Spinal manual therapy in patients with patellofemoral pain s
The aim of the present study was to compare the effectiveness of local exercise therapy and spinal manual therapy for knee pain, function and maximum voluntary peak force (MVPF) velocity of the quadriceps in PFPS patients. Increasing evidence has shown benefits of spinal manipulations in patients with patellofemoral pain syndrome (PFPS).

43 patients with PFPS were randomly assigned to a local exercise or spinal manual therapy group. The local exercise group received 6 sessions of supervised training of the knee-and hip muscles with mobilization of the patellofemoral joint. The spinal manual therapy group received 6 interventions of high velocity low thrust manipulations at the thoracolumbar region, sacroiliac joint, and/or hip.

All patients were also asked to do home exercises. Maximum, minimum and current pain were measured using the visual analogue scale. Function was assessed with the anterior knee pain scale (AKPS) and MPFV was recorded using a Biodex System 3 dynamometer. Patients were assessed before intervention, after 6weeks of intervention and after 6weeks of follow-up.

Results:
--Pain and functionality improved more following spinal manipulative therapy than local exercise therapy.

--After 6weeks of intervention the between-group difference (local versus spinal) for maximal pain was 23.4mm and 12.4 for the AKPS.

--At 6weeks of follow-up the between-group difference for maximal pain was 18.7mm and 11.5 for the AKPS.

This study suggests that spinal manual therapy is more effective than local exercise therapy in improving pain and function in patients with PFPS in the medium term.

Source: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04310-9
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