Use of an Elastomeric Knee Brace in Patellofemoral Pain Syndrome: Short-Term Results

Purpose This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Methods Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease-specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Results Kujala scale's values showed constant and progressive improvement. The mean score at 6 months was 79.8 ± 6.8 points in group A and 76.8 ± 8.6 in group B, rising at 12 months to 80.9 ± 7.5 in group A and 78.4 ± 8.3 in group B. VAS scores significantly differed (p < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12 months was 0.9 ± 1.3 in the brace-treated group and 1.8 ± 1.6 in the controls. The patients who used a brace showed a quicker return to sports and 75% of the patients in this group were satisfied. Conclusion All the scores improved progressively in both groups. The most significant improvement concerned pain, showing that the brace used in this study may allow a better subjective outcome and a quicker return to sport. Level of Evidence Level II, prospective randomized controlled trial.

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Combined Hip Abductor and External Rotator Strengthening and Hip Internal Rotator Stretching Improves Pain and Function in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial With Crossover Design

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121989729 ◽

2021 ◽

Vol 9 (4) ◽

pp. 232596712198972

Author(s):

Anis Jellad ◽

Amine Kalai ◽

Mohamed Guedria ◽

Mahbouba Jguirim ◽

Sana Elmhamdi ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Level Of Evidence ◽

Randomized Controlled ◽

Group Standard ◽

Hip Muscle ◽

And Function

Background: Active rehabilitation has an important role in the management of patellofemoral pain syndrome (PFPS). Although some studies have shown the benefit of hip-muscle strengthening, the effect of combining hip-muscle stretching with strengthening has not yet been defined. Purpose: To evaluate the effect of combined strengthening of the hip external rotators and abductors and stretching of the hip internal rotators on pain and function in patients with PFPS. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 109 patients with PFPS (75 female and 34 male; mean age, 31.6 ± 10.8 years) were first randomly assigned to protocol A (n = 67) of the A-B arm (AB group; standard rehabilitation) or protocol B (n = 42) of the B-A arm (BA group; standard rehabilitation with strengthening of the hip external rotators and abductors and stretching of the hip internal rotators). Each protocol consisted of 3 sessions a week for 4 weeks. After a washout period, corresponding to a symptom-free period, rehabilitation programs were crossed over. A visual analog scale (VAS) evaluating perceived pain, the Functional Index Questionnaire (FIQ), and the Kujala score were administered at baseline, the end of each rehabilitation protocol, and 12 weeks after the completion of the second protocol for each group. Results: Until the final follow-up, VAS, FIQ, and Kujala scores were significantly improved in both the A-B and B-A arms ( P < .05 for all). Compared with protocol A, protocol B provided significant improvement in terms of pain and function in both the BA (VAS and Kujala; P < .001) and AB (VAS and Kujala; P < .001) groups. Conclusion: Combined strengthening of the hip abductors and external rotators with stretching of the hip internal rotators provided better outcomes, which were maintained for at least 12 weeks, in terms of pain and function in patients with PFPS.

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Fulkerson's Modified Elmslie-Trillat Procedure for Objective Patellar Instability and Patellofemoral Pain Syndrome

Swiss Surgery ◽

10.1024/1023-9332.6.6.328 ◽

2000 ◽

Vol 6 (6) ◽

pp. 328-334 ◽

Cited By ~ 7

Author(s):

Rillmann ◽

Oswald ◽

Holzach ◽

Ryf

Keyword(s):

Patellar Instability ◽

Pain Syndrome ◽

Treatment Method ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Activity Level ◽

Radiographic Examination ◽

Significant Difference ◽

Group A ◽

Group B

Twenty two knees were either operated for objective patellar instability (Group A: 14 patients) or patellofemoral pain syndrome (Group B: 8 patients) using Fulkerson's modified Elmslie-Trillat procedure. The objective of this retrospective study was to evaluate the results of this method and to detect whether or not there were differences in the outcome comparing the two groups. Twenty knee joints (Group A: 13; group B: 7) were available for clinical and radiographic examination after an overall mean follow-up of 63 months. Duration of pre- and postoperative physical therapy was significantly longer for group B, the activity level increased significantly for these patients and the Q-angle could be corrected significantly in this group comparing pre- and postoperative values. The overall outcome (Turba score) detected no statistically significant difference between the groups, only good and excellent results were obtained. No signs of osteoarthritis were found radiologically. A pathological patellar congruence angle could be corrected significantly by this method. We conclude that Fulkerson's modified Elmslie-Trillat operation is an excellent treatment method with a very low morbidity for patients with patellofemoral malalignment after failed conservative treatment.

