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Demirjian T, Crues J, Ho KY, Tsai LC, Powers C. Patellar articular overlap is better associated with patellar alignment during weight-bearing than traditional measures of patellar height. Knee 2024; 49:176-182. [PMID: 39013353 DOI: 10.1016/j.knee.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND A consequence of a high riding patella is reduced osseous stability and malalignment of the patella (i.e., lateral patellar tilt and displacement). Although quantification of patellar height is a routine part of the radiographic examination of the patellofemoral joint, it is not clear which measure of patellar height is best associated with patella alignment. HYPOTHESIS/PURPOSE To determine if patellar articular overlap (PAO) is better associated with lateral patellar tilt and lateral patellar displacement compared to traditional measures of patellar height. STUDY DESIGN Cross-sectional. METHODS Magnetic resonance images were obtained from 50 female participants (21 with patellofemoral pain and 29 healthy controls) under loaded conditions (25-35% bodyweight) at 15-20 degrees of knee flexion. Measurements of lateral patellar tilt and displacement as well as the PAO, Insall-Salvati ratio (ISV), Caton Deschamps-index (CD-index), or the Blacburn Peel-index (BP-index) were obtained from sagittal and axial plane images. RESULTS The PAO was found to significantly correlated with lateral patellar tilt (r = -0.77, p < 0.001). In contrast, the ISV, CD-index, or the BP-index were not found to be associated with lateral patellar tilt (r = 0.13, p = 0.34; r = -0.14, p = 0.33; r = -0.08, p = 0.56, respectively). Both the PAO and ISV were found to be significantly correlated with lateral patellar displacement (r = -0.52, p < 0.001; r = 0.43, p = 0.002, respectively). Conversely, the CD-index and BP-index were not found to be associated with lateral patellar displacement (r = 0.03 p = 0.83; r = 0.05 p = 0.74, respectively). CONCLUSION Of the measures of patellar height evaluated, the PAO was found to provide the greatest association with lateral patellar tilt and displacement.
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Affiliation(s)
- Thomas Demirjian
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar St #155, Los Angeles, CA 90033, United States.
| | - John Crues
- RadNet MSK Imaging, 1510 Cotner Ave, Los Angeles, CA, 90025, United States.
| | - Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas 4505 S. Maryland Parkway, Box 453029, Las Vegas, Nevada 89154, United States.
| | - Liang-Ching Tsai
- Department of Physical Therapy, Georgia State University, 140 Decatur Street Suite 1271, Atlanta, GA 30303, United States.
| | - Christopher Powers
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar St #155, Los Angeles, CA 90033, United States.
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Siegel M, Taghizadeh E, Lange T, Fuchs A, Yilmaz T, Maier P, Meine H, Schmal H, Izadpanah K. Influence of Medial Patellofemoral Ligament Reconstruction on Patellofemoral Contact in Patients With Low-Flexion Patellar Instability: An MRI Study. Orthop J Sports Med 2023; 11:23259671231160215. [PMID: 37213660 PMCID: PMC10192662 DOI: 10.1177/23259671231160215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/19/2023] [Indexed: 05/23/2023] Open
Abstract
Background Medial patellofemoral ligament (MPFL) reconstruction is a well-established procedure for the treatment of patients with patellofemoral instability (PFI) at low flexion angles (0°-30°). Little is known about the effect of MPFL surgery on patellofemoral cartilage contact area (CCA) during the first 30° of knee flexion. Purpose/Hypothesis The purpose of this study was to investigate the effect of MPFL reconstruction on CCA using magnetic resonance imaging (MRI). We hypothesized that patients with PFI would have a lower CCA than patients with healthy knees and that CCA would increase after MPFL reconstruction over the course of low knee flexion. Study Design Cohort study; Level of evidence, 2. Methods In a prospective matched-paired cohort study, the CCA of 13 patients with low-flexion PFI was determined