Journal of athletic training · 2026
Pain Intensity and Knee Extensor Strength Across Different Ranges of Motion During Knee Extension Exercise in Individuals With Patellofemoral Pain.
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Brilhante Ronieri M, Neves Lia M A, Nunes Ana K S, Silva Danilo De Oliveira, Almeida Gabriel P L
Аннотация
CONTEXT: Knee extensor weakness has been identified as one of the strongest risk factors for the development of patellofemoral pain (PFP), and strengthening exercises for the quadriceps are widely recommended to improve pain and function. However, conflicting biomechanical findings and small studies-often conducted in pain-free individuals-limit guidance on the optimal range of motion (ROM) for knee extension exercises in PFP. This uncertainty hinders clinical decision-making, despite knee extension being one of the most commonly prescribed exercises for this population.
OBJECTIVE: To compare pain intensity and knee extensor strength at different ROMs in individuals with PFP.
DESIGN: Cross-sectional study.
SETTING: Data were collected at the Human Movement Analysis Laboratory of the Federal University of Ceará between July and November 2024.
PATIENTS OR OTHER PARTICIPANTS: One hundred individuals with a clinical diagnosis of PFP were included.
MAIN OUTCOME MEASURES: Pain intensity assessed using the numeric pain rating scale (0-10) and knee extensor strength using an isokinetic dynamometer at ROMs of 90°-45°, 70°-25°, and 45°-0°.
RESULTS: Ninety-four percent of participants with PFP reported knee pain in at least 1 ROM. The 70°-25° ROM demonstrated greater pain intensity than the 45°-90° ROM (mean difference [MD] = 1, 95% CI = 0.4, 1.6). No significant differences in pain intensity were observed between 45°-0° and 90°-45°. Participants had lower knee extensor strength in the 45°-0° ROM than the 70°-25° (MD = -27.5, 95% CI = -32.6, -22.5) and 90°-45° (MD = -29.9, 95% CI = -32.6, -22.5) ROMs.
CONCLUSIONS: Knee pain during resisted knee extension is highly prevalent in individuals with PFP. Although the 70°-25° ROM elicited greater pain, the 45°-0° ROM produced lower torque. Clinicians may tailor the ROM during knee extension exercises based on symptom response and the balance between pain exacerbation and torque generation.
OBJECTIVE: To compare pain intensity and knee extensor strength at different ROMs in individuals with PFP.
DESIGN: Cross-sectional study.
SETTING: Data were collected at the Human Movement Analysis Laboratory of the Federal University of Ceará between July and November 2024.
PATIENTS OR OTHER PARTICIPANTS: One hundred individuals with a clinical diagnosis of PFP were included.
MAIN OUTCOME MEASURES: Pain intensity assessed using the numeric pain rating scale (0-10) and knee extensor strength using an isokinetic dynamometer at ROMs of 90°-45°, 70°-25°, and 45°-0°.
RESULTS: Ninety-four percent of participants with PFP reported knee pain in at least 1 ROM. The 70°-25° ROM demonstrated greater pain intensity than the 45°-90° ROM (mean difference [MD] = 1, 95% CI = 0.4, 1.6). No significant differences in pain intensity were observed between 45°-0° and 90°-45°. Participants had lower knee extensor strength in the 45°-0° ROM than the 70°-25° (MD = -27.5, 95% CI = -32.6, -22.5) and 90°-45° (MD = -29.9, 95% CI = -32.6, -22.5) ROMs.
CONCLUSIONS: Knee pain during resisted knee extension is highly prevalent in individuals with PFP. Although the 70°-25° ROM elicited greater pain, the 45°-0° ROM produced lower torque. Clinicians may tailor the ROM during knee extension exercises based on symptom response and the balance between pain exacerbation and torque generation.