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Chiropractic Research Review

Effect of Patellar Mobilization on Patellofemoral Pain

Patellofemoral pain syndrome (PFPS) can include a number of conditions associated with patellofemoral joint dysfunction, although the etiology of the pain remains poorly understood. The suggestion that conservative management of PFPS may lie in sufficient stretching/lengthening of tight, passive peripatellar structures emphasizes the potential effectiveness of patella mobilization.

This pilot study served to investigate the efficacy of chiropractic patella mobilization in the treatment of PFPS. Thirty subjects were randomly divided into two groups for comparison: group A received patella mobilization; group B received detuned ultrasound as placebo. Patients were diagnosed with PFPS if they presented with localized peri- or retropatellar pain originating from the peripatella tissue or the patellofemoral joint, and if the pain was reproducible under at least two of the following conditions: squatting, kneeling, stair climbing, prolonged sitting, or isometric quadriceps femoris muscle contraction.

Data were gathered using the McGill Pain Questionnaire, the Numerical Pain Rating Scale-101, and the Patient-Specific Functional Scale; the Mann-Whitney U-test and the Wilcoxin Sign-Rank test were used to analyze intergroup and intragroup data, respectively. Results showed a greater positive treatment effect of mobilization than that observed in patients receiving the placebo; the authors speculate that the mechanism behind this positive effect may have been "...stretching of tight, passive peripatella structures... which may be, in some, the primary cause of PFPS."

The authors conclude that their results appear to support the potential efficacy of chiropractic mobilization for PFPS patients, and suggest that patellar mobilization may be useful when combined with patient-specific treatment options such as exercise, orthoses and activity modification.

Note: Although the sample used in this study was small, the clinical and statistical methods were well-employed. The authors are encouraged that the results offer a positive springboard for further research in this area.

Rowlands BW, Brantingham JW. The efficacy of patella mobilization in patients suffering from patellofemoral pain syndrome. Journal of the Neuromusculoskeletal System 1999:7(4), pp142-49.
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Chiropractic Research Review

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