before and after MPFL reconstruction, and the data were compared with those of 13 healthy volunteers (controls). MRI was performed with the knee at 0°, 15°, and 30° of flexion in a custom-designed knee-positioning device. To suppress motion artifacts, motion correction was performed using a Moiré Phase Tracking system via a tracking marker attached to the patella. The CCA was calculated on the basis of semiautomatic cartilage and bone segmentation and registration. Results The CCA (mean ± SD) at 0°, 15°, and 30° of flexion for the control participants was 1.38 ± 0.62, 1.91 ± 0.98, and 3.68 ± 0.92 cm2, respectively. In patients with PFI, the CCA at 0°, 15°, and 30° of flexion was 0.77 ± 0.49, 1.26 ± 0.60, and 2.89 ± 0.89 cm2 preoperatively and 1.65 ± 0.55, 1.97 ± 0.68, and 3.52 ± 0.57 cm2 postoperatively. Patients with PFI exhibited a significantly reduced preoperative CCA at all 3 flexion angles when compared with controls (P ≤ .045 for all). Postoperatively, there was a significant increase in CCA at 0° of flexion (P = .001), 15° of flexion (P = .019) and 30° of flexion (P = .026). There were no significant postoperative differences in CCA between patients with PFI and controls at any flexion angle. Conclusion Patients with low-flexion patellar instability showed a significant reduction in patellofemoral CCA at 0°, 15°, and 30° of flexion. MPFL reconstruction increased the contact area significantly at all angles.
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Affiliation(s)
- Markus Siegel
- Department of Orthopedic Surgery and
Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg,
Freiburg, Germany
- Markus Siegel, MD,
Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital,
Albert Ludwigs University Freiburg, Hugstetter Strasse 55, Freiburg, 79098
Germany ()
| | - Elham Taghizadeh
- Fraunhofer Institute for Digital
Medicine MEVIS, Bremen, Germany
| | - Thomas Lange
- Division of Medical Physics, Department
of Diagnostic and Interventional Radiology, Medical Center–University of Freiburg,
Faculty of Medicine, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - Andreas Fuchs
- Department of Orthopedic Surgery and
Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg,
Freiburg, Germany
| | - Tayfun Yilmaz
- Department of Orthopedic Surgery and
Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg,
Freiburg, Germany
| | - Philipp Maier
- Department of Orthopedic Surgery and
Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg,
Freiburg, Germany
| | - Hans Meine
- Fraunhofer Institute for Digital
Medicine MEVIS, Bremen, Germany
| | - Hagen Schmal
- Department of Orthopedic Surgery and
Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg,
Freiburg, Germany
- Department of Orthopedic Surgery,
University Hospital Odense, Odense, Denmark
| | - Kaywan Izadpanah
- Department of Orthopedic Surgery and
Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg,
Freiburg, Germany
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Watson R, Sullivan B, Stone AV, Jacobs C, Malone T, Heebner N, Noehren B. Lateral Patellar Dislocation: A Critical Review and Update of Evidence-Based Rehabilitation Practice Guidelines and Expected Outcomes. JBJS Rev 2022; 10:01874474-202205000-00004. [PMID: 35748823 DOI: 10.2106/jbjs.rvw.21.00159] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Nonoperative treatment of a lateral patellar dislocation produces favorable functional results, but as high as 35% of individuals experience recurrent dislocations. » Medial patellofemoral ligament reconstruction is an effective treatment to prevent recurrent dislocations and yield excellent outcomes with a high rate of return to sport. » Both nonoperative and postoperative rehabilitation should center on resolving pain and edema, restoring motion, and incorporating isolated and multijoint progressive strengthening exercises targeting the hip and knee. » Prior to return to sports, both functional and isolated knee strength measurements should be used to determine leg symmetry strength and to utilize patient-reported outcome measures to assess the patient's perceived physical abilities and patellofemoral joint stability.
