Combination information, training and podiatric intervention leads to a reduction of patellofemoral complaints
The combination of patient education, hip muscle exercises and podiatric inlays ensure a reduction of patellofemoral complaints. This is shown in a recent study by Nielsen et al. (2020).
Various studies have been conducted on the reduction of patellofemoral complaints, using only physiotherapy interventions. However, no studies have been conducted to date focusing on the combination of patient education, hip muscle exercises and podiatric inlays. The research by Nielsen et al. (2020) focuses on three interventions: patient education, hip exercises and podiatric intervention.
Patient education
Patients were educated about their foot-knee-hip posture during daily activities (ADL). The patients were also educated on how to perform these activities correctly with a neutral foot-knee-hip position. In addition, controlled pain was allowed during activities only if the patient felt no more pain than before the activity. Pain-inducing training (sports participation) was not recommended for a short period (the first 3 months).
Hip exercises
Three hip exercises and corresponding muscle groups were used: straight leg side raises (hip abduction-gluteus medius), standing hip abduction (hip abduction-gluteus medius / core stability) and clamshell exercise (external hip rotation-gluteus medius / gemelli and obturator muscles). The exercises were performed daily (3 × 10-15 repetitions) and lasted approximately 10 minutes per day.
Podiatric intervention
Patients with abnormal foot function were fitted with podiatric inlays. Shoe advice was also given, emphasizing that the heel cap / buttress must be sturdy.
Conclusions
Patients with patellofemoral complaints benefit from a simple intervention, which makes use of patient information, three daily exercises and podiatric intervention. The combination of these three interventions resulted in an 18-point improvement in the Anterior Knee Pain Scale (AKPS) scores and a 3 to 4-point decrease in the Numeric Rating Scale (NRS) scores. The research does have a number of limitations.
Source: Podiatry 14-4-2020, Bohn Stafleu van Lochum
