ANKMJ

Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

EndNote Style
Index
Original Article
The role of core endurance and proprioception on knee functionality in patients with patellofemoral pain syndrome
Aims: Patellofemoral pain (PFP) is one of the most common musculoskeletal diagnoses which is considered to be a complex and multifactorial problem. We aimed to determine how the deficiencies in body/core muscle strength and proprioception may affect PFP development.
Methods: Fifty patients with diffuse anterior knee pain and/or diagnosed with chondromalacia patella in the study group and 50 healthy adults in the control group were included in this prospective cross-sectional study. The patients with knee disorders except for chondromalacia patella, those who had lower extremity and spinal surgery, and/or had physical therapy in the last 3-months were excluded from the study. Active proprioceptive repositioning test and the prone-bridge test and side-bridge tests were used for primarily assessment of core muscles capacity. The knee functionality was evaluated with Kujala's knee score, and physical activity levels were evaluated with the short form of the International Physical Activity Questionnaire.
Results: The mean age, weight, and median of body mass index were higher in the study group while number of active working patients were significantly higher in the control group. (p=0.041) The mean of Kujala, Prone-bridge, Side-bridge (right and left) tests were significantly higher in the control group than the study group. (p=0.012) The mean Flex-30 test was significantly higher in the study group than control group. (p=0.037) In the study group, there were very strong correlations between hyperextension of body and Kujala tests and between hyperextension of body and prone-bridge tests (p<0.05) while there was a very strong correlation between hyperextension of body and flex-30 tests in the control group. (p<0.05)
Conclusion: As our body has a closed kinetic chain system, it is obvious that core musculature has great importance on the knee joint. In the current study, we demonstrated the importance of core musculature both in the sense of motor and sensory, on the functionality of knee joint in PFP.


1. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, BeutlerA. Gender differences in the incidence and prevalence ofpatellofemoral pain syndrome. Scand J Med Sci Sports 2010; 20:725-30.
2. Robinson RL, Nee RJ. Analysis of hip strength in females seekingphysical therapy treatment for unilateral patellofemoral painsyndrome. J Orthop Sports Phys Ther 2007; 37: 232-8.
3. Baquie P, Brukner P. Injuries presenting to an Australian sportsmedicine centre: a 12-month study. Clin J Sport Med 1997; 7:28-31.
4. Zhai G, Cicuttini F, Ding C, Scott F, Garnero P, Jones G. Correlatesof knee pain in younger subjects. Clin Rheumatol 2007; 26: 75-80.
5. Dye SF, St&auml;ubli HU, Biedert RM, Vaupel GL. The mosaic ofpathophysiologycausing patellofemoral pain: Therapeuticimplications. Operative Techniques in Sports Medicine 1999; 7:46-54.
6. Insall J. &quot;Chondromalacia patellae&quot;: patellar malalignmentsyndrome. Orthop Clin North Am 1979; 10: 117-27.
7. Witvrouw E, Danneels L, Van Tiggelen D, Willems TM, CambierD. Open versus closed kinetic chain exercises in patellofemoralpain: a 5-year prospective randomized study. Am J Sports Med2004; 32: 1122-30.
8. Cowan SM, Crossley KM, Bennell KL. Altered hip and trunkmuscle function in individuals with patellofemoral pain. Br JSports Med 2009; 43: 584-8.
9. Draper CE, Besier TF, Santos JM, et al. Using real-time MRI toquantify altered joint kinematics in subjects with patellofemoralpain and to evaluate the effects of a patellar brace or sleeve onjoint motion. J Orthop Res 2009; 27: 571-7.
10. Fulkerson JP. Diagnosis and treatment of patients withpatellofemoral pain. Am J Sports Med 2002; 30: 447-56.
11. Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM.Core stability measures as risk factors for lower extremity injuryin athletes. Med Sci Sports Exerc 2004; 36: 926-34.
12. Abdallah AA, Mohamed NA, Hegazy MA. A Comparative Studyof Core Musculature Endurance and Strength between SoccerPlayers with and without Lower Extremity Sprain and StrainInjury. Int J Sports Phys Ther 2019; 14: 525-36.
13. Kuru T, Dereli EE, Yaliman A. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome.Acta Orthop Traumatol Turc 2010; 44: 152-6.
14. Craig CL, Marshall AL, Sjostrom M, et al. International physicalactivity questionnaire: 12-country reliability and validity. MedSci Sports Exerc 2003; 35: 1381-95.
15. Hassan BS, Mockett S, Doherty M. Static postural sway,proprioception, and maximal voluntary quadriceps contractionin patients with knee osteoarthritis and normal control subjects.Ann Rheum Dis 2001; 60: 612-8.
16. Lund H, Juul-Kristensen B, Hansen K, et al. Movement detectionimpaired in patients with knee osteoarthritis compared to healthycontrols: a cross-sectional case-control study. J MusculoskeletNeuronal Interact 2008; 8: 391-400.
17. Shanahan CJ, Wrigley TV, Farrell MJ, Bennell KL, Hodges PW.Proprioceptive impairments associated with knee osteoarthritisare not generalized to the ankle and elbow joints. Hum Mov Sci2015; 41: 103-13.
18. van der Esch M, Knoop J, Hunter DJ, et al. The associationbetween reduced knee joint proprioception and medial meniscalabnormalities using MRI in knee osteoarthritis: results from theAmsterdam osteoarthritis cohort. Osteoarthritis Cartilage 2013;21: 676-81.
19. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J.The effects of core proprioception on knee injury: a prospectivebiomechanical-epidemiological study. Am J Sports Med 2007; 35:368-73.
20. de Moura Campos Carvalho ESAP, Peixoto Leao Almeida G,Oliveira Magalhaes M, et al. Dynamic postural stability andmuscle strength in patellofemoral pain: is there a correlation?Knee 2016; 23: 616-21.
21. Akseki D, Erduran M, Ozarslan S, Pinar H. (Parallelism ofvibration sense with proprioception sense in patients withpatellofemoral pain syndrome: a pilot study). Eklem HastalikCerrahisi 2010; 21: 23-30.
22. Goto S, Aminaka N, Gribble PA. Lower-extremity muscle activity,kinematics, and dynamic postural control in individuals withpatellofemoral pain. J Sport Rehabil 2018; 27: 505-12.
23. Steinberg N, Tenenbaum S, Waddington G, et al. Isometricexercises and somatosensory training as interventionprogrammes for patellofemoral pain in young dancers. Eur JSport Sci 2020; 20: 845-57.
24. Yosmaoglu HB, Kaya D, Guney H, et al. Is there a relationshipbetween tracking ability, joint position sense, and functional levelin patellofemoral pain syndrome? Knee Surg Sports TraumatolArthrosc 2013; 21: 2564-71.
25. Graci V, Salsich GB. Trunk and lower extremity segmentkinematics and their relationship to pain following movementinstruction during a single-leg squat in females with dynamicknee valgus and patellofemoral pain. J Sci Med Sport 2015; 18:343-7.
Volume 1, Issue 3, 2022
Page : 73-78
_Footer