Measuring Success in Physical Therapy: One Stair at a TimeThis report is the second in a two-part study on patellofemoral pain syndrome (PFPS). In the first study it was found that patients with PFPS use less knee flexion when going up and down stairs compared to healthy adults. In this study physical therapy was used to see if reducing pain would increase knee flexion while climbing stairs. The same group of PFPS patients was in both studies.
PFPS is a common cause of knee pain, especially when going up and down stairs. Normally the patella (kneecap) slides within a slot on the femur (thigh bone) called the trochlear groove. Sometimes the patella tracks improperly and doesn't stay in the groove. When this happens during movement pain occurs around the kneecap.
Patients were divided into two groups. One group received physical therapy to decrease knee pain and improve muscle control. These patients were given exercises, mobilization of the patella, and corrective taping of the patella. The goal was to retrain quadriceps muscle function. This would improve knee flexion during stair climbing.
The second group was the placebo group. They received a placebo taping and fake ultrasound (deep heat that wasn't turned on) along with a fake gel. Both groups were treated once a week for six weeks. Results were measured by overall pain levels and the number of steps the patient could make going up or down without pain. A special camera recorded how much knee flexion occurred while using stairs.
The authors report that patients had less pain and more knee flexion while walking after physical therapy. There was no change in the physical therapy group going up stairs. This same group had less knee flexion when coming down stairs. The placebo group had no change of any kind at any time.
Physical therapy to improve motor control of the quadriceps muscle can help patients with PFPS. Changes may not be seen with the naked eye but can be recorded on video. Pain levels and angle of knee motion are reliable measures of change.
Kay Crossley, et al. Physical Therapy Improves Knee Flexion During Stair Ambulation in Patellofemoral Pain. In Medicine & Science in Sports & Exercise. February 2005. Vol. 37. No. 2. Pp. 176-183.
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