Knee proprioceptive function and physical performance of patients with patellofemoral pain: A matched case-control study

Coelho, Vanessa K.; Gomes, Bruno Senos Queiroz; Lopes, Thiago Jambo Alves; Corrêa, Letícia Amaral; Telles, Gustavo Felicio; Nogueira, Leandro Alberto Calazans

doi:10.1016/j.knee.2021.08.031

Cited by 12 publications

(11 citation statements)

References 43 publications

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“…Chen and Qu [30] have measured the proprioception along with balance, and found that the proprioception declined when static balance decreased. Furthermore, Coelho et al [31] have found that the proprioception improved when dynamic balance increased. Collectively, these studies suggest that the proprioception is a good biomarker of one's static and dynamic balance.…”

Section: Introductionmentioning

confidence: 98%

Immediate Effect of Neuromuscular Electrical Stimulation on Balance and Proprioception During One-leg Standing

Choi

2022

Physical Therapy Korea

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Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects:We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion.Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

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Section: Introductionmentioning

confidence: 98%

Immediate Effect of Neuromuscular Electrical Stimulation on Balance and Proprioception During One-leg Standing

Choi

2022

Physical Therapy Korea

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“…Subgroup and meta-regression analyses did not indicate potential sources of heterogeneity (Additional file 7 ). Overall postural stability (15 studies [ 24 , 26 , 27 , 57 , 86 – 90 , 92 , 95 , 98 , 99 , 101 , 102 ] ): Moderate level evidence indicated that there is no difference between people with and without PFP for overall balance (SMD 0.38, 95% CI − 0.05–0.82; Fig. 4 and Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Meta-regression indicated that age is not a source of heterogeneity (Additional file 7 ). Posteromedial (PM) postural stability (4 studies [ 85 , 95 , 96 , 98 ] ): Moderate level evidence indicated a very large and non-significant effect for lower reach during SEBT PM in people with PFP (SMD 1.22, 95% CI − 0.59–3.02; Fig. 5 and Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Different aspects affecting people with PFP may compromise postural control, such as impairments in central control [ 129 ], proprioception [ 130 ], muscle activity [ 131 ] or muscle capacity [ 65 , 132 ]. Previous studies reported that postural control in people with PFP is correlated with knee muscle strength [ 23 ], hip muscle strength [ 87 , 100 ] and knee proprioception [ 98 ]. In contrast, studies reported controversial results on the correlation between postural control and pain [ 23 , 101 , 102 ].…”

Section: Discussionmentioning

confidence: 99%

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Is Postural Control Affected in People with Patellofemoral Pain and Should it be Part of Rehabilitation? A Systematic Review with Meta-analysis

et al. 2022

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Background Growing evidence supports that exercise therapy is effective for patellofemoral pain (PFP) rehabilitation. Nevertheless, the improvements have been reported not to be sustained in the long term, suggesting that the current protocols may not comprehend all required functional factors to provide a consistent recovery. A potential neglected factor in treatment protocols for PFP is postural control. However, it is unclear whether this population presents balance impairments or the influence of postural control on pain and function during rehabilitation programmes. Objective To investigate whether (Q1) balance is impaired in people with PFP compared to controls, (Q2) conservative interventions are effective to improve balance in people with PFP, and (Q3) balance exercises are effective to improve pain and function in people with PFP. Data sources Medline, Embase, CINAHL, SPORTDiscus, Web of Science and Cochrane Library, supplemented by hand searching of reference lists, citations and relevant systematic reviews in the field. Methods A systematic review with meta-analysis was conducted according to the Cochrane recommendations and reported according to the PRISMA statement recommendations. We included cross-sectional studies comparing balance between people with and without PFP; and randomised controlled trials verifying the effect of conservative intervention on balance and the effect of balance intervention on pain and function in people with PFP. The risk of bias was assessed using the Epidemiological Appraisal Instrument for cross-sectional studies and the Physiotherapy Evidence Database scale for randomised controlled trials. Results From 15,436 records, 57 studies (Q1 = 28, Q2 = 23, Q3 = 14) met the eligibility criteria. Meta-analyses indicated that people with PFP have worse anteroposterior (very low grade evidence, standardised mean difference [SMD] = 1.03, 95% CI 0.40–1.66) and mediolateral (moderate grade evidence, SMD = 0.87, 95% CI 0.31–1.42) balance compared to controls. Moderate grade evidence indicated that overall balance is not affected in people with PFP (SMD = 0.38, 95% CI − 0.05–0.82). Low to very low grade evidence indicates that interventions are ineffective for mediolateral (SMD = 0.01, 95% CI − 0.51–0.53) and overall (SMD = 0.49, 95% CI − 0.14–1.11) balance improvements, and low grade evidence indicates that interventions are effective to improve anteroposterior balance (SMD = 0.64, 95% CI 0.04–1.23). Moderate to low grade evidence indicated that balance interventions are effective to reduce pain (SMD = 0.82, 95% CI 0.26–1.38) and improve function (SMD = 0.44, 95% CI 0.09–0.80) when measured using questionnaires; and very low grade evidence indicated no efficacy for function measured via functional tests (SMD = 0.73, 95% CI − 0.16–1.61). Conclusion People with PFP likely present balance deficits compared to asymptomatic people. There was insufficient evidence to support the efficacy of interventions to improve or modify balance in people with PFP. Also, there was insufficient evidence to support the efficacy of balance exercises to improve pain and function in people with PFP. Trial Registration The present systematic review was registered in PROSPERO (CRD42018091717).