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Effects of Taping on Pain and Function in Patellofemoral Pain Syndrome: A Randomized Controlled Trial

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2004.1484 ◽

2004 ◽

Author(s):

Martin Whittingham

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Randomized Controlled ◽

And Function

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Efficacy of High-Power Laser in Alleviating Pain and Improving Function of Patients With Patellofemoral Pain Syndrome: A Single-Blind Randomized Controlled Trial

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.06 ◽

2018 ◽

Vol 10 (1) ◽

pp. 37-43

Author(s):

Farshad Nouri ◽

Seyed Ahmad Raeissadat ◽

Dariush Eliaspour ◽

Seyed Mansoor Rayegani ◽

Maryam Sadat Rahimi ◽

...

Keyword(s):

Controlled Trial ◽

Pain Syndrome ◽

The Other ◽

Short Term ◽

Randomized Controlled ◽

Group A ◽

Laser Group ◽

Group B ◽

Single Blind ◽

Post Therapy

Introduction: In this study, a single-blind and randomized controlled trial (RCT) for assessing the effectiveness of high-power (up to 12 W) laser therapy (HPLT) on patients with patellofemoral pain syndrome (PFPS) was carried out. Methods: Forty-four patients were randomly assigned to two treatment groups by generating random numbers with MATLAB 2014b software, where odd and even numbers were attributed to sham laser group (group A) and actual laser group (group B), respectively. Group B patients underwent HPLT with total dose of 300 J/session for 5 consecutive sessions separated by a 2-day interval. On the other hand, sham laser was applied to group A patients. Both groups had the same exercise therapy programs during the study period (3 months). The exercise therapy program included isometric knee exercise for 3 sets per day and 10 times in each set, with duration of 10 seconds per time and straight leg raise for 15 seconds 10 times a day. The group codes of patients were not revealed to subjects and data analyzer until completion of the study. Kujala, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) questionnaires were chosen as outcome measures. These questionnaires were completed at three points during the study; at the beginning of the study to obtain the pre-therapy conditions and one month and three months after the start of the study to evaluate post-therapy conditions. Results: Two main analyses were conducted: within-group and between-group analyses. Withingroup analyses indicated significant improvements in respect to all measurements where pretherapy and post-therapy comparisons were conducted in both groups (P < 0.05). On the other hand, between-group comparisons did not reveal any statistically significant functional difference between group A and group B regarding the evaluative criteria (P > 0.05) except for pain VAS (P < 0.05). Conclusion: This study indicated that short-term HPLT accompanied by appropriate exercise regimen significantly decreased pain in patients with PFPS. But it was not recommended as an efficient modality in functional improvement. Also, it was observed that, in the short-term period of study, HPLT was a safe modality.

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Effectiveness of Core Muscle Strengthening using Swiss Ball vs Traditional Core muscle Strengthening Exercises on Functional Impairments in Amateur Marathon Runners with Patellofemoral Pain Syndrome

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2021.153 ◽

2021 ◽

Vol 9 (4) ◽

pp. 3937-3943

Author(s):

Simran R. Sachadev ◽

◽

Ronald N Prabhakar ◽

Manal M Anthikat ◽

◽

...

