Patellofemoral Pain (PFP) is one of the most common causes of knee pain and is significantly present in recreational athletes who have previously been categorized as being in a subgroup of PFP. Understanding which intervention is most appropriate for this subgroup could give us important information about subgroup-based treatments, which are not yet described in the literature. Therefore, the aim of this study is to analyze the effect of two exercise interventions in a PFP subgroup: one focusing on neuromuscular control exercises and the other focusing on muscle strengthening.This study will recruit 10 individuals to each exercise group, and will assess pain, function, muscle activity and joint kinematics pre and post intervention. Mixed Model ANOVA tests will be used to determine the responses to the two interventions between the two groups over a 6-week treatment time.
Pain during resisted isometric quadriceps contraction
Pain with palpation of the posterior borders of the patella
Pain during squatting Classified as being within the strong subgroup of PFP (exemplified in the following sections).
Individuals who are not part of the 'strong' PFP group
Previous knee surgery and participants awaiting surgery for another lower limb joint problems
Ligamentous instability and/or internal pathology
History of patella subluxation or dislocation
Parallel
Exercise
Other interventionBalance and proprioceptive exercises
Muscle strengthening
Other interventionStrengthening of the lower limb muscles
Pain intensity
Full name: Numerical Pain Rating Scale (NPRS) Minimum value: 0; Maximum value: 10. Direction: Higher scores indicate a worse outcome, that is, greater pain intensity. Interpretation: 0: no pain 1-3: mild pain 4-6: moderate pain 7-10: intense/severe pain
Specific Knee Function
Full name: Anterior Knee Pain Scale (AKPS) Minimum value: 0 Maximum value: 100 Direction: higher scores indicate a better outcome (fewer symptoms and better knee function). General interpretation: 100 represents an absence of limitations/symptoms, while 0 represents greater functional impairment.
General function
Full name: Knee injury and Osteoarthritis Outcome Score - Physical Function Shortform (KOOS-PS) Minimum value: 0 Maximum value: 100 Direction: higher scores indicate a worse outcome (greater difficulty/limitation in physical function). Interpretation: 0 = no functional difficulty; 100 = extreme functional difficulty.
Kinesiophobia
Full name: Tampa Scale for Kinesiophobia (TSK-13) Number of items: 13 Minimum score: 13 Maximum score: 52 Direction: higher scores indicate a worse outcome, corresponding to a greater fear of movement/re-injury (kinesiophobia).
Pain Catastrophizing
Full name: Pain Catastrophizing Scale (PCS) Number of items: 13 Minimum score: 0 Maximum score: 52 Direction: higher scores indicate a worse outcome, corresponding to a higher level of pain catastrophizing.
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