جستجوی مقالات مرتبط با کلیدواژه « سندروم درد پاتلوفمورال » در نشریات گروه « پزشکی »

In order to evaluate postural control in people with musculoskeletal disorders, examining different standing positions provides useful information to researchers. On the other hands, visual manipulation also plays an important role in the analysis of postural control of people with patellofemoral pain syndrome in static and challenging conditions. The purpose of this research is to investigate the effect of vision manipulation and standing position on postural control in people with patellofemoral pain syndrome and control group.

30 participants with patellofemoral pain syndrome (aged 23.50 ± 3.76 years, height 167.5±8.58 cm, weight 63.86±12.05 kg) and 30 healthy control (aged 22.43 ± 2.84 years, height 166.25±9.7 cm, weight 59.36±9.35 kg) participated in the Quasi-experimental study in Ghaem Hospital of Mashhad in 2017. The postural sway measures (area, anterior-posterior displacement, medial-lateral displacement, and mean velocity) were recorded with force plate while standing (single-and double leg) in participants with and without patellofemoral pain syndrome. Also, two groups were examined in terms of manipulating visual inputs (eyes open or closed).

Interference of vision by standing position by group in all postural sway measures were statistically significant (p˂0.04). The removal of visual inputs led to a significant increase (p˂0.05) in the postural sway measures during single leg stance in participants with and without patellofemoral pain syndrome (p˂0.05).

It seems that the participants with and without patellofemoral pain syndrome use different central strategies for postural control.  The lack of visual input led to different response in terms of increasing postural sway in patients with patellofemoral pain syndrome as compared to healthy control.

Patellofemoral pain (PFPS) is considered as one of the most common reasons of knee pain with unknown cause and numerous biomechanical factors. Since patients report pain and functional constraints 5 to 8 years after treatment, therefore investigation of the lower limb kinematics during stair ambulation is necessary to determine compensatory mechanisms and the effectiveness of treatment interventions. The aim of the present review is to investigate the lower extremity kinematics during stair ambulation in people with PFPS.

The search articles from various databases Pubmed, Science Direct, Elsevier, Springer and articles about the years 2000 up to 2018 were extracted. To extract the articles, the following keywords have been used: PFPS, Hip adduction ، Rear foot eversion, Flexion knee. Finally, 1200 articles were found and after reviewing the abstract and titles of articles, 240 articles were selected for the next review. Then, considering the main subject of the present study and inclusion/ exclusion criteria, 10 articles were selected for final investigation.

The 10 extracted articles examined the kinematics of three sections: proximal, local, and distal during stair descent in PFPS patients.

According to the results of this study, changes in lower extremity kinematics during stairs ambulation will ultimately lead to an increase of reaction force and pressure in PFJ, which is one of main causes of development and pathology of PFPS Therefore, treatment interventions that comprehensively address changes in kinematics resulted in greater effectiveness in improving clinical symptoms for a long time.

Patellofemoral pain syndrome is a common musculoskeletal disorder. Quadriceps exercises are used as standard exercises for patellofemoral pain syndrome rehabilitation, but in addition to the weakness of quadriceps muscles, the weakness and shortness of the knee proximal and distal muscles are also effective in the incidence of this syndrome. The aim of the current study was to investigate the effect of knee local, proximal, and distal training on performance, dynamic balance, and pain in athletes with this syndrome.

A total of 39 athletes with patellofemoral pain syndrome, diagnosed by a specialist practitioner, with an average age of 25.5 ± 3.35 years, were voluntarily included in the study and were randomly assigned to three groups of proximal, including hip and knee muscles exercises (n=12), distal, including ankle and knee muscles exercises (n=11), and and control, including only knee muscles local exercises (n=12). Training was performed for 8 weeks. To evaluate the patients’ performance, dynamic balance, and pain severity, the WOMAC questionnaire, Y test, and visual analogue scale were used, respectively.

The results showed that in anthropometric characteristics, pain and function before intervention, there were not any significant differences between three experimental groups. In all the three groups, the pain, dynamic balance and performance in post-test were significantly improved compared with pretest (P = 0.001). Also, there was a significant difference in pain intensity between the proximal group and those of the other two groups (P = 0.016).

Based on the research findings, all three types of exercises are effective in reducing pain and improving performance and dynamic balance of patients, but the proximal exercises have a greater effect on reducing pain in patients with patellofemoral pain syndrome. Therefore, it is suggested that the combined hip and knee exercises be used in rehabilitation of patients with patellofemoral pain syndrome.

