Patients flexed their knees to 30° and removed the slack from the tubing. As described Inhibitor Library purchase in previous publications,12, 15, 16 and 26 patients then performed a partial squat against resistance from the start position to full knee extension while squeezing a ball between both knees. Outcome measures

were obtained on 3 separate occasions: at baseline, after 8 weeks of exercise (postintervention), and at 6 months (follow-up). A single tester who was not blinded to group assignment recorded all outcome measurements. For patients with bilateral PFP, the limb reported to be the most painful during initial testing was evaluated for all testing sessions. Self-reported pain intensity was Akt phosphorylation quantified using a 10-cm visual analog scale (VAS), which ranged from 0 (no pain) to 10 (worst pain possible). Individuals were asked to rate their pain based on activities

that aggravated symptoms during the previous week. The 10-cm VAS is a valid and responsive outcome measure for PFP with a minimal clinically important difference of 2.27 Self-reported health status was quantified using the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). The WOMAC is a 24-item questionnaire evaluating pain, stiffness, and physical function.28 This tool is a valid outcome measure for knee osteoarthritis29 and has been reported to be significantly correlated with an outcome measure specifically designed for PFP.30 The total summed score for the Likert scale version used in the current study ranged from 0 to 96 (pain, 0–20; stiffness, 0–8; physical function, 0–68); higher scores indicated worse health status. Independent t tests were used to evaluate group differences at baseline. A 2-factor, mixed-model analysis of variance (ANOVA) (2 groups × 3 time points) was used to compare outcome measures between groups over time. This analysis was repeated for the VAS and WOMAC scores. If a significant interaction was found, paired t tests (2-tailed) were used to assess changes in each group across the 3 time points. Additionally, independent t tests (1-tailed) were used to compare group differences PtdIns(3,4)P2 at each time point.

Because data were normally distributed and variance was equal between groups, parametric tests were justified. All statistical analyses were conducted with SPSS software b using a significance level of P=.05. At baseline, demographic characteristics, VAS scores, and WOMAC scores were comparable between groups (see table 1). Patients in both groups were moderately to severely impaired with respect to pain intensity and health status. All subjects completed the postintervention and 6-month follow-up assessments. On average, patients assigned to the posterolateral hip exercise group attended 22.4 supervised exercise sessions, whereas subjects assigned to the quadriceps exercise group attended 22.1 supervised exercise sessions.