Improving Patellofemoral Pain Syndrome: A Randomized Clinical Trial Investigating the Impact of Functional Stabilization Exercises on Pain Relief, Functionality, and Biomechanics of the Lower Extremity
Keywords:Exercise, Musculoskeletal Disorders, Pain, Patellofemoral Pain Syndrome, Physical Function
Patellofemoral pain (PFP) is a common musculoskeletal condition that affects many individuals. Hence our objective was to identify the effectiveness of functional stabilization exercises on pain relief, functionality, and biomechanics of the lower extremity in patients with PFP.
It was a double-blinded, randomized controlled trial that enrolled 60 participants diagnosed with PFP, randomly assigned to functional stabilization and conventional treatment group. Both groups received exercises for 8 weeks with 3 sessions on non-consecutive days of the week. Pain levels, functional performance, and lower extremity biomechanics were assessed.
The mean age of the participants was 23.48± 4.89 in FST and 21.98±3.42 in the CT group, with improvements observed in all variables in both groups. However, more significant results were reported in the FST group with mean differences of 2.15±0.5, 6.75±3.88, 14.47±12.21, and 1.7±0.47 for pain, physical function, single-leg triple hop, and Q-angle respectively.
Functional stabilization exercises are an effective treatment option for patients with PFPS. It can significantly improve pain levels, functional performance, and lower extremity biomechanics in patients with PFPS. The findings of this study support the use of functional stabilization training as a treatment option for patients with PFPS.
Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). British Journal of Sports Medicine. 2016;50(14):844-52.
Roush JR, Bay RC. Prevalence of anterior knee pain in 18–35 year-old females. International Journal of Sports Physical Therapy. 2012;7(4):396.
Bell-Jenje T, Olivier B, Wood W, Rogers S, Green A, McKinon W. The association between loss of ankle dorsiflexion range of movement, and hip adduction and internal rotation during a step down test. Manual Therapy. 2016;21:256-61.
Steinberg N, Tenenbaum S, Waddington G, Adams R, Zakin G, Zeev A, Siev-Ner I. Unilateral and bilateral patellofemoral pain in young female dancers: associated factors. Journal of Sports Sciences. 2020;38(7):719-30.
Baldon RD, Serrão FV, Scattone Silva R, Piva SR. Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial. Journal of Orthopedic & Sports Physical Therapy. 2014;44(4):240-51.
dos Santos Siqueira M, Souto LR, Martinez AF, Serrão FV, de Noronha M. Muscle activation, strength, and volume in people with patellofemoral osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and Cartilage. 2022.
Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clinics in Geriatric Medicine. 2010;26(3):355-69.
Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40:42-51.
Thomson C, Krouwel O, Kuisma R, Hebron C. The outcome of hip exercise in patellofemoral pain: A systematic review. Manual Therapy. 2016;26:1-30.
Manojlović D, Zorko M, Spudić D, Šarabon N. Effects of a targeted exercise program on inter-leg asymmetries in patients with patellofemoral pain. Symmetry. 2021;13(6):1075.
Hott A, Brox JI, Pripp AH, Juel NG, Paulsen G, Liavaag S. Effectiveness of isolated hip exercise, knee exercise, or free physical activity for patellofemoral pain: a randomized controlled trial. The American Journal of Sports Medicine. 2019;47(6):1312-22.
Manojlović D, Kozinc Ž, Šarabon N. Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis. Journal of Pain Research. 2021:1431-49.
Nakagawa TH, Moriya ÉT, Maciel CD, Serrão FV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. Journal of orthopaedic & sports physical therapy. 2012;42(6):491-501.
Tramontano M, Pagnotta S, Lunghi C, Manzo C, Manzo F, Consolo S, Manzo V. Assessment and management of somatic dysfunctions in patients with patellofemoral pain syndrome. Journal of Osteopathic Medicine. 2020;120(3):165-73.
Mathis RA, Taylor JD, Odom BH, Lairamore C. Reliability and validity of the patient-specific functional scale in community-dwelling older adults. Journal of Geriatric Physical Therapy. 2019;42(3):E67-72.
Straszek CL, Rathleff MS, Graven Nielsen T, Petersen KK, Roos EM, Holden S. Exercise‐induced hypoalgesia in young adult females with long standing patellofemoral pain–A randomized crossover study. European Journal of Pain. 2019;23(10):1780-9.
Delabastita T, Hollville E, Catteau A, Cortvriendt P, De Groote F, Vanwanseele B. Distal to proximal joint mechanics redistribution is a main contributor to reduced walking economy in older adults. Scandinavian Journal of Medicine & Science in Sports. 2021;31(5):1036-47.
Kısacık P, Tunay VB, Bek N, Atay ÖA, Selfe J, Karaduman AA. Short foot exercises have additional effects on knee pain, foot biomechanics, and lower extremity muscle strength in patients with patellofemoral pain. Journal of Back and Musculoskeletal Rehabilitation. 2021;34(6):1093-104.
Pompeo KD, da Rocha ES, Melo MA, de Oliveira NT, Oliveira DF, Sonda FC, Dos Santos PF, Rodrigues R, Baroni BM, Vaz MA. Can we replace exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in women with patellofemoral pain? A randomized controlled trial. Physical Therapy in Sports. 2022;58:1-7.
Copyright (c) 2023 Zahid Mehmood, Dr. Mazhar Ali Bhutto , Zeb Jehan Rana, Muhammad Farid Nasir, Abdul Waheed , Fadwa Tariq
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.