Stretching the shortened structures by stretch exercises is one of the most effective methods for function improvement in patients with patellofemoral pain. Thus, the aim of this study was to compare the effects of proprioceptive neuromuscular facilitation (PNF) and Classic physiotherapy stretching (CPS) exercises on the balance and function in patellofemoral pain patients.
This was a semi-experimental research in which 33 women with patellofemoral pain syndrome were randomly divided into three PNF (n=11), CPS (n=11) and control (n=11) groups. The PNF group participated in the quadriceps and hamstring PNF for two months, the CPS members participated in the Classic physiotherapy stretching exercisesfor the same period, while the control group did not participate in any exercise program. The function, static as well as dynamic balances were measured by WOMAC scale, Sharpend Romberg test, and SEBT, respectively. Data were analyzed by ANOVA repeated measures at significance level of 0.05.
Findings: As there were no differences between functions and balances of different groups, (P>0.05) before training interventions, PNF group’s knees functions improved significantly compared to CPS (P0.05).
Discussion & According to the conclusions of our research, PNF training is more effective in improving function and balance patients with patellofemoral pain; although, classic physiotherapy stretching exercises are often used for the treatment of such patients. Hence, applying PNF exercises for the treatment of such diseases are recommended to physiotherapists and rehabilitation professionals.

Patellofemoral pain syndrome (PFPS) is a common disorder of the knee.­ the conservative treatment of patellofemoral pain syndrome is to correct shortness of soft tissue. The aim of this study was to determine the effect of PNF stretching exercise on PFPS.
Twenty female volunteers with PFPS were randomly assigned to PNF and control groups. The experimental group accomplished their own specific treatment protocols for 8 weeks, whereas the control group did not follow the treatment plan. Pain and functional disability were assessed by visual analogue scale (VAS) and Kujala questionnaire respectively, before and after exercise. Using SPSS 20 software, data were analyzed by t-test. P The experimental group showed a significant reduction in the pain (P We concluded that PNF stretching may have positive effects on PFPS.

Patellofemoral pain syndrome is one of the most common knee disorders in the athletes and women. Despite use of water-based exercise in the treatment of musculoskeletal disorders and sport injuries, its impact on the pain and knee function in the patients with patellofemoral pain syndrome has not been investigated appreciably. The present study made a comparison between the effects of water-based exercise and conventional land- based exercise in the female athletes with patellofemoral pain syndrome.
Material and 20 collegiate athletes with patellofemoral pain syndrome were included in this study and randomly assigned to two groups: water-based (n = 10) and Land-based (n = 10) groups. Land – based protocol was performed in the gym and water-based training was implemented in the pool. Exercises were designed to strengthen the hip abductors and external rotator muscles. We used NRS to assess pain intensity, and Kujala and LEFS scale for the assessment of the knee function in various activities before and after the exercises protocols. We used repeated measures ANOVA for analysis of the effects of the therapeutic interventions.
According to the results of repeated measure ANOVA we found significant differences in NRS (p=0.040) and LEFS (p=0.024) after intervention between the two groups. Statistical analysis showed no significant difference in kujala scores between the two groups (p=0.927).
The results showed that water-based exercise as a therapeutic modality was more effective in reducing the pain and improvement of the knee function in the patients with patellofemoral pain syndrome, compared to land-based exercise.

Patellofemoral pain syndrome (PFPS) is among the most common musculoskeletal disorders in the athletes and active individuals. Observation of muscular responses to unexpected perturbations is one of the most common methods to evaluate the neural strategies. The aim of this study was to evaluate the EMG response of vastus muscles to dynamic postural perturbations in the athletes with PFPS.
Material and This study included 10 male athletes with PFPS and 10 healthy male athletes. NPRS scale was used to assess pain. EMG activity of VMO and VL muscles measured during dynamic postural perturbation. The EMG signals were collected using a 16- channel BTS-FREEEMG 300 system, manufactured in Italy. Independent-t test was used for data analysis.
RMS values for VMO and VL muscles in PFPS group, were higher than the corresponding values of the control group by 33.59% and 33.35% respectively, in the forward postural perturbation. There was a significant difference in VL muscle RMS values between the two groups (P=0.04). RMS values for VMO and VL muscles in PFPS group were higher than those of the control group by 38% and 49.52% respectively, in the backward postural perturbation and there was a significant difference in VL muscle RMS values between the two groups (P=0.04).
The results showed that valtus muscles were more active in response to dynamic postural perturbation in the athletes with PFPS in comparison to the healthy athletes. Patellofemoral pain syndrome and in general joint disorders can lead to dysfunction in the whole sensory-motor system. Therefore, instead of focusing on local symptoms we should examine the whole body in sensory-motor system dysfunction.

