Patellofemoral Pain Syndrome: Difference between revisions
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<div class="editorbox"> | <div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox"> | ||
'''Original Editor '''- [[User:Kristin Zumo|Kristin Zumo]] | '''Original Editor '''- [[User:Kristin Zumo|Kristin Zumo]], [[User:Quentin Desantoine|Quentin Desantoine]] | ||
'''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | '''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | ||
</div> | </div> | ||
== Search Strategy == | == Search Strategy == | ||
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== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
add text here | add text here relating to '''''clinically relevant''''' anatomy of the condition<br> | ||
== Epidemiology /Etiology == | == Epidemiology /Etiology == | ||
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== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Patient's usually present with compliant of anterior knee pain that is aggravated by activities that increase patellofemoral compressive forces such as: ascending/descending stairs, sitting with knees bent, kneeling, and squatting.<br> | |||
== Differential Diagnosis == | == Differential Diagnosis == | ||
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== Diagnostic Procedures == | == Diagnostic Procedures == | ||
add text here related to medical diagnostic procedures | add text here related to medical diagnostic procedures | ||
== Outcome Measures == | |||
add links to outcome measures here (also see [[Outcome Measures|Outcome Measures Database]]) | |||
Lower Extremity Functional Scale ([http://academic.regis.edu/clinicaleducation/pdf's/Knee_Pain_LEFS.pdf http://academic.regis.edu/clinicaleducation/pdf's/Knee_Pain_LEFS.pdf]) | |||
[http://academic.regis.edu/clinicaleducation/pdf's/Knee%20Outcome%20Survey.doc http://academic.regis.edu/clinicaleducation/pdf's/Knee%20Outcome%20Survey.doc] | |||
== Examination == | == Examination == | ||
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== Physical Therapy Management <br> == | == Physical Therapy Management <br> == | ||
Common interventions for the treatment of PFPS are listed below: | Common interventions for the treatment of PFPS are listed below: | ||
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'''''Take Home Message:'''''<i>Focus on identifying the root cause of the problem and always consider proximal and distal influences (regional interdependence). Based on the available evidence, exercise and manual therapy seem to be the most benefical in the managment of anterior knee pain. Addressing the strength and ROM deficits at the hip and pelvis has also shown to be effective in management of anterior knee pain.</i><strike></strike> | '''''Take Home Message:'''''<i>Focus on identifying the root cause of the problem and always consider proximal and distal influences (regional interdependence). Based on the available evidence, exercise and manual therapy seem to be the most benefical in the managment of anterior knee pain. Addressing the strength and ROM deficits at the hip and pelvis has also shown to be effective in management of anterior knee pain.</i><strike></strike> | ||
== | == Key Research == | ||
add | add links and reviews of high quality evidence here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== Resources <br> == | == Resources <br> == | ||
add appropriate resources here | add appropriate resources here <br> | ||
== | == Clinical Bottom Line == | ||
add | add text here <br> | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
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<references /> | <references /> | ||
[[Category:Articles]] [[Category:Condition]] [[Category:EIM_Student_Project_2]] [[Category:Knee]] [[Category:Musculoskeletal/Orthopaedics]] | [[Category:Vrije_Universiteit_Brussel_Project|Template:VUB]] [[Category:Articles]] [[Category:Condition]] [[Category:EIM_Student_Project_2]] [[Category:Knee]] [[Category:Musculoskeletal/Orthopaedics]] | ||
Revision as of 17:45, 9 November 2010
Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
Original Editor - Kristin Zumo, Quentin Desantoine
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Search Strategy[edit | edit source]
add text here related to databases searched, keywords, and search timeline
Definition/Description[edit | edit source]
add text here
Clinically Relevant Anatomy[edit | edit source]
add text here relating to clinically relevant anatomy of the condition
Epidemiology /Etiology[edit | edit source]
add text here
Characteristics/Clinical Presentation[edit | edit source]
Patient's usually present with compliant of anterior knee pain that is aggravated by activities that increase patellofemoral compressive forces such as: ascending/descending stairs, sitting with knees bent, kneeling, and squatting.
Differential Diagnosis[edit | edit source]
add text here
Diagnostic Procedures[edit | edit source]
add text here related to medical diagnostic procedures
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Lower Extremity Functional Scale (http://academic.regis.edu/clinicaleducation/pdf's/Knee_Pain_LEFS.pdf)
http://academic.regis.edu/clinicaleducation/pdf's/Knee%20Outcome%20Survey.doc
Examination[edit | edit source]
add text here related to physical examination and assessment
Medical Management
[edit | edit source]
add text here
Physical Therapy Management
[edit | edit source]
Common interventions for the treatment of PFPS are listed below:
- Manual Therapy
- Exercise (open vs. closed chain)
- Quadriceps strengthening
- Patellar Taping
- Orthotics
- Proximal Muscle strengthening
- Modalities
What treatments LACK support by current evidence?
- No significant difference was noted in open vs. closed chain exercises with respect to exercise type.
- Further evidence is needed to investigate the long term effects of patella taping, the mechanism of action and direction of force (medial, neutral, lateral). Clinical evidence for the success of this intervention is still unclear due to an insufficient amount of high level evidence, inconsistency of tape application techniques, in ability to identify the precise mechanism of aciton, and variance in measurements of specific outcome variables.
- No date is available regarding massage, thermotherapy, TENS, electrical stimulation, and biofeedback for treatment of PFPS.
What treatments are SUPPORTED by the best available evidence?
- Tyler et al noted the role of hip muscle function in the treatment of PFPS. A 93% success rate occurred with hip flexor strenght improvements and normalization of Ober (IT band/tensor fascia latae) and Thomas (hip flexor) tests.
- A case report by Mascal et al documented weakness of hip abductors, extensors and external rotators in testing of 2 patients with PFPS. Treatment consisted of recruitment and endurance training of the hip, pelvis, and trunk musculature which resulted in a significant reduction in pain, improved LS kinematics during dynamic testing and ability to return to original level of function.
- Whittingham et al investigated the effectiveness of daily patella taping and exercise on pain and function in individuals with PFPS. Results suggest that patella taping may be useful in conjunction with strengthening exercise to enhance speed of recovery.
- 2 articles were reviewed in regards to the effect of foot orthoses on PFPS. Both studies suggest that the use of orthotics in patient's who present with excessive pronation resulted in improved pain/stiffness (note: multiple interventions were used in these studies, including orthosis). Patients with patellofemoral pain may benefit from the use of foot orthosis if the patient demonstrates the following: excessive foot pronation and/or a LE alignment profile that includes excessive lower extremity internal rotation during weight bearing and increased Q-angle. Additional studies are needed to assess the treatment efficacy of foot orthosis for patients with PFPS.
Take Home Message:Focus on identifying the root cause of the problem and always consider proximal and distal influences (regional interdependence). Based on the available evidence, exercise and manual therapy seem to be the most benefical in the managment of anterior knee pain. Addressing the strength and ROM deficits at the hip and pelvis has also shown to be effective in management of anterior knee pain.
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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