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Affiliation(s)
- Richard Watson
- Department of Physical Therapy, University of Kentucky, Lexington, Kentucky
| | - Breanna Sullivan
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - Austin V Stone
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - Cale Jacobs
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - Terry Malone
- Department of Physical Therapy, University of Kentucky, Lexington, Kentucky
| | - Nicholas Heebner
- Department of Athletic Training, University of Kentucky, Lexington, Kentucky
| | - Brian Noehren
- Department of Physical Therapy, University of Kentucky, Lexington, Kentucky
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Tibial internal and external rotation taping for improving pain in patients with patellofemoral pain syndrome. J Sci Med Sport 2022; 25:644-648. [DOI: 10.1016/j.jsams.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 11/23/2022]
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Sonographic evaluation of patellar tendon displacement and its correlation with patellofemoral pain syndrome. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2021. [DOI: 10.1177/22104917211035555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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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Efficacy of Kinesio Taping and McConnell Taping Techniques in the Management of Anterior Knee Pain. J Sport Rehabil 2021; 29:79-86. [PMID: 30526288 DOI: 10.1123/jsr.2017-0369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 10/16/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Anterior knee pain also known as patellofemoral pain syndrome is a frequently encountered musculoskeletal disorder that worsens with activity. The multifactorial etiology of patellofemoral pain syndrome alters lower-extremity mechanics, increasing patellofemoral joint stresses during weight-bearing tasks. Kinesio and McConnell tapings are often incorporated into the treatment, but their efficacy is still unclear. OBJECTIVE To test the efficacy of Kinesio taping, McConnell taping, and sham taping in improving knee mechanics and reducing pain during activity. DESIGN Cross-sectional design. SETTING Clinical biomechanics laboratory. PARTICIPANTS Ten participants (age: 20.3 [1.5] y, height: 169.9 [10.4] cm, and mass: 70.17 [13.1] kg) with anterior knee pain and no history of trauma. INTERVENTION Three trials each of squat, drop jump, and step-down tasks with 3 taping conditions in a counterbalanced order. MAIN OUTCOME MEASURES Two-dimensional motion capture data of lower-extremities in frontal and sagittal planes were recorded and analyzed using 3 iPads and Spark Motion® application. Pooled effect sizes (Hedges' g), 95% confidence intervals, and repeated-measures analysis of variance (P < .05) compared baseline and taping conditions during exercises for pain Visual Analog Scale and knee flexion in all exercises, hip abduction during step-down and drop jump, frontal plane projection during step-downs, and knee translation in sagittal plane during squats. RESULTS Significant reductions in Visual Analog Scale were recorded during squats between tapes (F2.505,12.867 = 3.407, P = .04, Hedges' g = -0.70). Pairwise comparison showed a decrease in Visual Analog Scale for sham taping (mean difference = 1.14 cm, P = .01) and Kinesio taping (mean difference = 1.54 cm, P = .02) compared with baseline during squats. CONCLUSIONS A variety of taping methods can potentially reduce perceived pain in individuals with patellofemoral pain syndrome, allowing clinicians to perform rehabilitation exercises. Sensory effects associated with short-term taping may be sufficient enough to modify knee pain acutely by afferent input blocking nocioceptive pain before the participants could adapt. Most interestingly, the sham taping technique demonstrated promise for enhancing functional outcomes, depending on the length of the tape and area covered.
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Current Evidence Does Support the Use of KT to Treat Chronic Knee Pain in Short Term: A Systematic Review and Meta-Analysis. Pain Res Manag 2021; 2021:5516389. [PMID: 33859769 PMCID: PMC8009710 DOI: 10.1155/2021/5516389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/08/2021] [Accepted: 03/13/2021] [Indexed: 11/30/2022]
Abstract
Objective To demonstrate whether KT is better than placebo taping, nonelastic taping, or no taping in reducing pain. Methods PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to 20 October 2020 for randomized controlled studies that used KT to treat chronic knee pain according to PRISMA guidelines. We extracted the mean differences and SD in pretreatment and posttreatment for selected outcomes measured in the experimental and control groups for subsequent meta-analyses. Results In total, 8 studies involving 416 participants fulfilled the inclusion criteria. Our results indicated that KT is better than other tapings (placebo taping or nonelastic taping) in the early four weeks. The mean difference was −1.44 (95% CI: −2.04–−0.84, I2 = 49%, P ≤ 0.01). Treatment methods which were performed for more than six weeks (0.16 (95% CI: −0.35–0.68, I2 = 0%, P=0.53)) show no significant difference in reducing pain. In studies in which visual analogue scale was measured, a positive effect was observed for KT combined with exercise program training (−3.27 (95% CI: −3.69–2.85, I2 = 0%, P < 0.05)). Conclusion KT exhibited significant but temporary pain reduction.
