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Individualized Physiotherapy in the Treatment of Patellofemoral Pain.

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  • معلومة اضافية
    • Subject Terms:
    • Author-Supplied Keywords:
      faulty movement patterns
      individualized treatment
      lower limb alignment
      patellofemoral osteoarthritis
      patellofemoral pain
    • NAICS/Industry Codes:
      541712 Research and Development in the Physical, Engineering, and Life Sciences (except Biotechnology)
      621340 Offices of Physical, Occupational and Speech Therapists, and Audiologists
      541910 Marketing Research and Public Opinion Polling
    • Abstract:
      Background and Purpose. Patellofemoral pain (PFP) is associated with a wide range of local and global physical factors possibly contributing to pain and thus requires detailed assessment and individualized treatment. Yet, no cohort study was found that assessed the value of individualized physiotherapy, probably because this approach lends itself to clinical practice but not to scientific research. Most studies focus on a 'knee' or 'hip' treatment approach irrespective of individual global differences in lower limb alignment, movement patterns and muscle tightness. Therefore, this study aimed to determine the effectiveness of supplementing local treatment of PFP with individualized treatment targeting global contributing factors. Secondarily it aimed to subgroup the patients according to variations in lower limb alignment/laxity, movement patterns, biarticular muscle tightness and joint degeneration. Method. Forty-one patients (60 knees) with PFP who had followed a programme of local quadriceps strengthening, quadriceps stretching and taping for one fortnight were prescribed an individualized programme based on assessment. This global assessment included lower limb postural alignment, movement patterns, muscle tightness and range of motion. Another fortnights treatment was prescribed accordingly and included specific, individualized postural and movement retraining, stretching and functional weight-bearing, strengthening exercises. Seven outcome measures, namely four pain measures, isokinetic quadriceps strength, quadriceps length and eccentric knee control, assessed improvement. Results. All outcome measures showed further significant improvement following individualized treatment ( p < 0.03). Patients fell into four broad physical subgroups: hypermobility (often with malalignment), hypomobility (with three of four tight muscle groups), faulty movement patterns (mostly dynamic knee valgus) and patellofemoral osteoarthritis. Conclusions. Individualized treatment supplementing local standard physiotherapy for PFP leads to further significant improvement over 2 weeks. This study highlights the importance of assessing patients globally in order to optimize treatment and ongoing improvement. Recognition of different subgroups may guide treatment that should include both local and deficit-targeted global treatment. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Physiotherapy Research International is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1School of Health and Sports Sciences, The University of the Sunshine Coast, Queensland Australia
      2Private Practice, Sunshine Coast, Queensland Australia
      3School of Psychology and School of Social Work and Human Services, The University of Queensland, Queensland Australia
    • ISSN:
      1358-2267
    • Accession Number:
      10.1002/pri.1593
    • Accession Number:
      101422825
  • Citations
    • ABNT:
      KEAYS, S. L.; MASON, M.; NEWCOMBE, P. A. Individualized Physiotherapy in the Treatment of Patellofemoral Pain. Physiotherapy Research International, [s. l.], v. 20, n. 1, p. 22–36, 2015. DOI 10.1002/pri.1593. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=101422825&custid=s8280428. Acesso em: 14 ago. 2020.
    • AMA:
      Keays SL, Mason M, Newcombe PA. Individualized Physiotherapy in the Treatment of Patellofemoral Pain. Physiotherapy Research International. 2015;20(1):22-36. doi:10.1002/pri.1593
    • APA:
      Keays, S. L., Mason, M., & Newcombe, P. A. (2015). Individualized Physiotherapy in the Treatment of Patellofemoral Pain. Physiotherapy Research International, 20(1), 22–36. https://doi.org/10.1002/pri.1593
    • Chicago/Turabian: Author-Date:
      Keays, Susan L., Marjon Mason, and Peter A. Newcombe. 2015. “Individualized Physiotherapy in the Treatment of Patellofemoral Pain.” Physiotherapy Research International 20 (1): 22–36. doi:10.1002/pri.1593.
    • Harvard:
      Keays, S. L., Mason, M. and Newcombe, P. A. (2015) ‘Individualized Physiotherapy in the Treatment of Patellofemoral Pain’, Physiotherapy Research International, 20(1), pp. 22–36. doi: 10.1002/pri.1593.
    • Harvard: Australian:
      Keays, SL, Mason, M & Newcombe, PA 2015, ‘Individualized Physiotherapy in the Treatment of Patellofemoral Pain’, Physiotherapy Research International, vol. 20, no. 1, pp. 22–36, viewed 14 August 2020, .
    • MLA:
      Keays, Susan L., et al. “Individualized Physiotherapy in the Treatment of Patellofemoral Pain.” Physiotherapy Research International, vol. 20, no. 1, Mar. 2015, pp. 22–36. EBSCOhost, doi:10.1002/pri.1593.
    • Chicago/Turabian: Humanities:
      Keays, Susan L., Marjon Mason, and Peter A. Newcombe. “Individualized Physiotherapy in the Treatment of Patellofemoral Pain.” Physiotherapy Research International 20, no. 1 (March 2015): 22–36. doi:10.1002/pri.1593.
    • Vancouver/ICMJE:
      Keays SL, Mason M, Newcombe PA. Individualized Physiotherapy in the Treatment of Patellofemoral Pain. Physiotherapy Research International [Internet]. 2015 Mar [cited 2020 Aug 14];20(1):22–36. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=101422825&custid=s8280428