Effectiveness of Exercise Therapy Versus Spinal Manual Therapy in Patients With PFPS
Patellofemoral Pain Syndrome
About this trial
This is an interventional treatment trial for Patellofemoral Pain Syndrome focused on measuring effectiveness, exercise therapy, manipulative therapy, medium term, randimozed controlled trial
Eligibility Criteria
Inclusion Criteria:
- self-reported unilateral or
- bilateral anterior knee pain provoked by at least two of the following activities: jumping, squatting, ascending/ descending stairs, kneeling, prolonged sitting and or a
- positive patellar compression test
Exclusion Criteria:
- experiencing pain for less than 3 months
- a history of knee surgery
- meniscal lesion
- patellar subluxation/dislocation
- evidence of tendinopathy or ligamentous pathologies
- dislocation or fracture in the pelvic region
- spinal surgery
- osteoporosis
- pregnancy
- neurologic disorders
- findings of chondromalacia > grade 2 on MRI, echography or X-ray.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Local exercise therapy
Spinal manual therapy
The local exercise therapy group focused on strengthening knee and hip muscles three times a week for 6 weeks. Once a week, patients trained with the support of a physiotherapist. The physiotherapist gradually increased the intensity of the exercises improving muscle endurance. The exercises were supplemented with mobilisations of the patellofemoral joint. Twice a week, patients trained at home following a prescribed exercise program writing down their work-out in an exercise journal.
The spinal manual therapy group was treated one a week for 6 weeks. Before the first intervention an experienced manual therapist performed a clinical examination of the lower back, SIJ, hip and knee. Anatomical maps showing innervation areas of spinal nerve roots were used to explain the regional interdependence model in the treatment of anterior knee pain. Manual therapy treatment included manipulations of the thoracolumbar (T12-L3) region or SIJ as well as hip joint. Manipulation was conducted if a restriction of range of motion was found in any of the regions. Patients were also asked to do home exercises focusing on mobilizing the thoracolumbar region and to write down their performance in an exercise journal.