• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.65-70
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• 2016

Purpose: The aim of this study was to determine the effects of electromyographic (EMG)-Biofeedback using closed kinetic chain exercise (EB-CKCE) on quadriceps angle (Q-angle) and quadriceps muscle activation and muscle activation ratio in subjects with patellofemoral pain syndrome and to provide fundamental information on rehabilitation exercise in patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included. The subjects were randomly divided into three groups: control group (Group I, n=10), semi-squat exercise group (Group II, n=10), and EMG-Biofeedback using closed kinetic chain exercise group (Group III, n=10). Intervention was provided to each group for eight weeks (three times per week; 30 minutes per day). Subjects were measured on Q-angle and quadriceps muscle activation. Results: Significant difference in Q-angle and quadriceps muscle activation was observed in groups II and III compared with control group I (p<0.01). Results of post-hoc analysis showed a significant difference in Q-angle and quadriceps muscle activation in on group III compared with groups I and II. Conclusion: Findings of this study suggest that closed kinetic chain exercise using EMG-Biofeedback that provides real-time biofeedback information on muscle contraction may have a beneficial effect on improvement of Q-angle and quadriceps muscle activation in patellofemoral pain syndrome.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.68-73
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• 2014

Purpose: The purpose of this study was to investigate the effect of closed kinetic chain exercise using EMG-biofeedback for selective training of the vastus medialis oblique on functional ability and Q-angle in subjects with patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included in this study. Participants were randomly allocated to the control group (Group I, n=10), closed kinetic chain exercise group (Group II, n=10), and closed kinetic chain exercise using EMG-biofeedback group (Group III, n=10). Intervention was performed in three groups, three times per week, for a period of six weeks. Kujala patellofemoral score and Q-angle were measured before and after the experiment. Results: Some significant differences in kujala patellofemoral score were observed in group II and group III, compared with group I (p<0.01). There was no significant difference on in Q-angle at knee flexion angle $0^{\circ}$. However, some significant differences in Q-angle at knee flexion $60^{\circ}$ were observed in group III, compared with group I (p<0.01). Conclusion: Closed kinetic chain exercise using EMG-biofeedback that provides real-time biometric information on selected muscles in order to increase the efficiency of treatment may be helpful in improvement of functional ability and Q-angle in patellofemoral pain syndrome.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.2
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• pp.41-48
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• 2011

Background: Patellofemoral pain syndrome is very common knee problem and altered hip rotation may play a role in patellofemoral pain. The purpose of this case study is to describe the manual therapy of and the therapeutic exercise for a patient with asymmetrical hip rotation and patellofemoral pain. Method: The patient was a 29 years old woman with an 3 month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the VAS was Max 6 to Min 4. Left hip internal rotation was less than right hip internal rotation, and manual muscle testing showed weakness of the left hip internal rotator and abductor muscles. The intervention consisted of manual therapy and therapeutic exercise for three times a weeks, two weeks for increasing right hip medial rotation, improving left hip muscle strength, and eliminating anterior right knee pain. Result: After intervention for 2weeks, passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her VAS score was Max 2 to Min 0. Conclusion: Manual therapy and therapeutic exercise is effective in improving for patient had patellofemoral pain with pattern of asymmetrical hip rotation.

• Physical Therapy Korea
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• v.11 no.3
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• pp.33-42
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• 2004

