Physiotherapy treatment of a patient with patellofemoral pain syndrome - literature review

Uvod: Patelofemoralna bolečina je opisana kot razpršena, netravmatična bolečina v sprednjem delu kolena, ki se med dejavnostmi, kot so izvajanje počepov, tek, hoja po stopnicah ali dolgotrajno sedenje, še poslabša. Zdravljenje tovrstne bolečine vključuje počitek, uporabo nesteroidnih protivnetnih zdravil in fizioterapijo. Klinični test za diagnosticiranje patelofemoralnega bolečinskega sindroma ne obstaja, zato je pomemben podroben pregled, ki pripelje do končne diagnoze in izbire primernega pristopa zdravljenja. Zdravljenje je po večini konzervativno in individualno prilagojeno, z namenom zmanjšanja bolečine in izboljšanja funkcije sklepa. Namen: Zbrati in analizirati dokaze o najučinkovitejših postopkih fizioterapije za zdravljenje patelofemoralnega bolečinskega sindroma. Metode dela: Iskanje literature v elektronski podatkovni zbirki PubMed in pregled raziskav iz obdobja zadnjih petih let, ki so bile povezane s fizioterapevtsko obravnavo patelofemoralne bolečine. Rezultati: V diplomsko delo je bilo vključenih 6 raziskav. Z vsemi fizioterapevtskimi postopki, uporabljenimi v izbranih raziskavah so dosegli zmanjšanje bolečine in izboljšanje funkcije pri pacientih s patelofemoralnim bolečinskim sindromom. Razprava in zaključek: Ugotovili smo, da na zmanjšanje bolečine in izboljšanje funkcije pri patelofemoralnem bolečinskem sindromu vpliva terapevtska vadba, uporaba vibracijske plošče, manualnih tehnik hrbtenice in stopala ter elektromiografičnega biofeedbacka v kombinaciji z elastičnimi lepilnimi trakovi. V bodoče bi bilo za boljšo zanesljivost rezultatov potrebno vključiti večje število preiskovancev ter ovrednotiti dolgoročne učinke vadbe in ostalih fizioterapevtskih postopkov.Introduction: Patellofemoral pain is described as a diffuse nontraumatic pain in the anterior area of the knee, which is aggravated when preformingpatellofemoral joint loading activities such as squats, running, going up and downstairs or sitting for a long time. Treatment for this type of pain includes rest, use of nonsteroidal anti-inflammatory drugs and physiotherapy. There is no clinical test to diagnose patellofemoral pain syndrome. Because of that it is important to have a detailed examination. Physiotherapy treatment is mostly individually customized to reduce pain and improve joint function. Purpose: To collect and analyze the evidence of the most effective physiotherapeutic treatments for patellofemoral pain syndrome. Methods: Literature search was performed in the electronic database PubMed and studies in the last five years related to the physiotherapy treatment of patellofemoral pain were included in the literature review. Results: 6 studies were included in the diploma work. In all studies the physiotherapeutic procedures reduced pain and improved function in patients with patellofemoral pain syndrome. Discussion and conclusion: We found that the reduction of pain and improvement of function in patellofemoral pain syndrome is achieved by therapeutic exercise, use of whole-body vibration, spinal manual therapy, talonavicular joint mobilization and electromyographic biofeedback supplementation training with patellar taping. In the future, because of the reliability of results, it would be necessary to include a larger number of participants and evaluate the long-term effects of exercise and other physiotherapeutic procedures