Patello Femoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is often associated with imbalance and weakness in several key muscle group. These include the quadriceps (especially the vastus medialis oblique), hip abductors and external rotators and hamstrings as well as tightness in iliotibial band and gastrocnemius. Exercises involving isometrics, stretching, strengthening of knee along with core muscles has improved range, strength, coordination and motor control. This study aim to determine the effects of active release along with myofascial release technique on pain, range of motion and function in patients with patellofemoral pain syndrome. This study will be a randomized controlled trial and will be conducted in Riphah Rehabilitation Clinic Lahore (Physiotherapy Department) and Ghurki Trust Hospital Lahore. Non-probability consecutive sampling will be used to collect the data. Sample size of 30 subjects with age group between 15-40 years will be taken. Data will be collected from the patients having present complaint of anterior knee pain. Outcome measures will be taken by using Numeric pain rating scale (NPRS), Anterior knee pain scale (AKPS)for pain, Universal Goniometer (GU) for Range of motion and KOOS PS scale to assess physical function in patient with knee pain. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive RICE protocol, ice, stretching, strengthening and knee isometrics exercises, while Group A will receive active release and Group B will receive myofascial release technique. Outcome measures will be measured at baseline and after 6 weeks. Data analysis will be done by SPSS version 25.

The present study is the first one to compare the effectiveness of adding (FNG) versus (LPM ) to conventional exercise therapy in pain, knee functional abilities, hip extension ROM and femoral nerve electrophysiological studies among those with PFPS. This study will be conducted at the outpatient clinic of faculty of Physical Therapy, Cairo University Sixty patients with unilateral PFPS referred from an orthopaedic surgeon for selection criteria, will be included in the study. Measurement procedures, treatment procedures, and the study's goal will be explained to each patient before participation in the study. After being informed about the study aim, they will be asked to sign an informed consent for their approval to participate The study patients will be randomly assigned into three groups * Group A: control group will receive conventional hip-knee focused exercises only. * Group B: study group will receive FNG in addition to the same conventional hip-knee focused exercises. * Group C: study group will receive LPM in addition to the same hip-knee focused exercises All patients will receive 2 sessions/week for 6 weeks (12 sessions). They will be instructed to do the conventional hip-knee exercises at least two times per day. Each session will last for 20-30 minutes. Patients diagnosed with unilateral PFPS will be screened based on the following inclusion and exclusion criteria A sample size of 60 participants will be appropriate. The computations will done using G\* Power version 3.1.9.2 (Franz Faul, Uni Kiel, Germany) Randomization and blinding will be accomplished through using selected types such as A 1:1:1 allocation ratio will be employed for randomization using the website http://www.randomization.com. Blinding will be done on the patients, assessor, and statistician. All patients will be blinded to the task assigned to their group by ensuring they will be unaware of the exercises that the other group will complete. To maintain blinding, the intervention sessions will be administered to each member of the treatment group separately. Before the trial began, an impartial research assistant who will not participating in the study and he will keep the allocation sequence a secret. It will be kept hidden in opaque, sealed envelopes that will not be opened until baseline data will be collected Outcome Measures: 1. Knee Pain 2. Knee function 3. Electro-physiological studies including (sensory nerve conduction velocity and distal latency). 4. Sagittal plane hip extension range of motion as a reference for femoral nerve mechanosensitivity changes - The outcomes will be measured at baseline (pre-test) and after 12sessions (after 6 weeks) (post-test) Then patients will receive 4 types of assessments step's including pain assessment using NRS then knee function assessment using arabic version of AKPS then hip extension ROM assessment using digital goniometer after that the electrophysiological studies including femoral nerve will be conducted using the computerized electromyography device for measuring selective parameters such nerve conduction velocity and its amplitude along with onset and peak latency. Then Intervention will be completed as follow : All patients will receive two treatment session per week for six weeks (6 sessions), supervised by primary investigator. Separate sessions will be given to each treatment group's members. Each session lasted for 15-30 minutes. The three groups will receive hip-knee focused exercises approved by the clinical practice guidelines linked to the international classification of functioning, disability, and health from the Academy of Orthopedic Physical Therapy of the American Physical Therapy Association which consisted of hamstring/calf and ilio-tibial band stretching and hip/knee strengthening exercises. group B will receive FNG addition to hip-knee focused exercises. group C will receive LPM in addition to hip-knee focused exercise. The session of the control group will start with stretching exercises followed by strengthening exercises. On the other hand, the study group session will start with stretching exercises followed by femoral nerve glide and/or LPM then strengthening ex. The study has a 3 null hypothesis 1. There will be no statistically significant effects of adding FNG to conventional exercises in patients with PFPS on: A) Knee pain. B) Functional abilities. C) Hip extension ROM. D) Electrophysiological study (NCV and distal latency). 2. There will be no statistically significant effects of adding LPM to conventional exercises in patients with PFPS on: A) Knee pain. B) Functional abilities. C) Hip extension ROM. D) Electrophysiological study (NCV and distal latency). 3. There will be no statistically significant difference between adding FNG versus LPM to conventional exercises in patients with PFPS on: A) Knee pain. B) Functional abilities.C) Hip extension ROM. D) Electrophysiological study (NCV and distal latency).

The primary goal of this randomized clinical trial (RCT) is to evaluate whether Kinesio Taping versus McConnell Taping, when integrated into a standardized hip-knee strengthening and neuromuscular control program, produces significant effects in individuals aged 18-50 with patellofemoral pain syndrome (PFPS). The main question it aims to answer is: Does Kinesio Taping compared with McConnell Taping when both combined with a standardized hip-knee exercise program, produce different effects on quadriceps neuromuscular activation (VMO-VL sEMG), pain, functional knee pain, and dynamic knee valgus over a 6 week period intervention? Participants will be divided into three groups for comparison: the control group will receive a structured hip-knee physical therapy exercise program without any taping intervention, Kinesio Taping group with a standardized exercise program, and a McConnell Taping group with a standardized exercise program.

This randomized controlled trial compares blood flow restriction (BFR) resistance training (leg press and seated knee extension at 30% 1RM) versus BFR cycling (stationary cycling at low resistance) in 60 athletes (aged 18-40 years) diagnosed with patellofemoral pain syndrome. Both interventions are delivered over 8 weeks (3 sessions/week) with a pneumatic cuff set at 80% limb occlusion pressure. Primary outcomes include pain intensity (NPRS), quadriceps strength (handheld dynamometer), and functional ability (Kujala Anterior Knee Pain Scale), assessed at baseline and post-intervention.

The aim of this study is to examine in detail the ultrasonographic characteristics of the vastus medialis obliquus and vastus medialis longus muscles in individuals with patellofemoral pain syndrome and to compare these findings with those of healthy individuals. It is anticipated that the results obtained will contribute to a better understanding of the muscle-based mechanisms of PFAS and provide a scientific basis for the development of muscle-specific assessment and intervention strategies in physical therapy and rehabilitation practices.

This study aims to investigate and compare the effect of AI driven exercises program versus the conventional exercises therapy program on pain, function and dynamic knee valgus angle in treatment of patellofemoral pain syndrome.This study is randomized controlled trial and includes 40 participants .These participants divided into 2 groups (A, B), each group will be assessed with 3 measurments (vas ,dynamic knee valgus, Kujala Anterior Knee Pain Scale) and each group will receive difeerent treatments. The individuals in group A(study group) will preceive AI driven exercises program while the individual in group B will receive conventional exercises therapy program. Participants in the both groups are prescribed a 6-week comprehensive exercises program (3 sessions per week) day after day and assessment procedure will be performed pre and post treatmeant .