scholarly journals Lumbopelvic Joint Manipulation and Quadriceps Activation of People With Patellofemoral Pain Syndrome

2012 ◽  
Vol 47 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Terry L. Grindstaff ◽  
Jay Hertel ◽  
James R. Beazell ◽  
Eric M. Magrum ◽  
D. Casey Kerrigan ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Knee Extension ◽  
Quadriceps Strength ◽  
Patellofemoral Pain ◽  
Controlled Clinical Trial ◽  
Low Grade ◽  
Force Output ◽  
Quadriceps Force

Context: Quadriceps weakness and inhibition are impairments associated with patellofemoral pain syndrome (PFPS). Lumbopelvic joint manipulation has been shown to improve quadriceps force output and inhibition, but the duration of the effect is unknown. Objective: To determine whether quadriceps strength and activation are increased and maintained for 1 hour after high-grade or low-grade joint mobilization or manipulation applied at the lumbopelvic region in people with PFPS. Design: Randomized controlled clinical trial. Setting: University laboratory. Patients or Other Participants: Forty-eight people with PFPS (age = 24.6±8.9 years, height = 174.3 ± 11.2 cm, mass = 78.4 ± 16.8 kg) participated. Intervention(s): Participants were randomized to 1 of 3 groups: lumbopelvic joint manipulation (grade V), side-lying lumbar midrange flexion and extension passive range of motion (grade II) for 1 minute, or prone extension on the elbows for 3 minutes. Main Outcome Measure(s): Quadriceps force and activation were measured using the burst superimposition technique during a seated isometric knee extension task. A 2-way repeated-measures analysis of variance was performed to compare changes in quadriceps force and activation among groups over time (before intervention and at 0, 20, 40, and 60 minutes after intervention). Results: We found no differences in quadriceps force output (F5,33,101,18 = 0.65, P = .67) or central activation ratio (F4.84,92.03 = 0.38, P= .86) values among groups after intervention. When groups were pooled, we found differences across time for quadriceps force (F2.66,101.18 = 5.03, P = .004) and activation (F2.42,92.03 = 3.85, P = .02). Quadriceps force was not different at 0 minutes after intervention (t40 = 1.68, P = .10), but it decreased at 20 (t40 = 2.16, P = .04), 40 (t40 = 2.87, P = .01) and 60 (t40 = 3.04, P = .004) minutes after intervention. All groups demonstrated decreased quadriceps activation at 0 minutes after intervention (t40 = 4.17, P <.001), but subsequent measures were not different from preintervention levels (t40 range, 1.53–1.83, P >.09). Conclusions: Interventions directed at the lumbopelvic region did not have immediate effects on quadriceps force output or activation. Muscle fatigue might have contributed to decreased force output and activation over 1 hour of testing.

scholarly journals In vivo Evaluation of Patellar Tendon Stiffness in Individuals with Patellofemoral Pain Syndrome

2008 ◽  
Vol 5 (2) ◽  
pp. 59-63
Author(s):  
Hsin-Yi Liu ◽  
Michelle Boling ◽  
Darin Padua ◽  
R. Alexander Creighton ◽  
Paul Weinhold
Keyword(s):  
Patellar Tendon ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Knee Extension ◽  
Patellofemoral Pain ◽  
Knee Extensors ◽  
Ultrasonic Technique ◽  
In Vivo Evaluation ◽  
Tendon Stiffness

The objective of this study was to utilise an ultrasonic technique to assess the effect of patellofemoral pain syndrome (PFPS) on the mechanical properties of the patellar tendon. Seven subjects with PFPS and seven matched control subjects volunteered to participate in this study. Subjects were asked to perform isometric maximal voluntary contractions of the knee extensors while their knee extension torque was monitored and the displacement of the patellar tendon was recorded with an ultrasonic system. Our results showed significantly lower tendon stiffness (by ∼30%) in the PFPS subjects. Although tendon secant modulus was lower by 34% in the PFPS subjects, the difference was not statistically significant. Therefore, we conclude that the ultrasonic technique was able to detect a decrease in the structural stiffness of the patellar tendon associated with PFPS. The decrease in tendon stiffness was moderately correlated with the length of symptoms in these individuals.

