Effect of Agility and Perturbation Training on Pain, Balance and Functional Ability in Subjects with Patellofemoral Pain Syndrome

Background: Agility and Perturbation training have been advocated to improve pain, balance and functional abilities in subjects with osteoarthritis of knee but effect of same on Patellofemoral pain have not been explored in studies. The above techniques would be helpful along with standard rehabilitation programs in reducing dynamic knee instability or improving dynamic stability upon return to high level physical activity and have an additive effect of reducing pain in OA knee. Objective: The purpose of the study is to find the effect of Agility and Perturbation training on improvement of pain, balance and functional abilities in subject with Patellofemoral Pain Syndrome. Method: A randomized controlled study with 40 individuals has been taken with patellofemoral pain syndrome. 20 subjects have been selected for control group and 20 subjects for study group. Outcome measures includes Kujala function scale, Y balance test and Numeric pain rating scale were measured before and immediately after the treatment. Results: Analysis using Mann Whitney U Test and Independent t between the groups found that when pre intervention means of NPRS, Composite score YBT and Kujala Score were compared there is a statistically significant difference between the groups. When post intervention means of NPRS and Kujala score were compared between the groups there is no statistically significant difference between the groups. When post intervention means of Composite score YBT were compared there is a statically significant difference. Conclusion: The present study concludes that Agility and Perturbation training shown significant improvement of pain, function and balance in subject with Patellofemoral Pain Syndrome. Key words: Patellofemoral Pain Syndrome, Kujala function Scale, Y balance test.

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Comparing the Effect of Kinesiology Taping on Dynamic Balance and Pain of Men and Women With Unilateral Patellofemoral Pain Syndrome

Journal of Rehabilitation ◽

10.32598/rj.21.4.3071.1 ◽

2021 ◽

Vol 21 (4) ◽

pp. 470-487

Author(s):

Javid Mostamand ◽

◽

Zohreh Shafizadegan ◽

Mohammad Javad Tarrahi ◽

Zeinab Sadat Hosseini ◽

...

Keyword(s):

Muscle Activation ◽

Dynamic Balance ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

T Test ◽

Balance Test ◽

Men And Women ◽

Significant Difference ◽

Before And After

Objective: Patellofemoral Pain Syndrome (PFPS) is one of the most common disorders of the knee joint. It is characterized by pain, reduced proprioception, and altered pattern of vastus muscle activation, which effectively maintain the balance needed for performing daily living activities such as walking and running. One treatment method that can reduce pain and improve balance in people with PFPS is Kinesiology Taping (KT). Considering the physiological and anatomical differences in the knee structure of men and women and the importance of studying the effect of KT on the dynamic balance of men with PFPS, this study aims to compare the effect of KT on dynamic balance and pain of men and women with unilateral PFPS. Materials & Methods: This is a quasi-experimental and non-randomized clinical trial. The participants were 30 males and 31 females aged 18-40 years suffering from unilateral PFPS. They were recruited using a convenience sampling method. First, the subjects performed the Y-balance test three times in each of the anterior, posteromedial, and posterolateral directions. The maximum score obtained from the three repetitions in each direction was divided by the limb length and recorded in percentage as a dynamic balance score. After 5 minutes of rest and performing initial tests, the subjects performed the intervention. In this stage, KT with a tension equal to 50%-75% of its initial length was applied on the patella of the involved limb to cause medial glide. The effectiveness of KT was examined under a single-leg squat-test. For this purpose, all subjects performed unilateral squatting on their affected leg for 10 seconds with 45 degrees of knee flexion before and after KT, while their pain level was recorded using the visual analog scale. In case of a 50% reduction in pain, the subjects were allowed to enter the final stage (performing the Y-balance test); otherwise, patellar taping was repeated to obtain the appropriate pain reduction. Results: Within-group comparison of balance parameters before and after KT using the paired t-test showed an increase in the reach distance at three directions in the Y-balance test, revealing a significant improvement in the dynamic balance following KT (P<0.05). According to the independent t-test results, there was no significant difference in balance parameters between males and females before and after the intervention (P>0.05). Moreover, the pain was significantly reduced in both genders after KT (P<0.05), but its difference between men and women was not statistically significant (P>0.05). Conclusion: KT is an appropriate therapeutic intervention for improving dynamic balance and reducing pain in people with PFPS. It seems that KT has the same effect on dynamic balance and pain of women and men with PFPS.

