Efficacy of Electromyographic-Biofeedback Supplementation Training with Patellar Taping on Quadriceps Strengthening in Patellofemoral Pain Syndrome among Young Adult Male Athletes

This study compares the effects of electromyographic-biofeedback (EMG-BF)-guided isometric quadriceps strengthening with patellar taping and isometric exercise alone in patellofemoral pain syndrome (PFPS) among young adult male athletes. Sixty young adult male athletes with PFPS participated in the study. Participants were randomly divided into two groups: (1) EMG-BF-guided isometric exercise training with patellar taping (experimental group, n = 30), and (2) sham EMG-BF training with an isometric exercise program (control group, n = 30). Participants conducted their respective exercise programs for five days per week across four weeks. Study outcomes were pain (measured by the visual analog scale), functional disability (measured by the Kujala Anterior Knee Pain scale), and quadriceps strength (measured by an ISOMOVE dynamometer). Measurements were taken at baseline, Week 2, Week 4, and during a follow-up at Week 6. The experimental group demonstrated significantly lower VAS score at Weeks 2 and 4 compared to that of the control group (p = 0.008 and 0.0005, respectively). The score remained significantly lower at the Week 6 follow-up compared to the control group (p = 0.0005). There were no differences in knee function at Weeks 2 and 4 between the two groups (p = 0.086 and 0.171, respectively); however, the experimental group showed significantly better knee function at Week 6 compared to the control group (p = 0.002). There were no differences in quadriceps strength at Week 2 between the two groups (p = 0.259); however, the experimental group demonstrated significantly higher quadriceps strength at Weeks 4 and 6 compared to the control group (p = 0.0008). Four weeks of EMG-BF supplementation training with patellar taping demonstrated significant improvements in pain intensity, functional disability, and quadriceps muscle strength in young adult male athletes with PFPS.

A Systematic Review of Clinical Practice Guidelines for Physical Therapist Management of Patellofemoral Pain

Objective The purpose of this study was to conduct a systematic review to evaluate clinical practice guidelines for the physical therapist management of patellofemoral pain. Methods Five electronic databases (CINAHL, Embase, Medline, Psychinfo, Cochrane Library) were searched from January 2013 to October 2019. Additional search methods included searching websites that publish clinical practice guidelines containing recommendations for physical therapist management of patellofemoral pain. Characteristics of the guidelines were extracted, including recommendations for examination, interventions, and evaluation applicable to physical therapist practice. Quality assessment was conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, applicability of recommendations to physical therapist practice was examined using the AGREE Recommendation Excellence instrument, and convergence of recommendations across guidelines was assessed. Results Four clinical practice guidelines were included. One guideline evaluated as higher quality provided the most clinically applicable set of recommendations for examination, interventions, and evaluation processes to assess the effectiveness of interventions. Guideline-recommended interventions were consistent for exercise therapy, foot orthoses, patellar taping, patient education, and combined interventions and did not recommend the use of electrotherapeutic modalities. Two guidelines evaluated as higher quality did not recommend using manual therapy (in isolation), dry needling, and patellar bracing. Conclusion Recommendations from higher-quality clinical practice guidelines may conflict with routine physical therapist management of patellofemoral pain. This review provides guidance for clinicians to deliver high-value physical therapist management of patellofemoral pain. Impact This review addresses an important gap between evidence and practice in the physical therapist management of patellofemoral pain. Lay Summary If you have kneecap pain, this review offers guidance for your physical therapist to provide examination processes, treatments, and evaluation processes that are recommended by high-quality guidelines.

Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta-analysis

ObjectiveTo investigate the comparative effectiveness of all treatments for patellofemoral pain (PFP).DesignLiving systematic review with network meta-analysis (NMA).Data sourcesSensitive search in seven databases, three grey literature resources and four trial registers.Eligibility criteriaRandomised controlled trials evaluating any treatment for PFP with outcomes ‘any improvement’, and pain intensity.Data extractionTwo reviewers independently extracted data and assessed risk of bias with Risk of Bias Tool V.2. We used Grading of Recommendations, Assessment, Development and Evaluation to appraise the strength of the evidence.Primary outcome measure‘Any improvement’ measured with a Global Rating of Change Scale.ResultsTwenty-two trials (with forty-eight treatment arms) were included, of which approximately 10 (45%) were at high risk of bias for the primary outcome. Most comparisons had a low to very low strength of the evidence. All treatments were better than wait and see for any improvement at 3 months (education (OR 9.6, 95% credible interval (CrI): 2.2 to 48.8); exercise (OR 13.0, 95% CrI: 2.4 to 83.5); education+orthosis (OR 16.5, 95% CrI: 4.9 to 65.8); education+exercise+patellar taping/mobilisations (OR 25.2, 95% CrI: 5.7 to 130.3) and education+exercise+patellar taping/mobilisations+orthosis (OR 38.8, 95% CrI: 7.3 to 236.9)). Education+exercise+patellar taping/mobilisations, with (OR 4.0, 95% CrI: 1.5 to 11.8) or without orthosis (OR 2.6, 95% CrI: 1.7 to 4.2), were superior to education alone. At 12 months, education or education+any combination yielded similar improvement rates.Summary/conclusionEducation combined with a physical treatment (exercise, orthoses or patellar taping/mobilisation) is most likely to be effective at 3 months. At 12 months, education appears comparable to education with a physical treatment. There was insufficient evidence to recommend a specific type of physical treatment over another. All treatments in our NMA were superior to wait and see at 3 months, and we recommend avoiding a wait-and-see approach.PROSPERO registeration numberPROSPERO registration CRD42018079502.

McConnell patellar taping on postural control of women with patellofemoral pain syndrome: randomized clinical trial

Introduction: The effects of McConnell patellar taping on the postural control of women with patellofemoral pain syndrome (PFPS) are controversial. Objective: To evaluate the effects of McConnell patellar taping on the static one-leg stance postural control and during squatting in women with PFPS. Method: A randomized, blinded clinical trial that comprised 40 women with PFPS, aged between 18 and 35 years. The study sample was allocated to two groups: McConnell patellar taping group (MPTG) and Placebo taping group (PTG). The analysis included the one-leg static support and squat on the lower limb with PFPS. The center of pressure (CoP) displacement parameters recorded by a force platform were analyzed using two-way ANOVA and Cohen’s d. Results: For the static postural control, no significant differences were found between the groups in terms of time or interaction (p>0.05); with small effect size. For the postural control during the one-leg squat, significant differences were found regarding the time of intervention for both groups, with reduced CoP parameters after the application of taping. However, the MPTG demonstrated a large effect size in frequency of oscillation and medium effect size in speed of oscillation, both during the squat exercise. Conclusion: McConnell patellar taping and placebo taping improved postural control during the one-leg squat. It should be observed that the changes and effect sizes determined for the MPTG were significantly higher compared to the PTG, emphasizing its clinical importance in the treatment of individuals with PFPS, during dynamic activities.

A comparison of the Effect of Quadriceps Taping versus Patellar Taping on Balance and Functional Performance in Patients with Knee Osteoarthritis

Backgrounds Osteoarthritis (OA) is primarily a disease of cartilage destruction. Knee OA is the most common type of arthritis which can be treated with kinesio taping (KT). Purpose The current study was aimed to compare the effect of quadriceps muscle taping vs. patellar taping on balance and functional performance in patients with knee OA. Patients and Methods 40 patients with knee OA aged from 40 to 65 years entered this interventional study. Eligible participants were randomly divided into 2 groups, the Quadriceps taping group, and patellar taping group. The balance was measured using the modified star excursion balance test (SEBT), functional reach test (FRT), and Berg balance scale test (BBST). Also, functional activity was evaluated using the step test. All variables measured before, immediately after and 24 hr after the intervention in both groups. Results Within-group comparison in both groups showed that KT therapy improved modified SEBT, FRT and step test scores immediately after and 24 h after the intervention compared to baseline, and the difference was more significant 24 h after the intervention compared to immediately after the intervention. However, BBS score was not different in assessed times compared to baseline in both groups. The results of between-group analyses of variables showed no significant differences between the two groups in assessed times. Besides, repeated measure ANOVA showed that time significantly influenced modified SEBT, FRT, and step test. However, there was no group effect on assessed variables. Conclusion Both quadriceps and patellar taping positively influenced balance and functional level of the patients with knee OA. Also, there is no superiority between these 2 methods.