Physical Therapist Management of Anterior Knee Pain

McClinton, Shane; Cobian, Daniel G.; Heiderscheit, Bryan C.

doi:10.1007/s12178-020-09678-0

Cited by 12 publications

(10 citation statements)

References 120 publications

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“…A large study in Denmark [ 7 ] showed that a 6-week physical therapy program, consisting of patient education and exercises, improved physical function and decreased pain, medication intake, and sick leave time. Other disorders [ 8 ] and most post-surgery knee conditions, such as total knee arthroplasty [ 9 ], require range of motion and strengthening exercises to the legs. Unfortunately, due to inconvenient logistics, non-availability of physical therapy, patient’s lack of insurance and other factors, many patients cannot or do not take advantage of similar services.…”

Section: Introductionmentioning

confidence: 99%

Quality of knee strengthening exercises performed at home deteriorates after one week

Mitchell

Lee

Dennis

et al. 2022

BMC Musculoskelet Disord

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Background To compare the performance (as determined by lower extremity kinematics) of knee exercises in healthy middle-aged and older individuals immediately after instruction and one week later. Methods This is a cross-sectional study in a laboratory setting. Nineteen healthy volunteers (age [y] 63.1 ± 8.6, mass [kg] 76.3 ± 14.7, height [m] 1.7 ± 0.1) participated in this study. High speed video and reflective markers were used to track motion during four exercises. The exercises were knee flexion, straight leg raise, and “V “in supine position, and hip abduction in side lying position. All participants received verbal and tactile cues during the training phase and the therapist observed and, if necessary, corrected the exercises. Upon return a week later the participants performed the same exercises without any further instructions. Knee and hip sagittal and rotational angles were extracted from the motion capture. A repeated measures t-test was used to compare the motions between two visits. Results Participants demonstrated more knee flexion during straight leg raise and “V in” exercises at the 2nd visit compared to the 1st visit (both p < 0.05). During the “V out” exercise, they performed more external rotation (p < 0.05) while they showed more internal rotation during the “V in” exercise at the 2nd visit compared to the 1st visit. Conclusions Exercise performance declined significantly in healthy middle-aged and older individuals one week after instruction. This decline occurred despite an instructional exercise sheet being given to every participant. Other approaches designed to help individuals retain the ability to perform rehabilitative exercises correctly need to be explored.

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Section: Introductionmentioning

confidence: 99%

Quality of knee strengthening exercises performed at home deteriorates after one week

Mitchell

Lee

Dennis

et al. 2022

BMC Musculoskelet Disord

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“…To date, there have been few reports on conservative clinical treatments for improving flexibility and lesions of the IPFP, which are associated with anterior knee pain [ 7 ]. Conservative treatment, such as physical therapy, is an option for anterior knee pain [ 13 , 14 ]. However, no studies have so far examined the effects of physical therapy intervention on the IPFP.…”

Section: Introductionmentioning

confidence: 99%

Effect of physical therapy on the flexibility of the infrapatellar fat pad: A single-blind randomised controlled trial

2022

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The infrapatellar fat pad plays a biomechanical role in the knee joint. After knee injury or surgery, its dynamics decrease because of an inflammatory response. Physical therapy might be one of the valuable treatments for the recovery of knee joint mobility. This study aimed to evaluate the immediate effect of physical therapy on the dynamics of the infrapatellar fat pad in healthy participants using ultrasonography. In this prospective, single-blind, randomised controlled trial, 64 healthy young participants were enrolled and randomly assigned to one of the following three interventions: manual therapy, hot pack treatment, and control. Ultrasound images of the infrapatellar fat pad were obtained before and after the intervention. The thickness change ratio of the infrapatellar fat pad was calculated to compare the changes between and within groups before and after the intervention. No significant inter-group differences were observed. The effect sizes were relatively small. Manual therapy or hot pack intervention might not have an immediate effect on infrapatellar fat pad flexibility in healthy participants. Thus, it is necessary to consider more intensive treatments to change the dynamics of the infrapatellar fat pad.

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“…Stretching the tight lateral structure and general quadriceps strength training are both included in treatment programs because they are thought to stimulate VMO activation [ 21 , 22 ]. PFPS treatment typically includes patient education, electromyographic biofeedback, activity adjustment, neuromuscular electric stimulation (NMES), knee braces and orthotics, physical agents for deep and superficial heating, and nonsteroidal anti-inflammatory medications [ 23 ]. In order to concentrate the patella and improve patellar tracking, it was hypothesized that patella taping would generate a mechanical medial shift.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial

Hasan

Alonazi

Anwer

et al. 2022

Pain Research and Management

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Background. The severity of the articular lesion is the single most essential element in investigating the extent of flexion that is required for activities. However, a prior study found no differences in muscle strength gains of quadriceps muscles at different knee angles in people with patellofemoral pain syndrome (PFPS). Objective. The effects of patellar taping and electromyographic biofeedback (EMG-BF)-guided isometric quadriceps strengthening at different knee angles (e.g., 30°, 60°, and 90° of knee flexion) on quadriceps strength and functional performance in people with PFPS were compared in this single-blind randomized controlled parallel trial. Methods. Sixty adult male athletes with PFPS (age: 26.9 ± 1.4 years) were randomly divided into two groups. The experimental group (n = 30) received patellar taping and EMG-BF-guided isometric contraction exercise at 30°, 60°, and 90° angles, and the control group (n = 30) received sham patellar taping without EMG-BF-guided exercises for six weeks. Pain intensity, knee function, muscle strength, and the single-leg triple hop (SLTH) test were assessed. Results. The pain intensity and SLTH scores between the groups were significantly different at the end of the trial ( p ≤ 0.001 ). The EMG-BF and control groups had mean pain scores of 1.3 (0.8) and 4.5 (0.8), respectively. The EMG-BF and control groups had mean functional scores of 80.4 (5.1) and 69.1 (6.1), respectively. The mean SLTH score for the EMG-BF group was 540.7 (51.2) and for the control group it was 509.4 (49.8) after the trial. Quadriceps muscle strength was significantly higher in those who performed quadriceps strength training at 60° of knee flexion after six weeks than in those who performed strength training at 30° or 90° of knee flexion. Conclusion. The findings indicated that individuals who trained their quadriceps at a 60° knee angle had significantly stronger quadriceps muscles than individuals who trained at 30° or 90° of knee flexion. Trial Registration. This trial is registered at Clinical Trials.gov under the identifier NCT05055284.

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Physical Therapist Management of Anterior Knee Pain

Cited by 12 publications

References 120 publications

Quality of knee strengthening exercises performed at home deteriorates after one week

Quality of knee strengthening exercises performed at home deteriorates after one week

Effect of physical therapy on the flexibility of the infrapatellar fat pad: A single-blind randomised controlled trial

Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial

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