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DERAJAT QUADRICEPS ANGLE MEMPENGARUHI PATELLA FEMORAL PAIN SYNDROME

Jurnal Fisioterapi dan Rehabilitasi ◽

10.33660/jfrwhs.v4i1.109 ◽

2020 ◽

Vol 4 (1) ◽

pp. 72-78

Author(s):

Adnan Faris Naufal ◽

Dini Afriani Khasanah ◽

Ulfa Noviyana

Keyword(s):

Patellofemoral Joint ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

P Value ◽

Q Angle ◽

Kujala Score

ABSTRAK Patellofemoral pain syndrome tidak memikili definisi gejala yang jelas karena gejala dan sakit yang dirasakan pasien mungkin berbeda dan rata-rata mengganggu aktivitas fisik pasien. Salah satu konsep penting dalam patellofemoral joint adalah Q-angle. Secara teoritis, lebih tinggi Q-angle meningkatkan tarikan lateral paha depan femoris pada patella dan mempotensiasi gangguan patellofemoral. Penelitian ini dilakukan untuk mengevaluasi hubungan antara nyeri lutut anterior dan Q-angle. Pengukuran pada penelitian ini dilakukan dengan menggunakan kujala score untuk mengukur keluhan patellofemoral pain syndrome, untuk mengukur besar sudut Q-angle diukur dengan goniometer. Data yang dikumpulkan kemudian dianalisis menggunakan uji Spearman Rho. Hasil penelitian menunjukan adanya hubungan Q-angle dan patellafemoral pain syndrome pada pemain bola basket wanita. Nilai p value dari Q-angle sebesar 0,024 sehingga Ho ditolak dengan nilai r = 0,579 menunjukan hubungan positif dan kekuatan korelasi yang tinggi, patellofemoral pain syndrome 0,043 dengan nilai r = 0,528 menunjukan hubungan positif dan kekuatan korelasi yang kuat. Nilai korelasi tersebut menunjukkan terdapat hubungan Q-angle terhadap keluhan patellofemoral pain syndrome.

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The validity and reliability of the Thai version of the Kujala score for patients with patellofemoral pain syndrome

Disability and Rehabilitation ◽

10.3109/09638288.2015.1114035 ◽

2016 ◽

Vol 38 (21) ◽

pp. 2161-2164 ◽

Cited By ~ 8

Author(s):

Adinun Apivatgaroon ◽

Chayanin Angthong ◽

Prakasit Sanguanjit ◽

Bancha Chernchujit

Keyword(s):

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Validity And Reliability ◽

Kujala Score

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Sonographic evaluation of patellar tendon displacement and its correlation with patellofemoral pain syndrome

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/22104917211035555 ◽

2021 ◽

Vol 28 ◽

pp. 221049172110355

Author(s):

Consuelo B Gonzalez-Suarez ◽

Cherie-Lee A Apiag ◽

Kris A. Agarao ◽

Fe T. Chavez ◽

Reil V. Espino ◽

...

Keyword(s):

Patellar Tendon ◽

Pain Syndrome ◽

Potential Method ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Football Players ◽

Comprehensive Understanding ◽

Patellar Maltracking ◽

Significant Difference ◽

The Difference

Background Patellofemoral pain syndrome is the most common knee condition and is associated with patellar maltracking. Ultrasound is used in studying patellar maltracking. The objective is to determine if the technique which analyzes the displacement of the patellar tendon in the trochlear sulcus is associated with patellofemoral pain syndrome. Methods In total, 68 knees of 34 football players (males = 20, females = 14) were included. Patellar tendon displacement was assessed in supine and standing positions. Patellar tendon displacement difference in the two positions was determined. Results There was a significant difference in the lateral patellar tendon displacement during standing which was larger in patellofemoral pain syndrome than without patellofemoral pain syndrome (Mean Rank = 39.20 vs. 30.32, p = 0.02). There was no significant difference between the two groups for lateral patellar tendon displacement in supine and the difference in patellar tendon displacement from supine to standing. Conclusion The technique could be a potential method in assessing patellar maltracking. It could be used to have a comprehensive understanding of the pathomechanics and treatment of patellofemoral pain syndrome.

