Comparative Effects of Perturbation and Functional Stabilization Training on Patellofemoral Pain Syndrome

The main objective of this study is to determine the comparative effects of perturbation and functional stabilization training on pain, balance, and performance in athletes with patellofemoral pain syndrome(PFPS). Patellofemoral pain syndrome is one of the well known causes of anterior knee joint pain. Proximal and distal joint muscle imbalances are the most predisposing factors in knee pain especially knee cap. Anterior knee pain Increase during flexion of the knee, i.e., jumping, running, squatting and descending stairs. PFPS have a crucial impact on balance and functional activities, particularly for young athletes under the age 40. Individuals with PFPS manifest abnormalities in the dynamic and kinematic balance of the lower extremity. Participants between the age of 18-30 with knee pain and have difficulty performing the activities. Perturbation training is the part of the neuromuscular training program include the balancing activities that test the balance during the rehabilitation program. Functional stabilization training is used to improve the muscle control and strength. This particular program focuses on improving balance and determining the effect of training on prformance and balance of athletes with PFPS.

Patellofemoral pain syndrome is one of the best-known causes of anterior knee joint pain. Proximal and distal joint muscle imbalances are the most prevalent factors in knee pain, especially in the knee cap. Patellofemoral pain syndrome is the most prevalent reason that brings young individuals to sports clinics. Possible mechanism that is used to explain the possibility of the occurrence of PFPS has been identified as joint pain, which in turn causes reflexive inhibition of VMO, Glut max, muscular weakness, reduces knee function, and causes discomfort and pain in the knee joint. Pain is aggravated with repetitive activities such as squatting, descending stairs, running and jumping. Individuals with PFPS may experience a loss of equilibrium and impaired function due to a lack of proprioception. Neuromuscular electrical stimulation, hip abductors and external rotator strengthening with proprioceptive training, and mayofascial release to the gluteal medius are some of the techniques that can be used for the management of PFPS. Athletic performance depends on the number of skills that require balance and muscular control. This particular study focuses on the comparative effects of functional stabilization and perturbation training.

A randomized clinical study will be conducted at pakistan sports board Board in Lahore on athletes with patellofemoral pain syndrome. The sample size of the study was calculated using G.Power. Non -Probability convenient sampling technique will be used for research. The sample size will be 34. The sample will be split into 2 groups. FSE along with traditional treatment, will be given to Group 1 and perturbation training will be given to Group 2. Tools that will be used to assess the baseline measures include (NPRS), horizontal and vertical jump tests, the lower extremity functional scale (LEFS), 40-yard splint tests, and the star excursion balance test before and after the intervention. The data will be analyzed using SPSS version 25. First, the Shapiro-Wilk test will be used to determine the normality of the data; the P-value will be greater than 0.05, and the data will be distributed normally. After assessing the normality of the data, it will be decided whether a parametric or non-parametric test will be used withn and between two groups.

Eligibility Criteria:
Inclusion Criteria:

1. Anterior knee pain.
2. Age between 15 to 30.
3. Pain between 3 to 10 on NPRS.

Exclusion Criteria:

1. patellar fracture.
2. Intra-articular pathology( ligamental and meniscal injury of the knee).
3. Knee surgery
4. Fracture of hip, knee, shin bone and foot
5. Vestibular and visual disorders