Comparison of Concentric-eccentric Exercises in Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is due to dysfunctional dynamic knee valgus resulting from decrease in strength of hip abductors or abnormal rear-foot eversion with pes pronatus valgus. It is also associated with vastus medialis/vastus lateralis disbalance, hamstring tightness or iliotibial tract tightness.

Patellofemoral pain syndrome is due to dysfunctional dynamic knee valgus resulting from decrease in strength of hip abductors or abnormal rear-foot eversion with pes pronatus valgus. It is also associated with vastus medialis/vastus lateralis disbalance, hamstring tightness or iliotibial tract tightness. The pain is felt around or behind the patella. The causes are multifactorial. A decline in ability to perform physical activity is seen. The aim of this study will be to compare the effects of concentric and eccentric exercises on pain, strength and ROM in patellofemoral pain syndrome.A randomized clinical trial will be performed at Barki Advance Physiotherapy Center Multan through convenience sampling technique on 24 patients which will be allocated through random sampling through sealed opaque enveloped into group A and group B. Group A will receive eccentric exercises like walking down stairs, lowering a weight during shoulder press, the downward motion of squatting, the downward motion of a push-up, lowering the body during a crunch, lowering the body during a pull-up 3 sets with 10 RM (repetition maximum) for six week training. The group B will receive concentric exercises like walking upstairs, pushing up in a bench press, the beginning portion of a deadlift when you lift the barbell off the ground, sitting up in a sit up, pushing up from a lowered push-up and standing up in a back squat 3 sets with 10 RM. Screening tools include patellar grind test with positive Clark's sign and VAS (visual analogue scale) for pain rating. Outcomes will be measured through knee resisted test and MMT grading for knee extensor/flexor strength and goniometer for ROM. Data will be analyzed using SPSS software version 25. After assessing normality, it will be decided either parametric or non parametric test will be used within a group or between two groups. Effectiveness of concentric and eccentric exercises will be analyzed by comparison in individuals with patellofemoral pain syndrome.

Eligibility Criteria:
Inclusion Criteria:

* Players between the age 18 to 36 years.
* Both male and female gender.
* Patients who have Patellar grind test positive.
* The presence of retropatellar or peripatellar pain.
* Reproduction of retropatellar or peripatellar pain with squatting, stair climbing, prolonged sitting, or other functional activities loading the PFJ in a flexed position.

Exclusion Criteria:

* Individuals with a history of recent trauma or surgery of lower limb (16), administration of steroid injection in the past 6 months.
* Recent administration of platelet-rich plasma containing growth factors, diagnosis of rheumatoid arthritis, myositis ossificans, diagnosis of other muscular disorder.
* Patients who had taken physical therapy of any sort in the past six months will be excluded from the study.
* Furthermore, individuals with any history of occupation-related pain will be ruled out