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The Effect of Valgus Control Instruction Exercises on Pain, Strength, and Functionality in Active Females With Patellofemoral Pain Syndrome

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119837622 ◽

2019 ◽

Vol 11 (3) ◽

pp. 223-237 ◽

Cited By ~ 5

Author(s):

Mahsa Emamvirdi ◽

Amir Letafatkar ◽

Mehdi Khaleghi Tazji

Keyword(s):

Injury Prevention ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Knee Valgus ◽

Valgus Angle ◽

Significant Difference ◽

Hop Test ◽

Control Instruction ◽

Dynamic Valgus

Background: Patellofemoral pain syndrome (PFPS) is sometimes related to excessive hip adduction and internal rotation, as well as knee valgus during weightbearing activities in females. Research on injury prevention and rehabilitation strategies has shown the positive effects of valgus control instruction (VCI) exercise programs in training. Hypothesis: A VCI program would result in a positive change in pain, eccentric hip muscle torque, and performance in females with PFPS. Study Design: Controlled laboratory study. Level of Evidence: Level 1. Methods: Sixty-four amateur female volleyball players from our university (age, 18-25 years) with PFPS and equal years of exercise experience were randomly divided into VCI (n = 32; age, 22.1 ± 5.88 years) and control (n = 32; age, 23.1 ± 6.49 years) groups. Function (single, triple, and crossover hops), strength (hip abductor and external rotators), pain (visual analog scale), and knee valgus angle (single-leg squat) were assessed at baseline and after intervention. Results: There was a significant difference before and after implementation of the VCI program with regard to pain (49.18% ↓, P = 0.000), single-leg hop test (24.62% ↑, P = 0.000), triple-hop test (23.75% ↑, P = 0.000), crossover hop test (12.88% ↑, P = 0.000), single-leg 6-m timed hop test (7.43% ↓, P = 0.000), knee dynamic valgus angle (59.48% ↓, P = 0.000), peak abductor to adductor eccentric torque ratio (14.60% ↑, P = 0.000), peak external (59.73% ↑, P = 0.023) and internal rotator (15.45% ↑, P = 0.028) eccentric torques, and the ratio of peak external to internal rotator eccentric torque (40.90% ↑, P = 0.000) ( P < 0.05). Conclusion: PFPS rehabilitation and prevention programs should consider VCI exercises to decrease pain, improve strength, and increase athletes’ functional performance. Clinical Relevance: This study investigated the effect of VCI exercises on knee valgus angle, pain, and functionality of individuals with PFPS. The VCI program improves performance, knee dynamic valgus angle, and strength in participants with PFPS. A controlled and optimal knee valgus angle during a functional task is the most important factor for injury prevention specialists. VCI training can be used as a supplemental method to prevent and treat lower extremity injury in patients with PFPS.

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Differences in Sonographic Characteristics of the Vastus Medialis Obliquus between Patients with Patellofemoral Pain Syndrome and Healthy Adults

The American Journal of Sports Medicine ◽

10.1177/0363546509333483 ◽

2009 ◽

Vol 37 (9) ◽

pp. 1743-1749 ◽

Cited By ~ 41

Author(s):

Mei-Hwa Jan ◽

Da-Hon Lin ◽

Jiu-Jenq Lin ◽

Chien-Ho Janice Lin ◽

Cheng-Kung Cheng ◽

...

Keyword(s):

