Patients Who Respond Best to Patellar TapingIn the mid-1980s, an Australian physical therapist (PT) by the name of Jenny McConnell developed a special way to tape the knee. Patients with patellofemoral pain syndrome (PFPS) seemed to respond well to this treatment.
PFPS is a painful knee condition caused by a misaligned patella (kneecap). The taping helps keep the kneecap in the center where it belongs. This allows better tracking of the patella as it moves up and down along a groove in the bone.
In this study, PTs tried to determine which patients with knee pain would respond best to patellar taping. This is called a clinical prediction rule (CPR). If therapists can tell early on which patients will respond well to treatment with taping, then treatment time and cost can be reduced.
All subjects in this study had PFPS and were given the same tests before treatment started. Some were tests of motion of the knee joint and the patella as it moves over the joint. Muscle strength and flexibility were tested. Ankle motion and alignment were also measured. The authors include a two-page summary of all the tests given.
Pain intensity was also rated on a scale from zero (no pain) to 10 (worst pain). Pain was measured before and after three functional activities. The activities included going up a step, coming down a step, and squatting.
The patients all had the same treatment for PFPS. The patella was shifted to the middle of the knee and taped in place. Each patient repeated the three functional tests and reported pain levels with the tape in place.
Just over half (52 per cent) had an immediate reduction in pain and reported a positive change in their condition. Two of the specific patellar tests (patellar tilt test, tibial varum test) were able to predict who would get better with patellar taping.
The patellar tilt test measures the movement of the kneecap. Too much movement toward the outside of the knee is a sign of patellar mobility that can be helped by taping. The tibial varum test measures the angle of the lower leg bone. More than five degrees of bowing contributes to PFPS and responds to taping.
More testing is needed before these two patient characteristics can be used as CPR for patellar taping. The next step is to repeat the same study with a larger number of patients to make sure the test is valid.
Jonathan D. Lesher, MPT, et al. Development of a Clinical Prediction Rule for Classifying Patients with Patellofemoral Pain Syndrome Who Respond to Patellar Taping. In Journal of Orthopaedic & Sports Physical Therapy. November 2006. Vol. 36. No. 11. Pp. 854-866.
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