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Analyze whether the effects of lower limb resistance training on pain and self-reported function were associated with the exercise volume prescribed for women with patellofemoral pain (PFP). A systematic search was undertaken in four databases from inception to May 2023. Eligible trials examined the effects of resistance training programs on pain (visual analogue scale or numerical pain scale) and function (Anterior Knee Pain Scale) in women with PFP. Meta-analysis was undertaken with a random-effects model. The association of resistance training volume-related variables with mean difference effects on pain and function were tested by exploratory univariable meta-regression models. From 1,404 estudies retained for screening after duplicate removals, 16 studies (579 patients) were included. Changes in knee pain were inversely associated with weekly training frequency (β = 0.5 ± 0.2, P = 0.012). No associations were found between the amount of resistance exercise prescribed per session or per week and effects on pain. Changes in function were associated with the number of sets per week (β = 0.1 ± 0.1, P = 0.044) and number of sets per session (β = 0.6 ± 0.2, P < 0.001) over the intervention. Most favorable results were achieved with 17 to 27 sets per session and >45 sets per week. The amount of prescribed resistance exercise does not seem to be critical for pain reduction in women with PFP. However, our findings support a dose-response effect in terms of improving function. •Pain reduction had no clear association with the amount of resistance exercise.•There was a dose-response effect for enhancement of self-reported function.•Most favorable outcomes were achieved with 17–27 sets per session.

To verify the effects of replacing exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in a rehabilitation program for patellofemoral pain (PFP). Randomized Controlled Trial. Fifty women with PFP. PFP participants were randomized into the standard rehabilitation group (SRG, n = 25) or distal exercise group (DEG, n = 25). Knee pain, patient-reported function, dynamic knee valgus and muscle strength were measured at baseline and after six and twelve weeks of the program start. SRG and DEG presented similar responses to rehabilitation (except for muscle strengthening). Knee pain reduced after 6 weeks (SRG: −37.7%, ES = 1.23; DEG: −30%, ES = 0.93) and 12 weeks (SRG: −47.4%, ES = 1.53; DEG: −43.3%, ES = 1.46). Patient-reported function improved after 6 weeks (SRG: +7.3%, ES = 0.45; DEG: +3.8%, ES = 0.22) and 12 weeks (SRG: +14.1%, ES = 0.80; DEG: +8.8%, ES = 0.50). Dynamic knee valgus reduced after 12 weeks (SRG: −29.7%, ES = 0.38; DEG: −34.5%, ES = 0.32). Both groups experienced increases in knee extension strength (SRG: +9%, ES = 0.28; DEG: +6%, ES = −0.29), but only SRG had strength gains for hip abduction (+10%, ES = 0.36) and extension (+11%, ES = 0.44). Exercises targeted on core/hip muscles can be replaced by exercises targeted on leg/foot muscles in a lower limb exercise-based rehabilitation program for women with PFP. NCT03663595. •Clinicians can target core/hip muscles or leg/foot muscles in PFP rehabilitation.•6 weeks of rehabilitation increased functionality and reduced pain in PFP women.•Hip muscles strength increased only with exercises targeted on core/hip muscles.

Purpose The purpose of this study was to assess if differences in hamstring strength, hamstring-to-quadriceps (H:Q) strength ratio, and biceps femoris long head (BF LH ) fascicle length exist between male and female professional football (soccer) players. Methods One-hundred professional footballers participated in this cross-sectional study: 50 men and 50 women. Ultrasound images of BF LH muscle and isokinetic dynamometry tests were performed. Results Men were stronger than women for hamstring concentric (2.01 ± 0.21 Nm/kg vs. 1.55 ± 0.23 Nm/kg; p  < 0.001; large effect size, 2.08) and eccentric (2.87 ± 0.45 Nm/kg vs. 2.39 ± 0.32 Nm/kg; p  < 0.001; large effect size, 1.23) peak torques. There was no sex-related difference for H:Q conventional ratio (concentric/concentric; 0.55 ± 0.06 vs. 0.55 ± 0.07); but women presented greater H:Q functional ratio (eccentric/concentric; 0.78 ± 0.12 vs. 0.85 ± 0.09; p  = 0.003; moderate effect size, 0.66). Men and women presented similar BF LH fascicle length: 0.24 ± 0.05 vs. 0.23 ± 0.05 (values normalized by muscle length). Conclusions Among the muscular factors assessed in this study, men presented stronger hamstring muscles, women presented greater H:Q functional ratio, and there was no sex-related differences for H:Q conventional ratio or BF LH fascicle length.