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Healthy Adults ◽

Control Group ◽

Vastus Medialis ◽

Healthy Controls ◽

Vastus Medialis Obliquus ◽

Fiber Angle ◽

Significant Difference

Background There is controversy regarding the relationship between patellofemoral pain syndrome (PFPS) and insufficiency of the vastus medialis obliquus (VMO). The conventional clinical practice of VMO strengthening for PFPS has been challenged for lack of evidence. The purpose of this study was to observe the difference in sonographic findings of the VMO between patients with PFPS and healthy adults. Hypothesis The morphological characteristics of the VMO are different between patients with PFPS and healthy adults. Study Design Case-control study; Level of evidence, 3. Methods Fifty-four patients with PFPS and 54 age-, gender-, body height—, and body weight—matched healthy adults as controls were enrolled in the study to measure by sonography the insertion level, fiber angle, and volume of the VMO at its insertional portion to detect differences between patients with PFPS and healthy controls. Results The insertion level, fiber angle, and VMO volume were all significantly smaller in the PFPS group than in the control group (P < .05). Multivariate analysis of variance has revealed a Wilks λ value of .845 and an F value of 5.640 (P = .001). Conclusion There was a significant difference in the 3 VMO measures between patients with PFPS and the healthy controls. Individuals might be predisposed to PFPS by different VMO characteristics, including insertion level and fiber angle. The current study cannot determine whether the observed morphological differences were the results of atrophy in response to pain or if they represent dysplasia that was predisposed to pain development. The clinical manifestations of VMO characteristics should be thoroughly investigated in other populations. Clinical Relevance The function of the VMO is important to consider in the rehabilitation of patients with PFPS.

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CLINICAL MUSCULAR EVALUATION IN PATELLOFEMORAL PAIN SYNDROME

Acta Ortopédica Brasileira ◽

10.1590/1413-785220182602187215 ◽

2018 ◽

Vol 26 (2) ◽

pp. 91-93

Author(s):

PAULO LOBO JÚNIOR ◽

ITAMAR ALVES BARBOSA NETO ◽

JOSÉ HUMBERTO DE SOUZA BORGES ◽

RODRIGO FERREIRA TOBIAS ◽

MARCOS VINÍCIUS DA SILVA BOITRAGO ◽

...

Keyword(s):

Range Of Motion ◽

Clinical Evaluation ◽

Case Series ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Kujala Score ◽

Muscle Groups ◽

Dynamic Valgus ◽

Ankle Dorsiflexors

ABSTRACT Objective: To define a profile of the muscle groups affected by patellofemoral pain syndrome (PFPS) to determine a pattern of functional weaknesses around the knee. Methods: Sixty-three female patients were randomly selected, and 17 included in this study, receiving a clinical evaluation with pre-established protocol which evaluated the quadriceps, abductors, range of motion in the internal rotators and ankle dorsiflexors, pelvic tilt, and dynamic valgus. Results: Losses were seen in abductor strength and ankle dorsiflexor range of motion in comparison with the contralateral limb (0.031 and 0.040, respectively). There was a loss of quadriceps strength and decreased amplitude of internal hip rotation when compared to the Kujala score (0.032 and 0.002, respectively). Dynamic valgus and pelvic fall were greater in comparison with the Kujala score (0.668 and 0.567, respectively). Conclusion: Clinical evaluation showed deficits in the quadriceps and abductor muscle groups, as well as decreased range of motion in the internal hip rotators and ankle dorsiflexors and increased dynamic valgus and pelvic drop. Level of Evidence IV; Case series.

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Validity and Reliability of the Indonesian Version of the Kujala Score for Patients With Patellofemoral Pain Syndrome

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120922943 ◽

2020 ◽

Vol 8 (5) ◽

pp. 232596712092294

Author(s):

Edi Mustamsir ◽

Krisna Yuarno Phatama ◽

Arimurti Pratianto ◽

Ananto Satya Pradana ◽

William Putera Sukmajaya ◽

...

Keyword(s):

Internal Consistency ◽

Short Form ◽

Intraclass Correlation ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Retest Reliability ◽

Sf 36 ◽

Kujala Score ◽

Test Retest Reliability

Background: The Kujala score is a useful diagnostic tool to evaluate patellofemoral pain syndrome (PFPS). However, no validated Indonesian version of the Kujala score has been available. Purpose: To develop and validate an Indonesian version of the Kujala score. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: This was a cross-sectional study to develop an Indonesian version of the Kujala score by using a forward-backward translation protocol. The resulting questionnaire was given to 51 patients diagnosed with PFPS. The validity of the questionnaire was evaluated by correlating the final score with the Indonesian version of the 36-Item Short Form Health Survey (SF-36). Reliability was measured by evaluating the internal consistency (Cronbach alpha) and test-retest reliability (intraclass correlation coefficient [ICC]). Results: The Indonesian version of the Kujala score had a positive correlation with the physical components of the SF-36. The internal consistency was fairly high (α = .74), and the test-retest reliability was excellent (ICC, 0.996). Conclusion: The Indonesian version of the Kujala score was proven to be a valid and reliable tool to diagnose PFPS. Future epidemiological studies could implement this score to find the prevalence of PFPS in Indonesia. Further, ensuing studies could explore the application of this scoring system in posttreatment and postoperative settings.