The purpose of this study was to assess the effect of rehabilitation exercise and neuromuscular electrical stimulation on a visual analysis scale and functional visual analysis scale regarding functional capacity. A total of 7 consecutive patients with the complaint of patellofemoral pain syndrome who received this diagnosis from a sports medicine physician were recruited to assess the effect of rehabilitation exercise and neuromuscular electrical stimulation (NMES) on Visual Analog Scale (VAS) and Functional Visual Analog Scale (FVAS), functional capacity patients with patellofemoral pain syndrome. The exercise rehabilitation consisted of a complex training program requiring five treatments a week for eight weeks. The training program consisted of four phases, and each lasted for two weeks. Statistical analyses were one-way ANOVA with repeated measures. The results were as follows: (1) There were significant differences in the VAS and FVAS during 8-weeks of rehabilitation exercise and neuromuscular electrical stimulation (p<.01). (2) There were no significant differences in the functional capacity during 8-weeks of rehabilitation exercise and neuromuscular electrical stimulation (p<.05). In conclusion, at the end of the eight weeks of this rehabilitation program and neuromuscular electrical stimulation, a significant reduction was found in VAS and FVAS, but there was no significant difference in functional capacity at the end of the treatment.

• Journal of Fisheries and Marine Sciences Education
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• v.27 no.1
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• pp.63-73
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• 2015

The purpose of this study was to examine EMG activities and VMO/VL ratio of the vastus medialis oblique, and vastus lateralis during step up exercise according to ankle and knee positions in soccer players with patellofemoral pain syndrome. Methods: Subject(patellofemoral pain syndrome, PFPS: n=8 and without PFPS, non PFPS; NPFPS: n=8) perfomed step up exercise at each knee and ankle position(knee flexion $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$, ankle internal rotation $30^{\circ}$, neutral, and external rotation $30^{\circ}$) while EMG activity was collected. The EMG signals were expressed by the % maximal voluntary isometric Contraction(%MVIC) values. Statistical analysis consisted of two way repeated measures analysis of variance with post hoc analysis. Results: Main results were as follows: 1) EMG of VMO, and VL was tend to be lower in PFPS compared to NPFPS. 2) EMG of VMO and VL with knee flexrion $60^{\circ}$ was significantly higher the results with knee flexion $30^{\circ}$, and $90^{\circ}$. VMO and VL with ankle external rotation $30^{\circ}$ was significantly higher the results with internal rotation $30^{\circ}$ and neutral position. Conclusion: Considering the EMG activity was reduced due to the to the PFPS and that performing step up with knee flexion $60^{\circ}$ with ankle external rotation $30^{\circ}$ position may provide the most effective condition for patients with patellofemoral pain syndrome.

• Physical Therapy Rehabilitation Science
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• v.7 no.2
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• pp.61-66
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• 2018

Objective: Patellofemoral pain syndrome (PFPS) is a condition that is characterized by patellar discomfort or pain that is aggravated during certain activities such as ascending/descending stairs. The Patellofemoral Disability Index (PDI) was developed to assess the effect of pain on functional activities in individuals with PFPS. The objectives of the current study were to determine the internal consistency, test-retest reliability, and validity of this index. Design: Cross-sectional study. Methods: Forty-one subjects who had PFPS with a mean age of $28.8{\pm}5.0years$ and a mean body mass index of $25.6{\pm}4.7kg/m^2$ participated in the study. All subjects were concurrently enrolled in a clinical trial for which they were instructed to complete hamstring-resistance exercises for 4 weeks. Over the course of the intervention, they completed both the PDI and the Oswestry Disability Index (ODI) at baseline after two weeks, and after four weeks. Pearson correlation coefficient was used to assess the criterion validity. Cronbach's ${\alpha}$ was used to examine the internal consistency. Intraclass correlation coefficients with 95% confidence interval were computed to examine test-retest reliability. Results: Subjects' responses within both the PDI and the ODI yielded Pearson correlation coefficient values that were positive and highly significant (range, 0.73-0.97; p<0.001). There was a high level of internal consistency (Cronbach's ${\alpha}{\geq}0.8$), with the exception of stair climbing (Cronbach's ${\alpha}=0.65$). Intraclass correlation ranged from 0.87 to 0.92, indicating high levels of test-retest reliability. Conclusions: The PDI is a valid, reliable, and feasible method of assessing pain and functional ability in patients with PFPS.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.35-38
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• 2014