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“…Previous analyses have shown that those suffering from patellofemoral symptoms exhibit diminished knee joint proprioception [47,48], with pain and inflammation contributing to proprioceptive deficiency [49]. This is problematic in active individuals; particularly as reduced proprioception causes diminished performance across a range of movements [50]. Therefore, taking into account the proposed pain-mediating and anti-inflammatory properties of tart cherries, improvements in proprioception mediated as a function of the intervention would be particularly important in this population.…”

Section: Hopmentioning

confidence: 99%

The efficacy of a tart cherry drink for the treatment of patellofemoral pain in recreationally active individuals: a placebo randomized control trial

et al. 2022

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Purpose This study aimed to explore the efficacy of U.S. Montmorency tart cherry in treating recreationally active individuals with patellofemoral pain. Methods Twenty-four recreationally active participants with patellofemoral pain were randomly separated into either placebo (males N = 8, females N = 4, age = 43.30 ± 7.86 yrs, mass = 72.10 ± 17.89 kg, stature = 171.16 ± 10.17, BMI = 24.31 ± 3.75 kg/m2, symptom duration = 30.18 ± 10.90) or Montmorency tart cherry (males N = 9, females N = 3, age = 41.75 ± 7.52 yrs, mass = 76.96 ± 16.64 kg, stature = 173.05 ± 7.63, BMI = 25.53 ± 4.03 kg/m2, symptom duration = 29.73 ± 11.88) groups. Both groups ingested 60 mL of either Montmorency tart cherry concentrate or taste matched placebo daily for 6 weeks. Measures of self-reported pain (KOOS-PF), psychological wellbeing (COOP WONCA), and sleep quality (PSQI) alongside blood biomarkers (C-reactive protein, uric acid, TNF alpha, creatinine, and total antioxidant capacity) and knee biomechanics were quantified at baseline and 6 weeks. Differences between groups were examined using linear mixed-effects models. Results There was 1 withdrawal in the cherry and 0 in the placebo group and no adverse events were noted in either condition. The placebo condition exhibited significant improvements (baseline = 67.90 ± 16.18 & 6 weeks = 78.04 ± 14.83) in KOOS-PF scores compared to the tart cherry group (baseline = 67.28 ± 12.55& 6 weeks = 67.55 ± 20.61). No other statistically significant observations were observed. Conclusion Tart cherry supplementation as specifically ingested in the current investigation does not appear to be effective in mediating improvements in patellofemoral pain symptoms in recreationally active individuals.

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Knee proprioceptive function and physical performance of patients with patellofemoral pain: A matched case-control study

Cited by 12 publications

References 43 publications

Immediate Effect of Neuromuscular Electrical Stimulation on Balance and Proprioception During One-leg Standing

Immediate Effect of Neuromuscular Electrical Stimulation on Balance and Proprioception During One-leg Standing

Is Postural Control Affected in People with Patellofemoral Pain and Should it be Part of Rehabilitation? A Systematic Review with Meta-analysis

The efficacy of a tart cherry drink for the treatment of patellofemoral pain in recreationally active individuals: a placebo randomized control trial

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