Rotational impairment of the knee (excessive adduction and internal rotation of the hip during weight-bearing activities) and hip muscles weakness have been proposed as one of the risk factors of PFPS. The effects of correction of these impairments, which are not related directly to patella-femoral joint, have not been studied up to now. The aim of this study was to compare the effects of “conventional physiotherapy alone” and “combined conventional physiotherapy with exercise therapy based on Sahrmann approach” in patients with PFPS.
In this randomized controlled clinical trial, 30 patients with PFPS (aged 20-50) were participated. The participants were divided into two groups: "traditional physiotherapy group" and “Sahrmann treatment group”. In both groups, interventions were applied for 6 weeks. Patients in traditional physiotherapy group only received TENS, hot packs, ultrasound, and knee exercise therapy. But in Sahrmann treatment group, in addition to traditional physiotherapy, posterior X taping, hip muscle strengthening and functional training was used. Before and immediately after the end of 6th week, quality of life variables (using questionnaires KOOS), pain (using the Visual Analogue Scale), and position sense of the knee were measured.
FINDINGS: All of the variables including pain, KOOS scale and position sense of the knee were significantly improved in both groups (p0.05).
Essentially, using of Sahrmann approach including “posterior X taping on thigh, strengthening of hip abductor, extensor and lateral rotators muscles”, compared to conventional physiotherapy, was not result in more effective improvement in patients with PFPS.

Patellofemoral pain syndrome (PFPS) is one of the most common knee chronic disorders especially among females that is closely related to forces imbalance of vastus medial is oblique (VMO) and vastus lateral is (VL) muscles. The purpose of study was to examine the effect of knee isokinetic extension in maximum lateral tibia rotation on VMO and VL amplitudes in PFPS patients.
Thirty-six women with PFPS participated voluntarily in this study and were randomly placed in one of three groups included the VMO selective isokinetic strengthening exercise, quadriceps general strengthening and control groups. Each exercise was performed for 8 weeks. Muscle RMS of VMO and VL and VMO/VL RMS ratio were recorded and calculated before and after training using of an 8-channels electromyography system. Data analysis was made by analyses of variance with repeated measures.
In baseline, VMO amplitude was less than VL in all groups (P≤0.05), but after interventions, it was more than VL in selective group (P=0.01) and less than VL in general (P=0.001) and control (P=0.036) groups. Before interventions, there was no difference between groups in muscles amplitude (P>0.05). Yet, after interventions, VMO amplitude and VMO/VL amplitude ratio were more in selective group than in general and control groups (P≤0.001), and VL amplitude was more in general group than in selective and control groups (P≤0.01).
According to the study results, isokinetic extension training with maximum lateral tibia rotation and in close to knee full extension can be recommended as an appropriate training for improving VMO/VL electrical activity ratio and decreasing imbalance between lateral and medial vastus muscles amplitudes in patients with PFPS.

Patellofemoral pain syndrome (PFPS) is one of the most common knee problems.
The gold standard for PFPS rehabilitation is quadriceps strengthening. It has been suggested that hip muscles weakness may be an important factor in the etiology of patients with PFPS. The purpose of this study was to evaluate the effect of hip external rotator and abductor muscles on pain and function in Male with patellofemoral pain.
30 participants diagnosed by PFPS were participated and randomly divided into two groups, quadriceps strengthening (n=15) and hip and quadriceps strengthening (n=15). The NRPS and Kujala scale were respectively used to assess pain intensity and function at baseline and at the end of the 6-week exercise program. Collected data were analyzed by paired t-test and independent t-test.
Findings: After 6 weeks of exercise therapy, mean scores of pain and function for two groups were significant improvement (P>0/05). But significant difference between the average of pain scores and physical function of combination exercise and quadriceps strengthening exercises was observed (P>0/05).
Discussion & Although, both combination and quadriceps muscle strengthening exercises were effective to reduce pain and improve function in patients with patellofemoral pain syndrome, combination exercises was more effective than quadriceps muscle strengthening exercises. Therefore, it is recommended to experts and researchers to use combination exercises in the rehabilitation programs to reduce pain and improve function in patients with patellofemoral pain syndrome.

