Tag: Patellofemoral Pain Syndrome

Effectiveness of concentric and eccentric strengthening program on pain and functional performance in patellofemoral pain syndrome among sprinters – A pilot study

Buvanesh Annadurai, Vinodhkumar Ramalingam, Devadharshini Balakrishnan, Surya Vishnuram, Shenbaga Sundaram Subramanian, Santhana Lakshmi S, Pavithra Aravind, Pavithra S, Rajesh G, Thamer A. Altaim

Buvanesh Annadurai et al. – Effectiveness of concentric and eccentric strengthening program on pain and functional performance in patellofemoral pain syndrome among sprinters – A pilot study –  Fizjoterapia Polska 2025; 25(3); 288-292

DOI: https://doi.org/10.56984/8ZG7D19JL5P

Abstract
Background. Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that primarily affects athletes, particularly those who engage in repetitive knee flexion and extension. Collegiate sprinters are especially susceptible to PFPS because certain strokes, including the freestyle and breaststroke, demand repetitive lower-limb actions. The estimated prevalence of PFPS in elite athletes is 35.7%, 28.9% in adolescents, and 13.5% in the military. PFPS affects individuals across various age groups, with a general population prevalence rate of 23%. Muscle imbalances surrounding the knee joint, especially weakness of the quadriceps muscles, which are essential for patellar stabilization, are frequently linked to PFPS. Strengthening exercises can be broadly divided into concentric and eccentric modalities, although different rehabilitation strategies may be applied. This study aims to compare the influence of concentric and eccentric strengthening programs on pain levels and functional performance in collegiate sprinters diagnosed with PFPS.
Objective. To compare the effectiveness of changes in functional performance and pain following both concentric and eccentric exercises in PFPS among collegiate sprinters.
Materials and methods. A total of 24 participants were allocated into two groups using a convenient sampling method: group A (n = 12) and group B (n = 12). Group A received concentric exercise, while group B underwent eccentric exercise for three weeks. Materials required included a chair, stopwatch, clear floor space, and measuring tape to ensure accurate assessment and execution of exercises. Outcome measures included the Numeric Pain Rating Scale (NPRS) to assess pain levels and the Timed Up and Go (TUG) test to evaluate functional mobility and balance.
Results. Statistical analysis of the quantitative data showed no statistically significant difference between group A and group B, with a p-value of < 0.0001. Both groups demonstrated considerable improvement post-intervention in pain and functional performance; however, no significant difference was found between the groups. Therefore, both concentric and eccentric strengthening programs appear equally effective in managing patellofemoral pain syndrome among collegiate sprinters.
Conclusions. According to this study’s findings, concentric exercises with therapeutic ultrasound (group A) and eccentric exercises with therapeutic ultrasound (group B) are similar in effectiveness in lowering pain and improving functional performance in collegiate sprinters with patellofemoral pain syndrome.
Key words
anterior knee pain, patellofemoral pain, patellofemoral pain syndrome
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The Influence of high kinesiophobia on dynamic postural stability among females with patellofemoral pain syndrome during a single-leg squat test

Amjad Shallan, Bodor Bin sheeha, Hadeel Almimi, Adnan Wshah, Saker M. Obaidat, Ahmad Muhsen, Mohanad Hawamdeh, Saad Al-Nassan

Amjad Shallan et al. – The Influence of high kinesiophobia on dynamic postural stability among females with patellofemoral pain syndrome during a single-leg squat test –  Fizjoterapia Polska 2024; 24(4); 412-417

DOI: https://doi.org/10.56984/8ZG01A8F7G9

Abstract
Objective. The purpose of this study was to examine the effect of Kinesiophobia level on postural stability during Single Leg Squat Test (SLST) in females with patellofemoral pain syndrome (PFPS).
Methods. Forty women with PFPS were divided into a High Kinesiophobia level group (HK), a Low Kinesiophobia level group (LK), and a pain-free control group of twenty participants. Postural stability was measured during the performance of the Single Leg Squat Test (SLST) on a force platform. The centre of pressure (COP) excursion and velocity were recorded.
Results. The HK group had a significantly higher mean medial–lateral and anterior-posterior COP displacement compared to the LK and control groups. However, the results showed no significant differences in COP variables (velocity and displacement) between LK and healthy subjects. Muscle strength of participants with PFPS presented a significant deficit compared to healthy control group.
Conclusions. High Kinesiophobia negatively affects postural stability during the SLST. Kinesiophobia should be considered during the assessment and management of PFPS.
Key words
postural stability, patellofemoral pain syndrome, kinesiophobia, centre of pressure, single leg squat test
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Effect of foot orthoses on patellofemoral pain syndrome: A systematic review

Marihan Zakaria Aziz, Salwa Fadl Abd Elmajeed, Karima Abdelaty Hassan

Marihan Zakaria Aziz, Salwa Fadl Abd Elmajeed, Karima Abdelaty Hassan – Effect of foot orthoses on patellofemoral pain syndrome: A systematic review. Fizjoterapia Polska 2020; 20(5); 12-23

