Effect of Web-Based Exercise on Patellofemoral Pain

Patellofemoral pain syndrome (PFPS) is a common and challenging knee condition, characterized by pain around the patella. It primarily affects active women, athletes, and military personnel. PFPS accounts for a significant portion of musculoskeletal and knee complaints, though its true prevalence may be higher due to underdiagnosis. Diagnosis is based on a detailed history and physical exam, with symptoms like pain during activities such as kneeling, stair climbing, squatting, and running. The condition is caused by muscle imbalance, overactivity, overload, and trauma, leading to mechanical and dynamic control issues in the lower extremities.

Most PFPS treatments are conservative, focusing on physiotherapy approaches that include patient education, strengthening, flexibility, proprioception, and stretching exercises. Surgical interventions are rare.

Current literature lacks studies on the use of web-based remote exercise programs for PFPS patients. Therefore, this study aims to evaluate the effectiveness of a web-based, timed exercise program on pain, functional capacity, and kinesiophobia in individuals with PFPS.

Patellofemoral pain syndrome (PFPS) is one of the most common and challenging knee disorders to treat. It refers to pain around the patella and surrounding structures. PFPS was first described in 1928 and is most frequently observed in active women, athletes, and military personnel. It accounts for a significant portion of musculoskeletal complaints and knee problems, and the actual prevalence may be higher as not all cases are diagnosed. The diagnosis of patellofemoral syndrome largely relies on a detailed and accurate history and physical examination. Symptoms can be unilateral or bilateral and often include pain associated with activities such as kneeling, stair climbing, squatting, and running. PFPS is characterized by an imbalance among the static and dynamic structures of the lower extremity, muscle imbalance, overactivity, overload, and trauma. Patients with PFPS exhibit abnormalities in mechanical and dynamic control of the lower extremity.

Most treatment approaches for PFPS are conservative, with surgical interventions being rare. Treatment programs typically involve a multimodal physiotherapy approach, including functional patient education, lower extremity strengthening, flexibility, proprioception, endurance, and stretching exercises.

Upon reviewing the existing literature, no studies were found that investigated the use of a web-based remote exercise program among patients with PFPS.

Therefore, the aim of this study is to investigate the effectiveness of a web-based remote, timed exercise program on pain, functional capacity, and kinesiophobia in individuals with patellofemoral pain syndrome. The evaluation will include the Visual Analog Scale (VAS) for pain assessment, the Tampa Scale for Kinesiophobia, the Kujala questionnaire for patellofemoral function, and the Timed Up and Go (TUG) test for functional mobility.

Eligibility Criteria:
Inclusion Criteria:

* Having atraumatic pain lasting for at least 3 months,
* Exhibiting characteristic signs of patellofemoral pain syndrome (retropatellar pain, the presence of the movie sign, and a positive patellar grind test),
* Having one or more positive patellofemoral pain triggers, such as prolonged sitting, squatting, kneeling, descending stairs, ascending stairs, or a positive patellar grind test,
* No knee instability and no grade 2-3 ligament or meniscus tears,
* Voluntary participation in the study.

Exclusion Criteria:

* A history of patellofemoral dislocation, subluxation, or osteoarthritis,
* A previous history of surgery or the presence of congenital deformity,
* The presence of neurological or rheumatological disease,
* Speech or comprehension impairment that affects communication,
* Having previously undergone physical therapy and rehabilitation for patellofemoral pain syndrome.