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Immediate Effects of Kinesio Taping on pain in Athletes with Patellofemoral Pain Syndrome

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1147-9124 ◽

2020 ◽

Author(s):

Neelam Rehman ◽

Muhammad Kashif ◽

AbdulGhafoor Sajjad ◽

Hafiz Muhammad Junaid Hassan ◽

Humaira Iram

Keyword(s):

Treatment Group ◽

Rating Scale ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Control Group ◽

P Value ◽

Kinesio Taping ◽

Significant Difference ◽

The Difference

Abstract Background Ligaments injury and anterior knee pain is the most common problem in the knee joint. In practice, there are various interventions for the treatment of patellofemoral pain syndrome (PFPS). Kinesio taping is one of them, but little literature is available on the immediate effects of treating this problem. Methodology From June to September 2017, a randomized control study was conducted at the Army Sports Complex GHQ Rawalpindi to determine the effectiveness of Kinesio Taping (KT) in patellofemoral pain syndrome in athletes. Data were collected from 48 athletes who fully met the inclusion criteria and were randomly divided into 2 groups. The data collection tool was Numerical Pain Rating Scale (NPRS), Kujala PFPS Score, and self-structured Questionnaire. The data was analyzed on SPSS 21. Results The overall mean age was 22.7±3.0. The immediate effects showed improved NPRS in both groups; in the control group the NPRS pre 1st visit mean was 5.36±1.2 and post 1st visit mean was 4.68±1.3 with the difference of 0.68±0.1 having p value p<0.001. In the treatment group the NPRS pre 1st visit mean was 5.90±1.2 and post 1st visit mean was 5.00±1.0 with the difference of 0.90±0.1 having p value p<0.001. Conclusion This study shows immediate effects of Kinesio-Taping, however there was not any significant difference between both groups but the treatment group performed well after the sessions.

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Treatment of Patellofemoral Pain Syndrome with Dielectric Radiofrequency Diathermy: A Preliminary Single-Group Study with Six-Month Follow-Up

Medicina ◽

10.3390/medicina57050429 ◽

2021 ◽

Vol 57 (5) ◽

pp. 429

Author(s):

Manuel Albornoz-Cabello ◽

Cristo Jesús Barrios-Quinta ◽

Isabel Escobio-Prieto ◽

Raquel Sobrino-Sánchez ◽

Alfonso Javier Ibáñez-Vera ◽

...

Keyword(s):

Knee Flexion ◽

Pain Perception ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Drug Intake ◽

Lower Extremity Function ◽

Post Intervention ◽

And Function

Background and Objectives: Notwithstanding patellofemoral pain syndrome (PFPS) being one of the most common causes of pain in the front of the knee in outpatients, few studies have shown the effects of radiofrequency on knee pain and function in this population. The aim of the present study was to determine whether outpatients diagnosed with PFPS obtained improvement in pain and function after treatment by dynamic application of monopolar dielectric diathermy by emission of radiofrequency (MDR). Materials and Methods: An experimental study was conducted with 27 subjects with PFPS. Subjects were treated with 10 sessions of MDR in dynamic application. The visual analogue scale (VAS), the Kujala scale, the DN4 questionnaire, the lower extremity function scale (LEFS), the range of movement (ROM) in knee flexion and extension and the daily drug intake were measured pre- and post-intervention and at the time of the follow-up (six months). Results: Statistically significant differences were found in pain perception (VAS: F1,26 = 92.43, p < 0.000, ŋ2 = 0.78 and DN4: F1.26 = 124.15, p < 0.000, ŋ2 = 0.82), as well as improvements in functionality (LEFS: F1.26 = 72.42, p < 0.000, ŋ2 = 0.74 and Kujala: F1.26 = 40.37, p < 0.000, ŋ2 = 0.61]) and in ROM (Flexion: F1.26 = 63.15, p < 0.000, ŋ2 = 0.71). No statistically significant changes in drug intake were found. Conclusions: The present study shows that the dynamic application of MDR seems effective in reducing pain and increasing functionality and knee flexion in patients with PFPS, after a follow-up of six months.

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