To compare the effects of the Mikhled Knee Exercise Program with and without Stecco Fascial Manipulation on pain, range of motion, and functional outcomes Patellofemoral Pain Syndrome.
Male and female participants between the ages of 25-45 years (16)
Diffused anterior knee pain for at least 8 weeks (16)
Pain exacerbated by climbing stairs, prolonged sitting, walking, running, squatting, knee flexion, and isometric quadriceps contraction (14).
Patients had never received Stecco fascial manipulation and MKEP before.
Tendonitis
Osgood-Schlatter syndrome
OA
Fracture
Parallel
Mikhled Knee Exercises with Stecco Fascial Manipulation
Other interventionIntervention: Mikhled Knee Exercise Program (MKEP) Frequency: 3 sessions per week Duration: 6 weeks Session Duration: 30-45 minutes Supervision: Supervised by a physiotherapist Exercises: Wall slides, step-downs, eccentric decline squats, lateral step-ups, closed kinetic chain terminal knee extensions, single-leg stance with trunk rotation, and quadriceps isometric exercises Dosage: 2-3 sets of 10-15 repetitions per exercise Progression: Gradual increase in exercise intensity and difficulty based on participant tolerance and clinical progress. Intervention: Stecco Fascial Manipulation Frequency: 1-2 sessions per week (within the treatment session) Duration: 6 weeks Application Time: 10-15 minutes per session Provider: Performed by a trained physiotherapist Target Area: Centers of Coordination (CCs) in the fascia of the hip, thigh, and knee Technique: Manual fascial manipulation tailored to identified fascial restrictions
Mikhled Knee Exercise Program (MKEP)
Other interventionIntervention: Mikhled Knee Exercise Program (MKEP) Frequency: 3 sessions per week Duration: 6 weeks Session Duration: 30-45 minutes Supervision: Supervised by a physiotherapist Exercises: Wall slides, step-downs, eccentric decline squats, lateral step-ups, closed kinetic chain terminal knee extensions, single-leg stance with trunk rotation, and quadriceps isometric exercises Dosage: 2-3 sets of 10-15 repetitions per exercise Progression: Gradual increase in exercise intensity and difficulty based on participant tolerance and clinical progress.
Numeric Pain Rating Scale (NPRS)
It is a simple and widely used tool for assessing pain intensity, where patients rate their pain from 0 (no pain) to 10 (worst imaginable pain). It is highly reliable (ICC ranging from 0.87 to 0.96) and valid for assessing pain associated with knee injuries. It is sensitive to changes in pain levels over time, making it suitable for both baseline and follow-up assessments
Range of Motion (Flexion) by Universal Goniometer
It is a standard instrument to measure the knee joint's flexion angle. It is essential for evaluating knee mobility following injury or surgery. The tool has shown excellent reliability (ICC \> 0.90) and good validity when used by trained clinicians. During measurement, the fulcrum is placed over the lateral epicondyle of the femur. The stationary arm is aligned with the lateral midline of the femur, pointing toward the greater trochanter, while the movable arm is aligned with the lateral midline of the fibula, pointing toward the lateral malleolus
Anterior Knee Pain Scale (AKPS)
The Anterior Knee Pain Scale, also known as the Kujala Score, is a self-reported questionnaire used to evaluate functional limitations and pain in individuals with patellofemoral disorders. It includes 13 items assessing activities like walking, squatting, and running. For knee-related conditions, it demonstrates high reliability (ICC \> 0.90) and strong content validity in both clinical and research settings
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