Background: The case study examined the effect of a hip joint traction and hip posterolateral muscles strengthening on knee pain, range of motion, and lower extremity function scale of patients with patellofemoral pain syndrome (PFPS). Although PFPS has previously been attributed to quadriceps dysfunction, more recent research has linked this condition to impairment of the hip musculature and kinematic. Methods: Subject is a 27-years-old female with PFPS. Performed hip joint traction with belt and posterolateral muscles(hip abductors, external rotators) strengthening for 4 weeks, 3 times a week, once a day. Before and after the therapy, measurements were made on the visual analog scale (VAS) and of the ROM, and a lower extremity functional scale (LEFS) was conducted. Results: The results showed positive changes in VAS and range of motion and lower extremity functional scale. First VAS of knee changed from 6 to 2. Second hip joint range of motion showed that internal rotation recored from $53^{\circ}$ to $58^{\circ}$ and external rotation recorded from $32^{\circ}$ to $37^{\circ}$. Third The lower extremity functional scale showed before therapy of 44; after therapy, 63. Conclusion: The hip joint traction and hip posterolateral muscles strengthening was effective in alleviating knee pain, increasing ROM and Lower extremity functional scale of the PFPS patients.

• Physical Therapy Korea
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• v.22 no.3
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• pp.12-22
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• 2015

The purpose of this study was to investigate the effect of taping on knee joint for patellofemoral compressive force (PCF) during stair descent for elderly women. Ten healthy elderly women voluntarily participated in this study. A three-dimensional motion analysis system and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the maximum PCF, maximum quadriceps contraction force and maximum knee extension moment (p>.05) but, there was a pattern decreasing all values with the taping during stair descent. There were significant differences for the knee and ankle angle on the event of maximum PCF (p<.05) and there was a pattern decreasing all values with the taping during stair descent. Therefore, taping on the knee would be effective to relieve the pain like patellofemoral pain syndrome in the knee joint.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.1
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• pp.31-39
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• 2021

Background: Patellofemoral pain syndrome (PFPS) is common knee disorder encountered in clinical: notably, altered hip biomechanic may contribute to PFPS. In this study, We investigated the effects of hip joint mobilization on pain, balance, and gait in patients with PFPS. Methods: Patients were randomly assigned to a control group (n=18) or an experimental group (n=20). Both groups received exercise therapy thrice a week for 4 weeks. The experimental group performed additional hip joint mobilization thrice a week for 4 weeks. Measurement were obtained in each patient pre-intervention and post-intervention (after 4 weeks). Results: The assessed items included the visual analog scale (VAS), one leg standing test (OLS), timed up and go test (TUG), and the 10m walk test (10MWT). Post-intervention assessment showed significantly improved results in both groups (p<.01). A significant intergroup difference was observed only in the results of the 10MWT (p<.05). Conclusion: Our results indicate that hip joint mobilization with exercise therapy may be useful to improve PFPS.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.29-35
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• 2022

Objectives The purpose of this systematic review is to analyse randomized controlled trials about acupuncture for patellofemoral pain syndrome (PFPS) and evaluate it's pain improvement effect. Methods Studies will be searched from ten databases (Medline/PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure [CNKI], WanFang Data, Citation Information by NII [CiNII], ScienceON, Koreanstudies Information Service System [KISS], KMBASE, and KoreaMed). Participants will be patients diagnosed with PFPS, regardless of cause, gender, age or race, and interventions will be acupuncture, electroacupuncture, dry needling, fire needle, and acupotomy. Other treatments than interventions will be the control group and the main outcome will be reviewed by visual analogue scale (VAS). Results Data will be extracted and assessed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis flow chart and Cochrane risk of bias tools. Meta-analysis will be conducted using random effect model within 95% confidence interval. Conclusions We expect this systematic review to provide useful data about the pain improvements of patellofemoral pain using acupuncture and expect to stimulate and systematize acupuncture treatment on PFPS in the future.