• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.935-944
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• 2001

The patellofemoral pint is formed by the articulation of the patella and femoral condyles in the trochlear groove. The complexity of the patellofemoral pint is magnified by the fact that the tibiofemoral pint works in conjunction with the patellofemoral pint. Additionally, other pints such as the subtalar pint., hip and sacroiliac pints indirectly contribute to the function of the patellofemoral pint. This pint has little bony stability, Soft tissue surrounds the pint to increase stability. The patellofemoral pint increases the mechanical advantage of the quadriceps muscles and resists mechanical loading. In patellofemoral dysfunction, patellofemoral contact pattern is disrupted. leading to excessive compression at the pint. When you treat the patellofemoral dysfunction, you should evaluate anatomic and biomechanic components and find factors of patellofemoral dysfunction. Hamstring tightness. weakness of VMO and tightness of lateral retinaculum lead to flexed knee and abnormal patella tracking and patellofemoral pint reaction force and patellofemoral dysfunction. A through understanding of the anatomy and biomechanics may assist the clinician in the recognition and treatment of patients with patellofemoral pain. Therefore physical therapists should apply modality as well as therapeutic exercise, stretching and strengthening. In this paper, I will discuss the germane anatomical structures and biomechanics of the patellofemoral pint.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.73-81
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• 2019

Background: Patellofemoral pain is one of the common diseases of the musculoskeletal system. Many previous studies have recommended the application of exercise therapy to patellofemoral pain patients for treatment. The purpose of this study was to investigate effect of coordinative locomotor training (CLT) and sling exercise combined program on knee pain and functional movement in patellofemoral pain patient. Methods: In this study, single-subject design (A-B-A') was conducted for 6 weeks. A repeted-measure analysis was conducted to assess results of the anterior knee pain scale (AKPS), Clarke's test (CT), eccentric step down test (ESDT). During the intervention (B), the CLT and sling exercise combined program was conducted three times a week for 4 weeks. Results: From baseline period A to intervention period B, the AKPS, CT, ESDT were improved from 61 to 48 (27%), from 8.33 to 3 (64%), from 7.67 to 3,58 (53%). From baseline period A to baseline period A', the AKPS, CT, ESDT were improved from 70.67 to 48 (47%), from 0.67 to 3 (92%), from 1.33 to 3,58 (83%). Conclusion: Based on the results of this study, we recommend the application of CLT and sling exercise combined program to improve the pain and functional movement in patellofemoral pain patients.

• 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.

• 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.

• PNF and Movement
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• v.17 no.2
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• pp.311-319
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• 2019

Purpose: This study was conducted to determine the structural change in knees caused by quadriceps angle and the muscle activity in lower limbs. Indirect intervention was provided by using taping for stability in the ankle joints, which affected patellofemoral pain. Methods: The subjects in this study were 20 patients with patellofemoral pain who visited ${\bigcirc}{\bigcirc}{\bigcirc} $ Hospital in Busan. The visual analogue scale measured the dynamic quadriceps angle and the degree of pain felt by the patients while walking down stairs, which was a known factor of patellofemoral pain. In addition, muscle activities in the rectus femoris, vastus lateralis, vastus medialis, tibialis anterior, peroneus longus, and biceps femoris, which affect the knees and ankles, were measured using surface electromyography. The muscle activities were converted into %RVC for this study. The data obtained in this study were analyzed with the Wilcoxon signed-rank test using the SPSS Ver. 25.0 statistical program. The significance level ${\alpha}$ was 0.05. Results: The study results showed that the pain and dynamic quadriceps angle were significantly reduced statistically when applying the calcaneus fixation taping (p<0.05). Muscle activity in the lower limbs was significantly decreased in the vastus medialis, vastus lateralis, and tibialis anterior (p<0.05). Conclusion: The summary of the study results verified that the calcaneus fixation taping reduced the pain and dynamic quadriceps angle by providing stability in the ankle joints. It also produced efficient movement due to the difference in lower-limb muscle activity.

• Journal of TMJ Balancing Medicine
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• v.13 no.1
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• pp.27-31
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• 2023

The purpose of this case report is to introduce a case of immediate results with TMJ balancing therapy (TBT) in the treatment of chronic patellofemoral pain (PFP). A 17-year-old female patient with 4-month-old chronic knee pain that was unresponsive to conventional treatment was treated with TBT for a total of 5 sessions. The primary outcomes were evaluated using the Numeric Rating Scale (NRS) and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC). Following the first treatment, the NRS decreased rapidly, and the KWOMAC improved after a total of five treatments. These findings suggest that TBT can be an effective pain management option for chronic PFP patients with temporomandibular joint malposition. However, as this study is a report of a single case, further research is necessary.

• 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.

• 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 Physical Therapy
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• v.15 no.2
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• pp.123-130
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• 2003

This case study was performed to assess the effectiveness of taping therapy for the patient who have patellofemoral joint pain during knee extension exercise. The results were as follows: 1. Pain degree of VAS was decreased at every taping therapy. 2. A number of knee extension was increased at every taping therapy. 3. Diameter of quadriceps was increased at every taping therapy. 4. Pattern of gait was normalized at every taping therapy. We found improve of pain degree, a number of knee extension, diameter of quadriceps, and pattern of gait. These results are imply that taping therapy may have effectiveness to those who have patellofemoral joint pain during knee extension exercise.