scholarly journals Comparison of the Lumbosacral Manipulation Method Versus Knee Exercises Alone in Patients with Patellofemoral Pain Syndrome

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Sirous Azizi ◽  
Zahra Rezasoltani ◽  
Elaheh Shirzadi ◽  
Afsaneh Dadarkhah ◽  
Morvarid Elahi
Keyword(s):  
Clinical Trial ◽  
Muscle Strength ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Quadriceps Muscle ◽  
Patellofemoral Pain ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Quadriceps Muscle Strength ◽  
Randomized Controlled

Background: Patellofemoral Pain Syndrome (PFPS) is one of the most common diagnoses made for patients referred to physical/rehabilitation and orthopedic clinics. The most common symptom of PFPS is a diffuse pain in front of either one or both knees exacerbated by intense activity, kneeling, squatting, climbing, and weakness of quadriceps muscle. Lumbosacral manipulation and knee exercises are the most commonly used methods in physical medicine with no major side effects. Objectives: The current study aimed to compare the efficacy of the lumbosacral manipulation technique with knee exercises versus sole knee exercises in patients with PFPS. Study Design was Randomized Controlled Clinical Trial. Methods: In this randomized controlled clinical trial, 30 patients (18 females and 12 males) diagnosed with PFPS were divided into two groups of study and control, each with 15 subjects. Those in the intervention group received a single bilateral lumbosacral manipulation after ruling out any contraindication for lumbosacral manipulation by lumbosacral radiography. Quality of life, gait, quadriceps muscle strength, keen pain improvement, and range of motion were evaluated at the beginning and four weeks following the knee strengthening exercises for all participants. Results: The mean age of participants was 34 ± 5 years. The difference between the groups concerning the swing phase of walking and quadriceps muscle strength was in both groups was investigated following providing interventions. Conclusions: The manipulation technique had a greater effect on improving the function of patients with PFPS compared to therapeutic knee exercises.

scholarly journals Muscle Activation of Vastus Medialis Oblique and Vastus Lateralis in Sling-Based Exercises in Patients with Patellofemoral Pain Syndrome: A Cross-Over Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Wen-Dien Chang ◽  
Wei-Syuan Huang ◽  
Ping-Tung Lai
Keyword(s):  
Muscle Activation ◽  
Vastus Lateralis ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Knee Extension ◽  
Patellofemoral Pain ◽  
Voluntary Contraction ◽  
Vastus Medialis ◽  
Beneficial Effects ◽  
Knee Extension Exercise

Objectives. To examine what changes are caused in the activity of the vastus medialis oblique (VMO) and vastus lateralis (VL) at the time of sling-based exercises in patients with patellofemoral pain syndrome (PFPS) and compare the muscular activations in patients with PFPS among the sling-based exercises.Methods. This was a cross-over study. Sling-based open and closed kinetic knee extension and hip adduction exercises were designed for PFPS, and electromyography was applied to record maximal voluntary contraction during the exercises. The VMO and VL activations and VMO : VL ratios for the three exercises were analyzed and compared.Results. Thirty male (age = 21.19 ± 0.68 y) and 30 female (age = 21.12 ± 0.74 y) patients with PFPS were recruited. VMO activations during the sling-based open and closed kinetic knee extension exercises were significantly higher (P=0.04andP=0.001) than those during hip adduction exercises and VMO : VL ratio for the sling-based closed kinetic knee extension and hip adduction exercises approximated to 1.Conclusions. The sling-based closed kinetic knee extension exercise produced the highest VMO activation. It also had an appropriate VMO : VL ratio similar to sling-based hip adduction exercise and had beneficial effects on PFPS.

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