of the vastus medialis oblique, vastus lateralis, and hip adductor muscles during isometric exercises in females. J Ortho Sports Phys Ther, 26:23-28.