The effectiveness of combined spinal manipulation and patella mobilization compared to patella mobilization alone in the conservative management of patellofemoral pain syndrome

Abstract

Purpose. Patellofemoral pain syndrome (PFPS) refers to a syndrome associated with the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof (Wood 1998). The purpose of this investigation was to evaluate whether spinal manipulation, as an adjunct to patella mobilization, contributed significantly to the improvement of patients diagnosed with PFPS. A prospective trial using convenient sampling was implemented using the first 60 volunteers that met the requirements. These were randomly divided into two groups. Participants in group 2 received combined patella mobilization and spinal manipulative therapy, while those in group 1 received patella mobilization only. Each patient selected for the study was required to complete an informed consent form. The selected patients underwent a general medical case history, lower back and knee orthopaedic regional examinations. 8 clinical experiments were done: pain threshold (ALGI), pain tolerance (ALG2), the mean least pain experienced (NRS 1), the mean worst pain experienced (NRS2), the mean pain experienced (NRS3), pain quality (McGill), patellofemoral joint evaluation scale (PFJE) and a patient specific functional scale (PSFS). All were continuous variables except McGill, which was a categorical variable. For each clinical experiment, readings were taken 3 times, i.e. at the first, third and sixth consultations