RESUMO
Females are more prone for lateral displacement of patella than males due to increased Q-angle (15–18°) in them compared to males (12–15°). In a normal state, lateral displacement is prevented by geometry of the joint and by the passive stabilizers. Even though contraction of the quadriceps tends to displace the patella laterally, vastus medialis oblique (VMO) acts medially and posteriorly as much as it acts proximally, and so its tension helps in resisting the Q angle effect. There are two procedures in common practice to reduce Q-angle and thereby to prevent lateral displacement of patella– either through vastus medialis oblique (VMO) strengthening or by isometric quadriceps activation (quadriceps muscle strengthening). We wanted to compare the effects of isometric quadriceps activation and VMO strengthening in reducing Q angle in a group of young females.METHODSA non-randomized, two group, pre-test, post-test assessment of Q-angle was done. Twenty healthy females of 18-20 age group were selected and randomly divided into two groups. Isometric quadriceps activation and VMO strengthening was done for 4 weeks. Q-angles were measured before and after the strengthening exercise using a long arm goniometer.RESULTSThe mean q angle before treatment was 21. (minimum 20 and maximum 23). While after the treatment, q angles were significantly reduced in both the groups and mean q angle was 16.3.CONCLUSIONSBoth the isometric quadriceps activation and VMO strengthening reduced Q-angle significantly and there was no significant difference between the two procedures. Results of this study help the physiotherapist in choosing the exercise for the management of patellofemoral pain and lateral displacement of patella.
RESUMO
Background: Patello-femoral pain syndrome is a very common complaint seen in adolescence and young adults characterized by pain around and behind the patella. There has been prevalence of trigger points in the quadriceps leading to disruption of the VMO/VL firing pattern due to muscle inhibition by pain. Current studies suggest the use of strengthening exercises for hip and knee not focusing on releasing the trigger points. Releasing these trigger points could give additional benefit to the patient and can also be employed along with other conventional therapies. Purpose of the study: To find out which treatment method gives faster results and works directly on the pain and function of the patient. Objectives: To assess the immediate effect of Dry Needling Vs Ultrasound on releasing Trigger points in Quadriceps in patients with Patello-femoral Pain Syndrome on pain and knee/lower extremity function. Study Design: Randomized Control trail Setting: OPD setting. Participants: 70 patients with chronic anterior knee pain, without any ligament, bony or sensory involvement around the knee. Main outcome measures: Numerical Pain rating scale and Pressure Algometer. Results: In the ultrasound group there was a change of 38.60% seen in NRPS post values with a mean difference of 2.21±1.21 and for pressure algometer a change of 36.23% was seen with a mean difference of 3.08±4.40. In the dry needling group there was a change of 64.53% seen in NRPS post values with a mean difference of 3.07±1.48 and for pressure algometer a change of 56.86% was seen with a mean difference of 8.36±6.90. When compared within group dry needling had a better effect than ultrasound on both NRPS and Pressure algomter. Conclusion: The current study indicates that Dry needling is more effective than ultrasound for reducing pain and increasing functional outcome in patients with patellofemoral pain syndrome.