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McClinton SM, Cobian DG, Heiderscheit BC. Physical Therapist Management of Anterior Knee Pain. Curr Rev Musculoskelet Med 2020; 13:776-787. [PMID: 33128200 PMCID: PMC7661565 DOI: 10.1007/s12178-020-09678-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Anterior knee pain is a common musculoskeletal complaint among people of all ages and activity levels. Non-operative approaches with an emphasis on physical therapy management are the recommended initial course of care. The purpose of this review is to describe the current evidence for physical therapist management of anterior knee pain with consideration of biomechanical and psychosocial factors. RECENT FINDINGS The latest research suggests anterior knee pain is a combination of biomechanical, neuromuscular, behavioral, and psychological factors. Education strategies to improve the patient's understanding of the condition and manage pain are supported by research. Strong evidence continues to support the primary role of exercise therapy and load progression to achieve long-term improvements in pain and function. Preliminary studies suggest blood flow restriction therapy and movement retraining may be useful adjunct techniques but require further well-designed studies. Anterior knee pain includes multiple conditions with patellofemoral pain being the most common. An insidious onset is typical and often attributed to changes in activity and underlying neuromuscular impairments. A thorough clinical history and physical examination aim to identify the patient's pain beliefs and behaviors, movement faults, and muscle performance that will guide treatment recommendations. Successful physical therapist management involves a combination of individualized patient education, pain management, and load control and progression, with an emphasis on exercise therapy.
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Affiliation(s)
- Shane M. McClinton
- Doctor of Physical Therapy Program, Des Moines University, Des Moines, IA USA
| | - Daniel G. Cobian
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI USA
| | - Bryan C. Heiderscheit
- Departments of Orthopedics & Rehabilitation and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI USA
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Abstract
Patellofemoral pain (PFP) is among the most common injuries in recreational runners. Current evidence does not identify alignment, muscle weakness, and patellar maltracking or a combination of these as causes of PFP. Rather than solely investigating biomechanics, we suggest a holistic approach to address the causes of PFP. Both external loads, such as changes in training parameters and biomechanics, and internal loads, such as sleep and psychological stress, should be considered. As for the management of runners with PFP, recent research suggested that various interventions can be considered to help symptoms, even if these interventions target biomechanical factors that may not have caused the injury in the first place. In this Current Concepts article, we describe how the latest evidence on education about training modifications, strengthening exercises, gait and footwear modifications, and psychosocial factors can be applied when treating runners with PFP. The importance of maintaining relative homeostasis between load and capacity will be emphasized. Recommendations for temporary or longer-term interventions will be discussed. A holistic, evidence-based approach should consist of a graded exposure to load, including movement, exercise, and running, while considering the capacity of the individual, including sleep and psychosocial factors. Cost, accessibility, and the personal preferences of patients should also be considered.
