Abstract
BackgroundPatellofemoral pain syndrome (PFPS) is defined as pain around the patella while performing activities such as squats, running, and climbing steps. One of the inherent risk factors for PFPS is an excessively pronated foot posture. The aim of this study was to investigate the effect of foot intervention, talonavicular joint mobilization (TJM) and foot core strengthening (FCS), on PFPS.MethodsForty-eight patients with PFPS (mean age, 21.96 ± 2.34 years; BMI, 22.77 ± 2.95 kg/m2) were enrolled in the study. Participants were randomly assigned in a 1:1:1 ratio to three groups, and received 12 sessions of TJM, FCS, and blended intervention at university laboratory for 4 weeks. The primary outcomes were pain while the secondary outcomes were lower extremity function, valgus knee, foot posture, and muscle activity ratio measured at baseline, after 12 sessions, and at the 4-week follow-up.ResultsThe two-way repeated-measures ANOVA revealed significant interactions in all groups (p < 0.05). TJM reduced pain more than the FCS at post-test (mean difference, − 0.938; 95% Confidence interval [CI], − 1.664 to − 0.211; p < 0.05), and blended intervention improved lower extremity function (mean difference, 6.250; 95% CI, 1.265 to 11.235; p < 0.05) and valgus knee (mean difference, − 11.019; 95% CI, − 17.007 to − 5.031; p < 0.05) more than the TJM at 4 weeks follow-up. TJM was more effective in post-test (mean difference, − 1.250; 95% CI, − 2.195 to − 0.305; p < 0.05), and TJM (mean difference, − 1.563; 95% CI, − 2.640 to − 0.485; p < 0.05) and blended intervention (mean difference, − 1.500; 95% CI, − 2.578 to − 0.422; p < 0.05) were more effective in foot posture than the FCS in 4 weeks follow-up. Blended intervention displayed greater improvement in muscle activity than the TJM (mean difference, 0.284; 95% CI, 0.069 to 0.500; p < 0.05) and the FCS (mean difference, 0.265; 95% CI, 0.050 to 0.481; p < 0.05) at 4 weeks follow-up.ConclusionsOur study is a novel approach to the potential impact of foot interventions on patellofemoral pain. Foot intervention including TJM and FCS is effective for pain control and function improvement in individuals with PFPS.Trial registrationKCT0003176, 16/08/2018 (retrospectively registered).
Highlights
Patellofemoral pain syndrome (PFPS) is defined as pain around the patella while performing activities such as squats, running, and climbing steps
The Numeric pain rating scale (NPRS) scores of participants who complained of pain for more than 12 weeks were 4.44 ± 0.73 for talonavicular joint mobilization (TJM), 4.25 ± 0.45 for foot core strengthening (FCS), and 4.38 ± 0.81 for blended intervention, and there was no significant difference between groups
While the effects of studies on PFPS intervention remain controversial, biomechanical changes by pronated foot, an intrinsic risk factor, can stress the patellofemoral joints and cause patellofemoral pain [24]. This investigated the effects of structural and functional changes on patellofemoral pain following the application of TJM, FCS, and blended interventions in those in their 20s with high PFPS prevalence
Summary
Patellofemoral pain syndrome (PFPS) is defined as pain around the patella while performing activities such as squats, running, and climbing steps. Patellofemoral pain syndrome (PFPS) is defined as pain around the patella due to activities (squats, running, climbing, etc.) that load the patellofemoral joint without pathological changes [1, 2]. It is a common problem among adolescents and young adults, and the annual prevalence of patellofemoral pain in the general population was reported to be 22.7 and 28.9% in adolescents [3,4,5]. Changes in the lower extremity alignment can cause calcaneal eversion, tibia internal rotation, valgus knee, and femur internal rotation in the normal structure, altering the angle of muscle contraction of the quadriceps femoris, causing the patella to track in the lateral direction, resulting in lower extremity dysfunction [15, 16]
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