2. Wimbledon Clinics, Wimbledon, London, UK.
3. Department of Medical Physics and Clinical Engineering, St George's Healthcare NHS Trust, London, UK.
Background: Recent discussions have compared the use of closed-chain and open-chain kinetic exercises in the management of patellofemoral pain. Literature shows disparity over the preferred method. While the clinical effectiveness of the two different approaches has been compared, there is no information in the literature on the effect of these exercise types on the vasti muscles of the thigh. This study compared the impact of open-chain and closed-chain exercise regimes on the architecture of the vastus medialis oblique.
Methods: Vastus medialis oblique architecture was measured using ultrasound in 23 young, asymptomaticvolunteers. Matched subjects were then assigned to one of two six-week exercise programmes, using either closed-chain or open-chain kinetic exercises.
Results: Both groups showed a significant increase in mean vastus medialis oblique fibre angle, (from 70.27° to 74.5° [OCKE], and 67.5° to 73.0° [CCKE], p<0.001); insertion length (from 21.26 mm to 25.98 mm [OCKE], and 17.05 mm to 22.23 mm [CCKE]. p<0.001); and insertion ratio (from 41.0% to 48.46% [OCKE] and 32.0% to 41.57% [CCKE], p<0.001) following 6 weeks of both open-chain and closed-chain exercises. However, no significant difference was found between the two groups.
Conclusions: The results of this study suggest that both open-chain and closed-chain exercise regimes have an equal effect on the architecture of the vastus medialis oblique after six weeks of exercise therapy.
Keywords: Vastus medialis, exercise therapy, patellofemoral pain, ultrasound