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Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac Beauport, QC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- MoveMed Physiotherapy, Kelowna, BC, Canada
| | - Kevin Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Lively Health Clinic, Gainesville, VA
| | - Ellora Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Peak Performance Care Physical Therapy, Sonora, CA
| | - Blaise Dubois
- The Running Clinic, Lac Beauport, QC, Canada
- Physiothérapie et médecine du sport PCN, Quebec City, QC, Canada
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Sisk D, Fredericson M. Taping, Bracing, and Injection Treatment for Patellofemoral Pain and Patellar Tendinopathy. Curr Rev Musculoskelet Med 2020; 13:537-544. [PMID: 32500350 PMCID: PMC7340692 DOI: 10.1007/s12178-020-09646-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This article will focus on additional treatment options for the two most common causes of anterior knee pain, patellofemoral pain syndrome, and patellar tendinopathy. Conservative management is the first-line treatment for these conditions. For clinicians to maximize the efficacy of conservative treatment options for their patients, they must understand the most up-to-date literature evaluating the potential benefit of taping, bracing, and injections as adjunctive treatments for maximizing treatment success. RECENT FINDINGS Recent studies of bracing and taping have found them to be helpful for patients in the short-term management of pain and improving function. However, less is known about their exact mechanism but studies are encouraging that they have a subtle role in changing patellofemoral biomechanics. Injections remain a commonly used treatment for musculoskeletal conditions; however, the evidence for their use in patellofemoral pain and patellar tendinopathy is limited. The use of platelet-rich plasma (PRP), sclerosing, high volume, or stem cell injections is an exciting new area in the treatment of patellar tendinopathy. However, evidence at this time to recommend these treatments is lacking, and more well-designed studies are needed. The treatment of patellofemoral pain and patellar tendinopathy consists of a multi-faceted approach of physiotherapy and physical modalities. There is evidence for short-term use of taping and bracing for these conditions. The evidence for injections at this time is limited and remains under investigation. Future well-designed randomized controlled studies will provide insight into the efficacy of several different types of injections in the treatment of patellar tendinopathy. Physicians should feel comfortable integrating taping and bracing into their anterior knee pain treatment paradigm while making cautious use of invasive injections as adjunctive therapy.
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Affiliation(s)
- Daniel Sisk
- Department of Orthopedic Surgery, Division of Physical Medicine & Rehabilitation, Stanford University, Stanford, CA USA
| | - Michael Fredericson
- Department of Orthopedic Surgery, Division of Physical Medicine & Rehabilitation, Stanford University, Stanford, CA USA
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Arrebola LS, Teixeira de Carvalho R, Lam Wun PY, Rizzi de Oliveira P, Firmo Dos Santos J, Coutinho de Oliveira VG, Pinfildi CE. Investigation of different application techniques for Kinesio Taping® with an accompanying exercise protocol for improvement of pain and functionality in patients with patellofemoral pain syndrome: A pilot study. J Bodyw Mov Ther 2020; 24:47-55. [PMID: 31987562 DOI: 10.1016/j.jbmt.2019.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Patellofemoral pain syndrome (PFPS), characterized by retropatellar and peripatellar pain, is a common disorder affecting young women. Treatment has included exercise-based therapy and taping techniques for rapid reduction of symptoms and pain. Although Kinesio Taping® (KT) has been studied as adjunctive therapy, evidence on its effectiveness is limited and conflicting. OBJECTIVE To determine the feasibility of performing a double-blind randomized controlled trial (RCT) using KT® for PFPS treatment and to determine an ideal sample size. DESIGN Double-blind, randomized, controlled pilot study. METHOD Forty-three women (aged 18-45 years) with at least a 3-month history of PFPS were randomized based on the mechanical correction techniques: using KT® for patellar medialization (KT-PM), using KT® for lateral rotation of the femur and tibia (KT-LRFT), and the control group (CG). All groups underwent the same muscle strengthening and motor control procedures for 12 weeks. Knee pain and function were evaluated at baseline, at 6 weeks, at treatment completion (12 weeks), and during the 12-week follow-up using the numerical pain rating scale (NPRS) at rest and during effort, Anterior Knee Pain Scale (AKPS), and single jump hop test. RESULTS There were clinically significant differences between the KT-LRFT and the CG in terms of AKPS and NPRS scores during effort at the 6-week and 12-week follow-ups. All groups (within group) showed a significant improvement in pain and function. CONCLUSIONS A complete RCT using KT® for the treatment of PFPS is feasible with some changes regarding outcome measures and treatment protocols.
