Kinetic Chain Exercise For Patello Femoral Pain Syndrome - A Randomised Control Study

Abstract

Objective: The objective was to compare the effect of open kinetic chain exercise and closed kinetic chain exercise in quadriceps strength and pain in patients with patella femoral pain syndrome. Introduction: Patello femoral pain syndrome [PFPS] can be defined as retropatellar pain or peri patellar pain resulting from physical and biochemical change in patella femoral joint. The patients with patello femoral pain syndrome have anterior knee pain, which typically occurs during activity and often worsens with descending stairs and also triggered by prolonged sitting. Patello femoral pain syndrome is due to the degeneration in the articular cartilage of the knee cap. PFPS is the most prevalent disorder involving the knee and can be misdiagnosed sometime as bursitis, meniscus, and ligament instability. Osteoarthritis, chondromalacia patella produce more stress on the patella femoral mechanism. Materials & Methodology: After getting the ethical clearance for this study 30 patients with PFPS were selected and randomized into 2 groups after due consideration of the inclusive and exclusion criteria. The patients consent for this study was taken and documented. Procedure: Group A and Group B subjects were given with open kinetic chain [OKC] and closed kinetic chain [CKC] exercises respectively. The dosimetry of these exercises was 30 minutes duration every alternate day for 4 weeks. Data collected for statistical analysis included Maximal Isometric Voluntary Contraction [MVIC] using surface EMG on Vastus Medialis [quadriceps muscle] and Pain by visual analog scale [VAS] before and after exercise. Result: Data collected were statistically analyzed using the SPSS 11 version for t-test. The paired ttest value for both CKC and OKC shows that there is a significant improvement in the quadriceps strength and pain reduction in both the groups. The unpaired t-test between the groups for quadriceps interference [3.45] and pain score in VAS scale [2.89] with p value at 0.01 shows that closed kinetic chain [CKC] exercise is better than the open kinetic chain [OKC] exercise in improving the strength and reducing the pain among PFPS patients. Conclusion: To conclude, though both OKC and CKC exercises are beneficial in PFPS patients, CKC proved to be better than the OKC in improving the quadriceps muscle strength and reducing the pain. This study proves this statement statistically with significance.