Abstract

Background. Although foot orthosis may play a role in treatment of patellofemoral pain syndrome, its significance is still conflicting and previous studies show a low level of evidence. Objective. To find the latest evidence regarding the effectiveness of foot orthosis (FO) on adult patients with patellofemoral pain syndrome (PFPS). Methods. A comprehensive electronic database search of PubMed, Cochrane Library Database, the Physiotherapy Evidence Database (Pedro), ProQuest, EBSCo host, and Ovid databases was performed for randomized controlled trials (RCTs) in English language since January 2000 till February 2019 on adults with patellofemoral pain syndrome treated by foot orthosis and physical therapy, with hand searching to reference lists of previous systematic reviews and included papers. At least one primary outcome measure for pain or function must have been reported. Two authors independently reviewed and assessed each citation for inclusion, The Cochrane risk of bias tool was used to rate methodological quality and risk of bias. Data was met analyzed when this was not possible, qualitative data analysis was performed. Results. A total of 9 RCTs with a total number of 415 patients (6 on non-runners and 3 on runners) were included. Findings were summarized in four main comparisons as follows 1)foot orthosis versus flat insoles these results showed the positive efficacy of FO on pain, function and muscular activity, 2) foot orthoses alone versus physiotherapy have a poor indication of PFO alone as an intervention alternative to physiotherapy for PFPS, 3)foot orthoses versus no treatment may provide greater improvements on pain, function and neuromotor changes than natural history concerning foot posture, and 4)foot orthoses combined physiotherapy is better than physiotherapy alone even though the success may relate to clinical foot predictors for foot orthosis. Conclusion. The clinical efficacy of foot orthoses may correlate with targeting specific individuals based on specific foot measures and the comfort perception of the orthosis. On the kinematics, foot orthosis may behave minor neuromotor activity changes at the lower extremity. The effects of combining foot orthoses with physical therapy may be superior to physical therapy alone and result in better outcomes.

Key words:
Patellofemoral pain syndrome, foot orthosis, systematic review
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Mechanical Response of Hip and Knee Muscles Following Randomized Crossover Trials in Patellofemoral Pain Syndrome

Hamada A. Hamada, Hossam E. Fawaz, Ghada Koura, Noran A. Elbehary, Salam M. Elhafez

Hamada A. Hamada, Hossam E. Fawaz, Ghada Koura, Noran A. Elbehary, Salam M. Elhafez – Mechanical Response of Hip and Knee Muscles Following Randomized Crossover Trials in Patellofemoral Pain Syndrome. Fizjoterapia Polska 2020; 20(1); 160-168

Abstract
Background. Faulty hip kinematics during weight bearing activities is proposed to contribute to patellofemoral pain syndrome (PFPS). However, limited information exists to determine the effectiveness of exercises programs that not only act on the knee joint, but also on the hip joint in patients with PFPS. Purpose. The purpose of this study was to compare between the effect of the starting with hip strengthening exercises before knee exercises program and the starting with knee exercises program before hip strengthening exercises on pain intensity, Kujala questionnaire scale, quadriceps angle (Q-angle), anteversion angle, and eccentric peak torques (PT) for hip abductors, external rotators, and knee extensors in patients with PFPS. Materials and Methods. Twenty-four patients suffering from PFPS were randomly assigned into two equal groups of twelve. Group (A): their mean age, weight, height and BMI values were 23.33 ± 5.39 years, 71.16 ± 13.05 kg, 164.75 ± 4.5 cm, and 26.21 ± 4.71 kg/m² respectively. They received hip abductors and external rotators strengthening exercises for three weeks followed by knee extensors strengthening exercises and stretching exercises for hamstring quadriceps, iliotibial band and gastrocnemus for another three weeks. Group (B): their mean age, weight, height and BMI values were 23.16 ± 6.33 years, 69.41 ± 18.14 kg, 164.66 ± 7.27 cm, and 25.2 ± 6.2 kg/m² respectively. They received knee extensors strengthening exercises and stretching exercises for hamstring, quadriceps, iliotibial band and gastrocnemus for three weeks followed by hip abductors and external rotators strengthening exercises for another three weeks. Both groups received three to four sessions per week for six weeks. Pain level, Kujala scale, Q-angle, anteversion angle, and isokinetic eccentric PT for hip abductors, external rotators, and knee extensors were recorded before, after three weeks, and after six weeks of exercises. Results. 2×3 Mixed Design MANOVA revealed that there was a significant reduction in level of perceived pain and improvement of Kujala scale in group (A) compared with group (B) after six weeks of exercise (p < 0.05). However, there was no significant difference in the Q-angle, anteversion angle, and isokinetic eccentric PT for hip abductors, external rotators, and knee extensors between the tested groups after six weeks of exercise (p > 0.05). Conclusion. Starting rehabilitation program with hip strengthening exercises before knee exercises program is more effective than starting with knee exercises program before hip strengthening exercises in reducing pain and improving knee function in patients with PFPS. Consequently, this may help physiotherapists in designing the most effective and efficient prevention and rehabilitation programs for patients suffering from PFPS.

Key words:
Patellofemoral Pain Syndrome, Hip, Knee, Strengthening Exercises, Q -Angle, Anteversion Angle

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