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Affiliation(s)
- Lucas Simões Arrebola
- Federal University of São Paulo (UNIFESP), Human Movement Sciences Department, Campus Baixada Santista, Santos, São Paulo, Brazil; State Public Servant Institute of São Paulo (IAMSPE), Physical Therapy Department, São Paulo, São Paulo, Brazil.
| | - Rogério Teixeira de Carvalho
- State Public Servant Institute of São Paulo (IAMSPE), Orthopaedics and Trauma Department, São Paulo, São Paulo, Brazil
| | - Paloma Yan Lam Wun
- State Public Servant Institute of São Paulo (IAMSPE), Physical Therapy Department, São Paulo, São Paulo, Brazil
| | - Pedro Rizzi de Oliveira
- Federal University of São Paulo (UNIFESP), Human Movement Sciences Department, Campus Baixada Santista, Santos, São Paulo, Brazil; State Public Servant Institute of São Paulo (IAMSPE), Physical Therapy Department, São Paulo, São Paulo, Brazil
| | - Juliana Firmo Dos Santos
- State Public Servant Institute of São Paulo (IAMSPE), Physical Therapy Department, São Paulo, São Paulo, Brazil
| | - Vanessa Gonçalves Coutinho de Oliveira
- Federal University of São Paulo (UNIFESP), Human Movement Sciences Department, Campus Baixada Santista, Santos, São Paulo, Brazil; State Public Servant Institute of São Paulo (IAMSPE), Physical Therapy Department, São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Pinfildi
- Federal University of São Paulo (UNIFESP), Human Movement Sciences Department, Campus Baixada Santista, Santos, São Paulo, Brazil
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Ferreira DC, Silva Junior RAD, Araújo CGA, Mantovani PR, Macedo CDSG. McConnell patellar taping on postural control of women with patellofemoral pain syndrome: randomized clinical trial. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The effects of McConnell patellar taping on the postural control of women with patellofemoral pain syndrome (PFPS) are controversial. Objective: To evaluate the effects of McConnell patellar taping on the static one-leg stance postural control and during squatting in women with PFPS. Method: A randomized, blinded clinical trial that comprised 40 women with PFPS, aged between 18 and 35 years. The study sample was allocated to two groups: McConnell patellar taping group (MPTG) and Placebo taping group (PTG). The analysis included the one-leg static support and squat on the lower limb with PFPS. The center of pressure (CoP) displacement parameters recorded by a force platform were analyzed using two-way ANOVA and Cohen’s d. Results: For the static postural control, no significant differences were found between the groups in terms of time or interaction (p>0.05); with small effect size. For the postural control during the one-leg squat, significant differences were found regarding the time of intervention for both groups, with reduced CoP parameters after the application of taping. However, the MPTG demonstrated a large effect size in frequency of oscillation and medium effect size in speed of oscillation, both during the squat exercise. Conclusion: McConnell patellar taping and placebo taping improved postural control during the one-leg squat. It should be observed that the changes and effect sizes determined for the MPTG were significantly higher compared to the PTG, emphasizing its clinical importance in the treatment of individuals with PFPS, during dynamic activities.
