PROJECT PARTNERS
· Physiotherapy YsveldFysio, Berg en Dal, The Netherlands
· Physiotherapy Utrecht Oost, Utrecht, The Netherlands
FUNDING
None
BACKGROUND
Patellofemoral pain (PFP) is a challenging condition from both the athlete’s and clinician’s perspective. Multimodal treatment regimes are advised but the results are far from optimal which is reflected by the 50% positive outcomes of this type of intervention.
The majority of PFP research focuses on the results of exercise regimes whether or not combined with foot support (insoles). The exercise regimes target lower limb alignment and strength production from the greater kinetic chain. The role of soft tissue flexibility in PFP was only assessed in a small number of studies. New insights in lower limb function and multi-segmental tissue flexibility showed that flexibility of a musculo-tendinous structure is related to positions of other adjacent body segments and thereby can negatively affect patellofemoral joint kinematics.
The pathogenesis of PFP is still unknown. Increased innervation (vessels and nerves) of peripatellar tissue and increased intra-osseous pressure in the patella were previously reported. A homeostasis theory was proposed but this is still not adopted as the pain mechanism for this condition.
OBJECTIVES
In the first part of this PhD we investigate soft tissue flexibility in the kinetic chain in patients with PFP and healthy controls and how this may relate to pain-free knee function. As weight bearing knee flexion is provocative in this condition we developed a test incorporating this construct, which can then be used in the clinical evaluation of PFP patients. We studied the reliability and validity of this test.
In the second part of this PhD project, we investigate changes in arterial blood flow of the patellar bone.
The results of these studies likely assist in developing more targeted treatment regimes for PFP in order to increase the overall treatment effect in this common musculo-skeletal condition.
FURTHER INFORMATION
Publications of this project thus far: