• 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.

• Korean Journal of Applied Biomechanics
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• v.21 no.3
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• pp.335-343
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• 2011

Patellofemoral pain syndrome is the most common problem involving the knee, accounting for 25% of knee injuries. Repetitive, overuse activities cause increased force at the patellofemoral joint, resulting in pain during flexion and extension activities. Most research have been conducted in exploring the patellofemoral compressive force in gait, squat and lunges, even though in real cases, possibilities in landing exist. The purpose of this study was to compare the differences in patellofemoral compressive force according to two different height. Sixteen collegiate male students(age: 22.25 ${\pm}$ 3.30 yrs, height: 177.25 ${\pm}$ 4.44 cm, weight: 77.50 ${\pm}$ 8.18 kg) were chosen. The subjects performed drop landings in 45 cm, 60 cm. The findings demonstrated that higher height showed peak knee extension moment, quadriceps contraction force, patellofemoral compressive force with increased VGRF. Regarding the patellofemoral joint compressive force, it increased by quadriceps contraction force with knee flexion during landing, yet, it showed no difference in maximal knee flexion. To minimize patellofemoral joint stress and reduce the likelihood of developing PFPS, we recommend that predesigned quadriceps and hip muscle group strengthening are needed during conditioning and training.

• 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.

• Journal of Veterinary Science
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• v.21 no.5
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• pp.69.1-69.11
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• 2020

Background: An inappropriate Q angle may affect the biomechanics of the canine patellofemoral joint. Objectives: The purpose of this study was to evaluate the effects of changes in quadriceps angle (Q angle) on patellofemoral joint pressure distribution in dogs. Methods: Eight stifles were positioned at 45, 60, 75, 90, 105, and 120° of flexion in vitro, and 30% body weight was applied through the quadriceps. Patellofemoral contact pressure distribution was mapped and quantified using pressure-sensitive film. For the pressure area, mean pressure, peak pressure, medial peak pressure, and lateral peak pressure, differences between groups according to conditions for changing the Q angle were statistically compared. Results: Increases of 10° of the Q angle result in increases in the pressure area (P = 0.04), mean pressure (P = 0.003), peak pressure, and medial peak pressure (P ≤ 0.01). Increasing the Q angle by 20° increases the pressure area (P = 0.021), mean pressure (P ≤ 0.001), peak pressure (P ≤ 0.01), and medial peak pressure (P ≤ 0.01) significantly, and shows higher mean (P ≤ 0.001) and peak pressures than increasing by 10°. Decreasing the Q angle increases the mean pressure (P = 0.013), peak pressure, and lateral peak pressure (P ≤ 0.001). Conclusions: Both increases and decreases in the Q angle were associated with increased peak patellofemoral pressure, which could contribute to the overloading of the cartilage. Therefore, the abnormal Q angle should be corrected to the physiologically normal value during patellar luxation repair and overcorrection should be avoided.

• 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.

• 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.

• PNF and Movement
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• v.6 no.1
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• pp.53-60
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• 2008

Purpose : To describes the important aspects of knee joint movement and function used when applying PNF technique to the lower limb. Method : The knee was a very important roles in the lower limb movement and ambulation. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The tibiofemoral joint is usually described as a modified hinge joint with flexion-extension and axial rotation by two degrees of freedom movement. These arthrokinematics are a result of the geometry of the joints and the tension produced in the ligamentous structures. The patellofemoral joint is a sellar joint between the patella and the femur. Stability of the patellofemoral joint is dependent on the passive and dynamic restraints around the knee. In a normal knee the ligaments are inelastic and maintain a constant length as the knee flexes and extends, helping to control rolling, gliding and translation of the joint motions. Conclusions : It is important to remember that small alterations in joint alignment can result in significant alterations in patellofemoral joint stresses and that changes in the mechanics of the patellofemoral joint can also result in changes in the tibiofemoral compartments. Successful treatment requires the physical therapist to understand and apply these arthrokinematic concepts. When applied to PNF low extremity patterns, understanding of these mechanical concepts can maximize patient function while minimizing the risk for further symptoms or injury.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.674-687
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• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.9-16
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• 2006

Treatment of patellofemoral joint injuries consist of conservative and surgical methods. Conservative treatemnt is effective in many cases. The goal of rehabilitation of patellofemoral joint injuries is to reestabilish the functional integrity of the affected lower extremity. Each patient presents with diffenent aspects of positive findings. Therefore, individualized treatment for each patient must be applied.

• 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.