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This theory is further supported bythe decreased pain experienced by thequad group between weeks 4 and 8, whenisolated quad exercises were replaced bya comprehensive lower extremity exerciseprogram. Pain in the quad group decreasedby approximately 37% betweenweeks 4 and 8. While the initial exercisesisolated the quadriceps muscles, the secondarygroup of exercises tended to emphasizecocontraction of the musculaturearound the knee. Research has found thevastus medialis to be more active duringan isometric quadriceps contraction witha straight leg raise than during a bilateralsquat or single-leg stance.6The mean decrease in VAS scores forboth groups at 8 weeks, although statisticallysignificant, did not exceed 2 cm,which is commonly considered clinicallyimportant.16 Previous research has founda wide range in VAS scores followingrehabilitation intervention. Positive decreasesfollowing rehabilitative interventionshave ranged between 1 and 8 cmon the VAS.7,15,31 Additionally, a previousstudy on the reliability and responsivenessof VAS scores in individuals withPFPS identified a minimal clinically importantdifference of 1.5 to 2.0 cm, whichwould indicate that the change seen inthe current study is clinically relevant
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