Keyword(s):

Pain Syndrome ◽

Patellofemoral Pain ◽

Pain Severity ◽

Functional Impairments ◽

Severity Scale ◽

Marathon Runners ◽

Muscle Strengthening ◽

Group A ◽

Group B ◽

Swiss Ball

Background: Devashee S Mistry discovered that the prevalence of anterior knee pain in marathon runners is 68% in the age group of 15-30 years.(11) There are many literatures that shows correlation between core muscle instability and pain associated with Patellofemoral Pain Syndrome (PFPS). Although, there are many studies done to study the effectiveness of core muscle strengthening program on pain and functional impairment in general population with PFPS, there are only few literatures which evaluates its effectiveness on marathon runners. Study purpose/ Research Question: The purpose of this study is to compare the effectiveness of core muscle strengthening using Swiss ball versus traditional core muscle exercises on mat for managing the functional impairments in the amateur marathon runners with PFPS. Material and methodology: Amateur marathon runners with patellofemoral pain syndrome (n = 32) having anterior knee pain were included in this study. A comparative study was done where two group were made. Group A (n= 16) received core strengthening exercises using swiss ball and group B (n = 16) received traditional core strengthening exercises using mat. Both groups received conventional Physiotherapy intervention which included hot moist pack applied on anterior aspect of knee (10 minutes), strengthening for lower limb muscles and stretching for lower limb muscles, 10 seconds hold for each muscle for 3 repetitions. Treatment was given for 3 times a week, for 4 weeks. Pain and other functional impairment such as squatting, stair climbing, walking and running were assessed using VAS and Patellofemoral Pain Severity Scale. Results: Group A showed significant decrease in pain and functional impairments as compared to group B. Mean pre VAS of group A was 6.94 which was significantly higher than mean post VAS 1.60 (p< 0.001). Mean pre VAS of group B was 6.88 which was significantly higher than mean post VAS 2.71 (p<0.001). Mean pre Patellofemoral pain Severity Scale of group A was 72.56 which is significant higher than post Patellofemoral Pain Severity Scale 15.87 (p<0.001). Mean pre Patellofemoral Pain Severity Scale of group B was 74.31 which is significantly higher than post mean Patellofemoral Pain Severity Scale 33.12 (p< 0.001) Conclusion: Core muscle strengthening using swiss ball is more effective than traditional core muscle strengthening using mat in amateur marathon runners for reducing pain and functional impairments having PFPS KEY WORD: Anterior knee pain, Marathon runners, Patellofemoral, Runner’s knee.

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Decreased Pulsatile Blood Flow in the Patella in Patellofemoral Pain Syndrome

The American Journal of Sports Medicine ◽

10.1177/0363546507303115 ◽

2007 ◽

Vol 35 (10) ◽

pp. 1668-1673 ◽

Cited By ~ 25

Author(s):

Jan Näslund ◽

Markus Walden ◽

Lars-Göran Lindberg

Keyword(s):

Blood Flow ◽

Confidence Interval ◽

Knee Flexion ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Control Group ◽

Systematic Change ◽

Pulsatile Blood Flow ◽

Level Of Evidence

Background Anterior knee pain without clinical and radiologic abnormalities has primarily been explained from a purely structural view. A recently proposed biologic and homeostatic explanation questions the malalignment theory. No objective measurement of the pathophysiology responsible for changes in local homeostasis has been presented. Hypothesis Flexing the knee joint interferes with the perfusion of the patellar bone in patellofemoral pain syndrome. Study Design Case control study; Level of evidence, 4. Methods Pulsatile blood flow in the patella was measured continuously and noninvasively using photoplethysmography. Measurements were made with the patient in a resting position with knee flexion of 20° and after passive knee flexion to 90°. In total, 22 patients with patellofemoral pain syndrome were examined bilaterally, and 33 subjects with healthy knees served as controls. Results The pulsatile blood flow in the patient group decreased after passive knee flexion from 20° to 90° (systematic change in position, or relative position [RP] = —0.32; 95% confidence interval for RP, —0.48 to —0.17), while the response in the control group showed no distinct pattern (RP = 0.17; 95% confidence interval for RP, —0.05 to 0.31). The difference between the groups was significant (P = .0002). The median change in patients was —26% (interquartile range, 37). Conclusions Pulsatile patellar blood flow in patellofemoral pain syndrome patients is markedly reduced when the knee is being flexed, which supports the previous notion of an ischemic mechanism involved in the pathogenesis of this pain syndrome.

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