ORIGINAL ARTICLE –
of vastus medialis obliquus vs rectus femoris strengthening using open
kinematic and closed kinematic exercises in patellofemoral pain syndrome
Nagarajan Mohan, Shashi Kumar C.G.
Physiotherapy college, Yenepoya University, Manglore, India
patellofemoral pain syndrome (PFPS) is often treated conservatively
with voluntary exercise for the quadriceps femoris. Nevertheless, a
substantial percentage of patients remain symptomatic. Although
exercise seems a crucial element for treatment, it may serve to
increase patellar irritation with the resulting dilemma that patients
exercising the muscles may be simultaneously irritating the knee.
Patients with patellofemoral pain syndrome have been using quadriceps
strengthening exercises with varying results on muscle strength and
pain. However, there are various problems associated with these forms
of traditional quadriceps strengthening exercises. This study sought to
explore the effects of progressive functional retraining of vastus
medialis obliquus (VMO) in the context of patellofemoral pain syndrome.
Purpose: To compare the efficacy of
strengthening of vastus medialis obliquus vs rectus femoris using open
kinematic chain (OKC) and closed kinematic chain
(CKC) exercises in patellofemoral pain syndrome.
This study was conducted at Yenepoya Medical College Hospital,
Mangalore, India. Forty subjects with anterior knee pain fulfilling the
inclusion criteria were randomly assigned to 2 groups with the mean age
of 25.85 in group 1 and 27.65 in group 2. Group 1 received rectus
femoris strengthening exercises. Group 2 received strengthening of
vastus medialis obliqqus. Visual Analog Scale and anterior knee Pain
Scale were noted before and after the interventions (i.e. either rectus
femoris strengthening or strengthening of VMO. Results: after
2weeks of intervention in Group 1 there was a significant increase
anterior knee pain scale (AKPS) with mean diff of -4.95 and vastus
medialis obliquus co-ordination test status. There was also a
significant decrease in VAS and with mean difference of 0.5 , whereas
in Group 2 has AKPS with mean difference of -23.8, VAS with the mean
difference of 4.5 were all highly significant and there was a increase
in VMO co-ordination test but statistically not significant.
Strengthening of vastus medialis obliquus clinically as well as
statistically suggest that strengthening of vastus medialis obliquus is
more effective than the traditional strengthening of rectus femoris in
patients with patellofemoral pain syndrome.
pain syndrome, anterior knee pain scale, strengthening, visual analogue