Patellofemoral pain syndrome (PFPS) is the most common cause of anterior knee pain in adults. Patellar taping is used to correct patellar position and rehabilitate patients with PFPS. However, the effectiveness and clinical efficiency of this technique in the treatment of these patients are not fully determined. Therefore, this study aimed to evaluate the effects of knee taping on patellar alignment, quality of life, and pain in patients with PFPS. This cross-sectional study was conducted on 25 PFPS patients within the age range of 20-50 years. McConnell taping technique was applied for patients during four weeks. Before and immediately after the treatment, quality of life (via KOOS questionnaire), patellar alignment (via skyline radiography of the knee), and pain intensity were measured. After four weeks, McConnell taping technique caused a decline in pain intensity from 50.13±21.60 to 26.67±10.14 mm in patients with PFPS (P=0.001). However, this technique had no positive effects on quality of life (score on KOOS questionnaire) or patellar angle/position (P<0.05). Based on the findings, independent use of McConnell taping technique is not sufficient for improving the quality of life in patients with PFPS or correcting the abnormal alignment of patella however, it can help reduce the induced pain.

Patellofemoral Syndrome (PFPS) is one of the most common knee joint problems among the athletes. The present study was aimed to compare the effect of aquatic and land-based exercise methods on the pain level and motor function of the weight lifters with patellofemoral syndrome. A total of twenty weight lifters with patellofemoral syndrome participated in this quasi-experimental study. They were randomly divided to two groups of aquatic exercise and land-based exercise. Visual Analog Scale (VAS) and Kujala Scale were used before and after the exercise period to measure the pain and motor function، respectively. To compare the pre-test and post-test scores of the participating groups، dependent t-test was used and to compare the differences between groups، ANOVA was applied. The results of post-test showed a significant difference in both groups in terms of pain level and motor function compared to pre-test after eight weeks of strength exercise. However، the comparison of data indicated no significant difference between groups with regard to pain level and motor function. According to the findings of this study، exercise in water and on land can reduce the pain and improve the performance of the patients with patellofemoral syndrome.

Patellofemoral pain syndrome (PFPS) is one of the most common orthopaedic problems of the knee joint. Muscular weakness considered as a risk factor of this syndrome. Muscular weakness can alter lower extremity kinematics and lead to this syndrome. Also according to the kinetic chain, weakness in one motor segment can influence other motor segments. So the aim of this study was to determine the association between muscular strengths of both lower extremity and trunks muscles and PFPS. 40 women participated in this study (20 subjects with PFPS and 20 as controls). In both groups isometric strengths of the lower extremity and lower trunk muscles were evaluated with Nicholas hand-held dynamometer and then compared with each other. There was a significant decrease in strength of the hip abductors, adductors, external rotators, flexors and extensors, quadriceps, ankle plantarflexors, dorsiflexors, flexor and lateral flexors of the trunk in patients with PFPS. Our results indicate that decrease in strength of the hip and trunk muscles is associated with the knee injury. It seems strengthening of muscles of these areas to be effective in preventing the injury, reducing the risk of more injury and treatment of patients with this syndrome.

Patellofemoral pain syndrome is a common cause of anterior knee pain. This condition may arise from abnormal biomechanical factors that alter tracking of the patella within the femoral trochlear notch. This in turn may contribute to increased patellofemoral contact pressure causing pain and dysfunction. Some impairment such as limited flexibility of key lower extremity muscles may be important impairments to consider in the conservative management of patellofemoral pain syndrome. The purpose of this study was to compare lower extremity muscle length between persons with and without patellofemoral pain syndrome. Fifteen patients with patellofemoral pain syndrome and 15 age and sex matched controls participated in the study. Lower extremity muscle lengths (quadriceps gastrocenmius and soleus muscles) were measured by a standard goniometer in both groups. Patients with patellofemoral pain syndrome demonstrated significantly less flexibility of the gastrocnemius and soleus muscles compared to healthy persons (respectively p=.01 p=.02) but flexibility of the quadriceps muscle was similar in the two groups (p≥.05). This study suggests less flexibility of the gastrocnemius and soleus muscles in patellofemoral pain syndrome patients. This may be an important consideration in management of this syndrome.