Open versus closed kinetic chain exercises in treatment of patients with patellofemoral pain syndrome

Patellofemoral pain syndrome [PFPS] is a common cause of knee pain and one of the most prevalent musculokeletal injuries seen by physiotherapists. The purpose of this study is to compare the efficacy of open kinetic chain [OKC] exercises versus closed kinetic chain [CKC] exercises in treatment of patellofemoral pain syndrome. Thirty male and female PFPS patients, with a mean age of 29.75 [ +/- 6.12] years were participated in the study. Patients were randomly assigned into two equal groups; OKC exercises group and CKC exercises group. The mean duration of symptoms before the beginning of this study was 11.25 [ +/- 0.96] months for OKC group and 11.5 [ +/- 0.58] for CKC group. These patients were trained for 30 to 45 minutes per session, three sessions per week for five weeks. Pain severity and functional activity were measured using visual analogue scale and time taken for ascending and descending stairs, before and at the end of the treatment program. There was significant improvement in functional activity in both groups, with significant reduction in pain severity only in CKC group. However, comparison between groups revealed no clinically significant differences between closed or open kinetic chain exercises. The closed kinetic chain exercises are more efficient than open kinetic chain exercises for reduction of pain severity in patellofemoral pain syndrome patients. On the other hand, both types of exercises are effective for improving functional activity of those patients

Efficacy of muscle energy technique in treatment of chronic mechanical low back pain

This study was conducted to compare the effect of muscle energy technique versus combined spinal flexion-extension exercises on reduction of pain severity, functional disability; and increasing the range of motion of trunk flexion, extension, right, and left bending in mechanical low back pain patients. Forty male and female patients diagnosed as chronic mechanical low back pain participated in this study. Patients were divided randomly into two groups, the first group [Group A] consisted of 11 male and 9 female patients with a mean age 33 [ +/- 1.58] years treated with the combined spinal flexion-extension exercises program, the second group [Group B] consisted of 9 male and 11 female patients with a mean age 30.20 [ +/- 1.57] years treated with the muscle energy technique. Both groups were treated for 12 sessions, 3 sessions per week [each other day]. Patients were assessed before and after treatment by visual analouge scale, Oswestry disability index, and tape measurements. Both groups had significantly less low back pain severity and less functional disability after treatment. The improvement of pain and function in the muscle energy technique group was more than the combined spinal flexion-extension group. The combined spinal flexion-extension exercise were more effective in increasing lumbar flexion and extension motions than the muscle energy technique. There was no significant difference between groups regarding increasing the right and left trunk bending motions. The muscle energy technique is more effective than the combined spinal flexion-extension exercises in reducing low back pain severity and functional disability and is recommended to be used for patients with chronic mechanical low back pain. Spinal flexion-extension exercises are recommended to be used when increasing lumbar flexion and extension motions is an additional goal of treatment

Effect of shortwave diathermy on the electromyographic activity of the rectus femoris and vastus medialis muscles

To study the effect of deep heating produced by a 30 minute application of shortwave diathermy on the maximal electromyographic [EMG] activity of the rectus femoris and vastus medialis muscles. Twenty-one normal subjects participated in this study. They were tested before and immediately after the application of shortwave diathermy by using a dual channel surface recording EMG equipment. The testing procedure consisted of 5 consecutive repetitions of knee extension against maximal mechanical resistance. There was a significant reduction [p< 0.005] of the maximal EMG activity if the vastus medialis muscle and a non-significant reduction [p> 0.05] of the maximal EMG activity of the rectus femoris muscle. It is suggested that follow up evaluations of the quadriceps muscle strength should not be performed immediately after the application of shoetwave diathermy. It is also, advised not to do strengthening exercises for the quadriceps immediately following such treatment which is common in physical therapy practice