Open Access
Subscription Access
Open Access
Subscription Access
Kinetic Chain Exercise for Patello Femoral Pain Syndrome - A Randomised Control Study
Subscribe/Renew Journal
Introduction: Patello femoral pain syndrome [PFPS] can be defined as retropatellar pain or peri patellar pain resulting from physical and biochemical change in patella femoral joint. The patients with patello femoral pain syndrome have anterior knee pain, which typically occurs during activity and often worsens with descending stairs and also triggered by prolonged sitting. Patello femoral pain syndrome is due to the degeneration in the articular cartilage of the knee cap. PFPS is the most prevalent disorder involving the knee and can be misdiagnosed sometime as bursitis, meniscus, and ligament instability. Osteoarthritis, chondromalacia patella produce more stress on the patella femoral mechanism.
Materials & Methodology: After getting the ethical clearance for this study 30 patients with PFPS were selected and randomized into 2 groups after due consideration of the inclusive and exclusion criteria. The patients consent for this study was taken and documented. Procedure: Group A and Group B subjects were given with open kinetic chain [OKC] and closed kinetic chain [CKC] exercises respectively. The dosimetry of these exercises was 30 minutes duration every alternate day for 4 weeks. Data collected for statistical analysis included Maximal Isometric Voluntary Contraction [MVIC] using surface EMG on Vastus Medialis [quadriceps muscle] and Pain by visual analog scale [VAS] before and after exercise.
Result: Data collected were statistically analyzed using the SPSS 11 version for t-test. The paired ttest value for both CKC and OKC shows that there is a significant improvement in the quadriceps strength and pain reduction in both the groups. The unpaired t-test between the groups for quadriceps interference [3.45] and pain score in VAS scale [2.89] with p value at 0.01 shows that closed kinetic chain [CKC] exercise is better than the open kinetic chain [OKC] exercise in improving the strength and reducing the pain among PFPS patients.
Conclusion: To conclude, though both OKC and CKC exercises are beneficial in PFPS patients, CKC proved to be better than the OKC in improving the quadriceps muscle strength and reducing the pain. This study proves this statement statistically with significance.
Keywords
- Sacco, I.C.N., Konno, G.K., Rojas,.C., Marques G.B .Functional and EMG responses to a physical treatment in patellofemoral syndrome patients. Journal of Electromyography and Kinesiology.2006;16: 167-74.
- Tunay, V.B.,et al. Treatment of patellar tracking and pain in patellofemoral malalignment: Conservative versus surgery. The Pain Clinic, 2003a;15(2): 185-92.
- Martin MC et al. Patellofemoral morphometry in patients with idiopathic patellofemoral pain syndrome. European Journal of Radiology. 2010; 75 [1]: 64 – 67.
- Doucette SA, Goble EM. The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Sports Med 1992;20:434-40.
- Fredericson M, et al. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006; 85 [3]: 234 – 243.
- Cabral CM, de Oliveira Melim AM, de Camargo Neves Sacco I, Marques AP. Effect of a closed kinetic chain exercise protocol on patellofemoral syndrome rehabilitation. In: 25 International Symposium on Biomechanics in Sports (2007); August 23-27, 2007; Ouro Preto, Brazil. ISBS - Conference Proceedings Archive 2007. p. 688-91.
- Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther 2003;33:671-6.
- Thatiana Lacerda Nobre et al: Comparison of Exercise Open Kinetic Chain and Closed Kinetic Chain in The Rehabilitation of Patellofemoral Dysfunction: an Updated Revision. Clinical Medicine and Diagnostics 2012, 2(3): 7-11
- Donell S. Patellofemoral dysfunction-Extensor mechanism malalignment. Curr Orthop 2006;20:103-111.
- Escamilla RF et al. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Medicine and Science in Sports and Exercise. 1998; 30 [4]: 556 – 569.
- Fagan V, Delahunt E. Patellofemoral pain syndrome: a review on the associated neuromuscular deficits and current treatment options. British Journal Sports Medicine. 2008; 42: 789-795.
- Zwerver J, Bredeweg SW, Hof AL. Biomechanical analysis of the single-leg decline squat. British Journal Sports Medicine. 2007; 41: 264 – 268.
- Boucher, J.P., King, M.A., Lefebvre, R., and Pépin, A. Quadriceps femoris muscle activity in patellofemoral pain syndrome. American Journal of Sports Medicine. 1992;20(5): 527-32.
- Connolly KD, Differences in patellofemoral contact mechanics associated with patellofemoral pain syndrome. Journal of Biomechanics. 2009; 42: 2802 – 2807.
- Fleming Bc, Oksendahl H, Beynnon Bd. Openor Closed-Kinetic Chain Exercises After Anterior Cruciate Ligament Reconstruction. Exercise and Sport Sciences Reviews. 2005; 33 [3]:134 – 140.
- Witvrouw, E. Open versus closed kinetic chain exercises in patella-femoral pain. A 5- year prospective randomized study. The American Journal of Sports Medicine. 2004; 32 [5]: 1122 – 1130.
- Sheehan Ft, Derasari A, Fine Km, Brindle Tj, Alter Ke. Q-angle and J-sign. Clin. Orthop. Relat. Res. 2010; 468: 266 – 275.
- Pattyn E, et al. Vastus medialis obliquus atrophy: Does it exist in patellofemoral pain syndrome. The American Journal of Sports Medicine. 2011; 39 [7]: 1450 – 1455.
- Long-rossi F, Salsich GB. Pain and hip lateral rotator muscle strength contribute to functional status in females with patella-femoral pain. Physiotherapy Res Int. 2010; 15 [1]: 57 – 64.
- Selfe J, Callaghan M, McHenry A, Richards J, Oldham J. An investigation into the effect of number of trials during proprioceptive testing in patients with patellofemoral pain syndrome. J Orthop Res 2006;24:1218-24.
- Erik Witvrouw et al. Open Versus Closed Kinetic Chain Exercises for Patellofemoral Pain A Prospective, Randomized Study. Am J Sports Med 2000 28: 687
Abstract Views: 1112
PDF Views: 0