Patellofemoral Pain Syndrome
Conditions
Keywords
Popliteus Muscle Release, Patellofemoral Mobilization, Patellofemoral Pain Syndrome
Brief summary
This study will be conducted to compare the effect of popliteus muscle release and patellofemoral mobilization on pain intensity, function, and quadriceps muscle strength in patients with patellofemoral pain syndrome?
Detailed description
The gradual development of diffuse anterior knee pain is characteristic of patellofemoral pain (PFP), which is made worse by activities that put stress on the patellofemoral joint, such as running, stair climbing, and squatting. While 23% of the overall population has PFP, athletes can have a prevalence of 35%.Patellofemoral pain syndrome (PFPS) is a widespread disease with a significant impact on society, with a 22.7% prevalence in the general population.The patella is the largest sesamoid bone in the body and acts as a fulcrum to improve the mechanical advantage of the quadriceps. In full knee extension the patella does not articulate with the femoral condyles, and related to the lack of articular congruency, is able to glide more freely. The inferior patellar facet first contacts the femoral condyle around 20-30o of knee flexion.The popliteus tendon is a primary stabilizer of external knee rotation and has been described as the "fifth ligament of the knee." Injuries involving the posterolateral corner of the knee commonly involve the popliteus tendon; isolated injury to the popliteus tendon is relatively rare and usually involves a rotatory injury mechanism and symptoms of instability and pain.Myofascial release has been shown to improve pain, range of motion, and functional outcomes in individuals with knee disorders. By targeting fascial restrictions around the quadriceps, hamstrings, iliotibial band, and peri-patellar tissues, myofascial techniques help reduce tissue stiffness and abnormal tension that may contribute to altered patellar tracking and joint loading.Patellofemoral mobilization is considered an important intervention in the management of PFPS, particularly in patients presenting with pain, stiffness, or altered patellar tracking.Although both techniques are used to reduce anterior knee pain and improve function, current evidence is insufficient to determine which intervention is more effective. Therefore, further randomized controlled trials are needed to compare their effects on pain and functional outcomes in individuals with PFPS.
Interventions
the participant will lie supine and relaxed on a treatment bench. The therapist will begin the treatment by flexing the participant's knee to approximately 15-25 degrees. Then, the therapist will apply pressure to the popliteus muscle while simultaneously extending the knee to approximately 5 degrees of flexion. When the knee is extended, the pressure will be released. The therapist will repeat this procedure for up to 2 minutes plus tradional therapy
OTHERPatellofemoral Mobilization
Following the clinical guidelines established by Brukner and Khan, the mobilization will be performed with the patient in a supine position to ensure complete relaxation of the quadriceps musculature, thereby minimizing joint compressive forces. The intervention will include multidirectional glides tailored to specific functional deficits:Superior glides,Inferior glides,Medial-lateral excursions and tilt mobilization.Each mobilization will be applied as a gentle sustained glide for duration of 30 to 60 seconds per repetition
OTHERtraditional therapy
patients will receive quadriceps muscle strength, hip extension strength, hamstring stretch.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
opaque sealed envelope
Intervention model description
Popliteus Muscle Release and Patellofemoral Mobilization
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* Male and female participants aged 18-30 years. * minimum history of 3 months of unilateral PFP. * pain intensity score of ≥3 on a 10-cm Visual Analog Scale (VAS) for worst pain experienced during the previous week. * Pain reproduced during at least two of the following functional activities: stair ascent or descent, running, hopping, prolonged sitting, squatting, or kneeling. * Presence of pain on at least one of the following clinical tests: patellar compression test or palpation of the patellar facets.
Exclusion criteria
* Clinical, x-ray, or MRI findings indicative of other specific pathology including osteoarthritis, meniscal, ligament or cartilage injury, apophysitis. * Recurrent patellar subluxation or dislocation. * Cortisone use over an extended period of time. * Previous surgery to the knee joint; trauma to the knee joint affecting the presenting clinical condition. * Lower limb deformities.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | up to four weeks | The scale used will be the visual analogue scale (VAS), which consists of a line, usually 10 cm long, the patient will be instructed to place a vertical mark on to indicate his/ her pain, ranging from no pain or discomfort (0), to the worst pain that could possibly feel |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| knee disability | up to four weeks | The Kujala Arabic version will be used to assess knee disability. it is 13 items on the scale are used to assess subjective symptoms and functional restrictions. A score can have a minimum of 0 points or a maximum of 100 points.Lower scores reflect greater pain and disability |
| quadriceps muscle strength | up to four weeks | A handheld dynamometer will be used to assess quadrecips muscle strength |
Contacts
CONTACTmohamed Bahig, master
Outcome results
None listed