The effect of exercise on patellar tracking in lateral patellar compression syndrome

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Abstract
The influence of a physical therapy program on pain and patellar tracking was investigated clinically and radiologically with tangential views in 51 knees with lateral patellar compression syndrome. A pretest-post test design was used to evaluate physical measure ments of patellar alignment in subjects who had had patellofemoral pain for a minimum of 6 weeks. Eighty- four percent of the subjects were pain-free after an average of 8 weeks of rehabilitation or 11 physical therapy visits, with a mean qu adriceps strength to total body weight ratio of 61% in women and 86% in men. The pretest-posttest difference in Merchant's congru ence angle was significant at a probability of 0.0066 in the patients who were pain-free after exercise, dem onstrating less lateral patellar tracking. The pretest- posttest difference in iliotibial band flexibility was signif icant at a probability of 0.0017, with the patients who were pain-free after exercise becoming more flex ble. No significant differences were observed from before to after exercise in the patellofemoral index, Q angle, hamstring flexibility, thigh measurement, sclerotic sub chondral bone, or sulcus angle. We were unable to predict which subjects would become pain-free with exercise by patellar position because the group that improved began more laterally tilted. The results of this study indicate that patellar tracking is improved with vastus medialis oblique strengthening, iliotibial band stretching, and joint mobility exercise in the majority of subjects with lateral patellar compression syndrome.

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