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Capin JJ, Snyder-Mackler L. The current management of patients with patellofemoral pain from the physical therapist's perspective. ANNALS OF JOINT 2018; 3. [PMID: 31414069 DOI: 10.21037/aoj.2018.04.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Patellofemoral pain (PFP) is a common diagnosis that includes an amalgam of conditions that are typically non-traumatic in origin and result in peripatellar and/or retropatellar knee pain. The purpose of this review is to provide an overview of the physical therapist's management, including the evaluation and treatment, of the patient with PFP. A thorough history is critical for appropriately diagnosing and optimally managing PFP; the history should include the date of symptom onset, mechanism of injury and/or antecedent events, location and quality of pain, exacerbating and alleviating symptoms, relevant past medical history, occupational demands, recreational activities, footwear, and patient goals. Physical examination should identify the patient's specific impairments, assessing range of motion (ROM), muscle length, effusion, resisted isometrics, strength, balance and postural control, special tests, movement quality, palpation, function, and patient reported outcome measures. Objective assessments should guide treatment, progression, and clinical decision-making. The rehabilitation program should be individually tailored, addressing the patient's specific impairments and functional limitations and achieving the patient's goals. Exercise therapy, including hip, knee, and core strengthening as well as stretching and aerobic exercise, are central to the successful management of PFP. Other complimentary treatments may include patellofemoral and tibiofemoral joint mobilizations, patellofemoral taping, neuromuscular training, and gait retraining. Appropriate progression of interventions should consider objective evaluations (e.g., effusion, soreness rules), systematic increases in loading, and the chronicity of symptoms. Although short-term changes or reductions in movement often are necessary in a protective capacity, the persistence of altered movement is a key characteristic of chronic pain, which may be managed in part through emphasis on function over symptoms, graded exposure, patient education, and perhaps referral. PFP etiology is largely movement related and a comprehensive conservative treatment using movement can be successful.
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Affiliation(s)
- Jacob John Capin
- Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Lynn Snyder-Mackler
- Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA.,Physical Therapy, University of Delaware, Newark, Delaware, USA
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Kuyucu E, Gülenç B, Biçer H, Erdil M. Assessment of the kinesiotherapy's efficacy in male athletes with calcaneal apophysitis. J Orthop Surg Res 2017; 12:146. [PMID: 28985751 PMCID: PMC6389206 DOI: 10.1186/s13018-017-0637-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to assess the efficacy of kinesiotherapy used for treating various disorders in athletes on pain and pedal functions in patients with calcaneal apophysitis. METHODS This prospective randomized controlled study included 22 patients with calcaneal apophysitis aged 8 to 16 years presenting with heel pain among junior athletes of a professional football club. The patients were randomly grouped into two groups, with one group receiving sham tape only and the other kinesio tape. American Orthopedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scores were recorded before and after the treatment. RESULTS The preoperative VAS score of the kinesio tape was 7, and AOFAS score was 62.4; the corresponding figures of the sham group were 6.81 and 70.5, respectively. The kinesio-tape group had a better AOFAS scores at 1st and 3rd month (p < 0.05). Posttreatment AOFAS score was 99.7 ± 0.9 for the kinesio-tape group and 97.4 ± 3.9 for the sham-tape group. Posttreatment VAS score was 0.1 ± 0.3 for the kinesio-tape group and 0.4 ± 0.5 for the sham-tape group (p > 0.05). DISCUSSION Conservative treatment modalities are preferentially used for its treatment. Kinesiotherapy is one of the treatment methods for the apophysitis. In the literature, our study is the first prospective randomized trial on the efficacy of kinesio taping in calcaneal apophysitis. CONCLUSIONS Although kinesio taping can be effectively used for the restoration of ankle functions of athletes with calcaneal apophysitis, its role in pain is limited. Since it lacks serious side effects, it can be used in combination with or as an alternative to pharmacological treatment in this patient group.
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Affiliation(s)
- Ersin Kuyucu
- Orthopaedics and Traumatology Department, Medipol University, Tem Avrupa Göztepe çıkışı/Bağcılar, Istanbul, Turkey
| | - Barış Gülenç
- Orthopaedics and Traumatology Department, Medipol University, Tem Avrupa Göztepe çıkışı/Bağcılar, Istanbul, Turkey.
| | - Hüseyin Biçer
- Physiotherapy Department, Medipol University, Tem Avrupa Göztepe çıkışı/Bağcılar, Istanbul, Turkey
| | - Mehmet Erdil
- Orthopaedics and Traumatology Department, Medipol University, Tem Avrupa Göztepe çıkışı/Bağcılar, Istanbul, Turkey
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