{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:07:17Z","timestamp":1789668437820,"version":"4.0.1"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research on the impact of three-dimensional capital on the employment of physical education teacher trainees under the new situation","award":["No. 2024AH053185"],"award-info":[{"award-number":["No. 2024AH053185"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Objective<\/jats:title>\n Hip stability training may influence the quadriceps angle (Q-angle) and pain, but the clinical relevance of static Q-angle changes remains uncertain. This study compared hip stability training with standard care for Q-angle, pain, and function in marathon runners with Patellofemoral Pain Syndrome (PFPS).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We identified 487 marathon runners with PFPS, of whom 312 met the eligibility criteria. After 1:1 propensity score matching, 94 runners were retained in each group: hip stability training (Hip-STAB) and standard care (Control). Outcomes were assessed at baseline (W0) and at 4, 8, and 16 weeks (W4, W8, W16). Primary outcomes were standing Q-angle, visual analog scale pain during running (VAS-Run; 0\u2013100 mm), and Anterior Knee Pain Scale (AKPS; 0\u2013100 points).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Both groups improved over 16 weeks. Linear mixed-effects models showed significant time effects for Q-angle, VAS-Run, and AKPS (all p\u2009<\u20090.001), but no significant time-by-group interactions for Q-angle (p\u2009=\u20090.190), VAS-Run (p\u2009=\u20090.302), or AKPS (p\u2009=\u20090.317). Bonferroni-adjusted post-hoc comparisons did not identify significant between-group differences at W16. The association between Q-angle reduction and VAS-Run improvement was significant in the Hip-STAB group (r\u2009=\u20090.35, 95% CI 0.16 to 0.52, p\u2009<\u20090.001) and the Control group (r\u2009=\u20090.44, 95% CI 0.26 to 0.59, p\u2009<\u20090.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Hip-STAB and standard care were each associated with improvements in static Q-angle, running pain, and function, but Hip-STAB was not superior to standard care. The correlation between Q-angle and pain changes should be interpreted as an association rather than evidence of a causal biomechanical mechanism.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0357057","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:23:42Z","timestamp":1789665822000},"page":"e0357057","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of hip stability training versus standard care on Q-angle and pain in marathon runners with patellofemoral pain syndrome: A retrospective cohort study"],"prefix":"10.1371","volume":"21","author":[{"given":"Donghuan","family":"Bai","sequence":"first","affiliation":[{"name":"Huaibei Normal University","place":["Huaibei, Anhui, China"],"department":["Department of Sports Training"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Cao","sequence":"additional","affiliation":[{"name":"Zhengzhou Technical College","place":["Zhengzhou, Henan, China"],"department":["Department of Sports"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6554-7654","authenticated-orcid":true,"given":"Shuolei","family":"Feng","sequence":"additional","affiliation":[{"name":"Hubei College of the Arts","place":["Wuhan, Hubei, China"],"department":["Department of Public Course Teaching (Department of Physical Education)"]},{"name":"Lincoln University College (LUC)","place":["Petaling Jaya, Selangor Darul Ehsan, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"issue":"12","key":"pone.0357057.ref001","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.4085\/1062-6050-0535.19","article-title":"A Contemporary Approach to Patellofemoral Pain in Runners","volume":"55","author":"J-F Esculier","year":"2020","journal-title":"J Athl Train"},{"issue":"1","key":"pone.0357057.ref002","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0190892","article-title":"Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis","volume":"13","author":"BE Smith","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"pone.0357057.ref003","article-title":"A Systematic Review on Quadriceps Angle in Relation to Knee Abnormalities","volume":"15","author":"R Sharma","year":"2023","journal-title":"Cureus"},{"issue":"12","key":"pone.0357057.ref004","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.3390\/ijerph21121547","article-title":"Impact of the Quadriceps Angle on Health and Injury Risk in Female Athletes","volume":"21","author":"H Gant","year":"2024","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0357057.ref005","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3390\/healthcare11010099","article-title":"The Relationship between Patellofemoral Pain Syndrome and Hip Biomechanics: A Systematic Review with Meta-Analysis","volume":"11","author":"P Xie","year":"2022","journal-title":"Healthcare (Basel)"},{"issue":"7","key":"pone.0357057.ref006","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000037102","article-title":"Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: A randomized controlled trial","volume":"103","author":"A Raju","year":"2024","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"pone.0357057.ref007","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/s13018-024-04688-x","article-title":"Effect of adding short foot exercise to hip and knee focused exercises in treatment of patients with patellofemoral pain syndrome: a randomized controlled trial","volume":"19","author":"AM Kamel","year":"2024","journal-title":"J Orthop Surg Res"},{"issue":"2","key":"pone.0357057.ref008","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.apmr.2023.08.030","article-title":"Is Adding Education to Trunk and Hip Exercises Beneficial for Patellofemoral Pain? 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