Changing the index of Functional Movement Screen Patterns in Girls with ‎Patellofemoral Pain Syndrome after 8 Weeks of Pilates exercises

Document Type : Original Article

Authors

Department of Sports Science, Faculty of Humanities, Shahrekord University, Shahrekord, Iran.

Abstract

Purpose:
Patellofemoral pain occurs in the anterior part of the knee (around and behind the patella) and in activities such as sitting and long walks, going up and down stairs, and squatting. Exercise therapy is one of the basic strategies in the treatment of this syndrome, and Pilates is one of the training methods in which the central muscles of the trunk are called in all its movements and then the target muscles are challenged. Functional movement Screen (FMS) is a tool to identify the quality of movement patterns and this test can be effective in predicting and recognizing the defects of basic patterns. Additionally, improving this index can indicate the effectiveness of an exercise program. Therefore, the aim of this study was to evaluate the effect of 8 weeks of Pilates training on the overall and individual scores of the FMS index in girls with Patellofemoral pain syndrome.
Methods:
In the present quasi-experimental study, 30 female students with Patellofemoral pain syndrome (mean age of 25.4 ± 4.9 years, height 161.8 ± 4.9 cm, weight 61.3 ± 5.2 kg) were randomly divided into two groups of control and pilates training. Subjects with a history of 6 months of pain in the anterior part of the knee and diagnosis and approval of a physician were included in the present study. All subjects were evaluated in the pre-test and post-test using FMS tools. The exercise program consisted of 8 weeks, three sessions per week, and each session lasted 45-60 minutes of selected pilates exercises. Data were analysed by SPSS software using Mann-Whitney and Wilcoxon statistical methods and interpreted at a significance level of 0.05.
Results:
The results of the present study showed that pilates training caused better performance with a significant difference in the overall FMS index (p=0.001) than the control group. Examination of the results of individual FMS tests showed that Pilates training compared to the control group improved the indicators of the pattern of Hurdle step (p=0.002), Straight-leg raise (p=0.015), Trunk stability push up (p=0.001) and Rotational stability (p=0.001). However, no significant differences were observed in Deep squat (p=0.249), In-line lunge (p=0.555) and Shoulder mobility (p=0.751) tests between the two groups.
Conclusion:
Based on the results, pilates training has significantly improved the functional movement Screen (FMS) index and some of its subtests in girls with Patellofemoral pain syndrome. Therefore, it is recommended that trainers and people with this syndrome use pilates exercises to improve their motor function.

Keywords


  1. Abulhasan J.F,  M.J Grey. Anatomy and physiology of knee stability. J Funct Morphol Kinesiol 2017; 2(4): 34.
  2. Tramontano M, Pagnotta S, Lunghi C, Manzo C, et al. Assessment and management of somatic dysfunctions in patients with patellofemoral pain syndrome. JOM 2020; 120 (3): 165-173.
  3. Pollatos D, Chandolias K, Giordamni M.A, Chalkia A, et al. Review of New Data in Physiotherapeutic Approach to Patellofemoral Pain Syndrome (PFPS). J Biosci 2021; 9(02): 103.
  4. Vicente Basanta, E. A pain-coping approach for chronic patellofemoral pain syndrome:a randomized controlled clinical trial 2020.
  5. Panayiotou Charalambous, C. Patellofemoral Pain Syndrome, in The Knee Made Easy. Springer cham 2022; 579-588.
  6. Hott A, Brox J.I, Pripp A.H, Juel N.G, et al. Predictors of pain, function, and change in patellofemoral pain. Am J Sports Med. 2020; 48(2): 351-358.
  7. Lankhorst N.E, S.M. Bierma-Zeinstra, M van Middelkoop. Risk factors for patellofemoral pain syndrome:a systematic review. J Orthop Sports Phys Ther 2012; 42(2): 81-94.
  8. Moyano F.R, Valenza M.C, Martin L.M, Caballero Y.C, et al. Effectiveness of different exercises and stretching physiotherapy on pain and movement in patellofemoral pain syndrome: a randomized controlled trial. Clinical rehabilitation 2013; 27(5): 409-417.
  9. McNeilan R.J, G.L Jones. Patellofemoral Pain Syndrome, in Orthopedic Surgery Clerkship 2017; 343-345.
  10. Prins M.R, P.Van der Wurff. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. J Physiother 2009; 55(1): 9-15.
  11. Willson J.D, Kernozek T.W, Arndt R.L, Reznichek D. A, et al. Gluteal muscle activation during running in females with and without patellofemoral pain syndrome. Clinical biomechanics 2011; 26(7): 735-740.
  12. Ferrari D, Kuriki H. U, Silva C. R, Alves, N, et al. Diagnostic accuracy of the electromyography parameters associated with anterior knee pain in the diagnosis of patellofemoral pain syndrome. Arch. Phys.Med.Rehabil. 2014; 95(8):1521-1526.
  13. Partovi, G ,Ghaffari, S, Madani, Z, Adib, H, et al. Effect of Taping and Quadriceps Strengthening and Hamstring Stretching on Patello-Femoral Pain Syndrome: A Randomized Clinical Trial. J Mazandaran Univ Med Sci 2021; 31(197): 55-64.
  14. Peters J.S, Tyson N.L. Proximal exercises are effective in treating patellofemoral pain syndrome: a systematic review. IJSPT 2013; 8(5): 689.‏
  15. Nakagawa, Moriya, É.T, Maciel, C. D, & Serrão F.V. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2012; 42(6): 491-501.
  16. Armaki R.H, K. Abbasnia, A. Motealleh. Comparison of Trunk Flexion Proprioception Between Healthy Athletes and Athletes With Patellofemoral Pain. JSR 2020; 30(3): 430-436.
  17. Weon Y. S, Ahn, S. H, Kim, J.H, Gwak, G.T, et al. Comparison of Knee Muscle Strength and Ankle Dorsiflexion Range of Motion Between Standing Workers With and Without Patellofemoral Pain Syndrome. Physical Therapy Korea 2020; 27(4): 241-249.
  18. Reijnders L, S.A Van de Groes. The quality of life of patients with patellofemoral pain–a systematic review. Acta Orthop Belg 2020; 86: 678-687.
  19. Coburn S. L, Barton C. J, FilbayS. R, Hart H. F, et al. Quality of life in individuals with patellofemoral pain: a systematic review including meta-analysis. Phys Ther Sport 2018; 33: 96-108.
  20. Manske, R.C, G.J. Davies. Examination of the patellofemoral joint. J Orthop Sports Phys Ther 2016; 11(6): 831.
  21. Fredericon, M, K. Yoon. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil 206; 85(3): 234-243.
  22. Loudon J.K, Wiesner D, Goist-Foley H. L, Asjes C, et al. Intrarater reliability of functional performance tests for subjects with patellofemoral pain syndrome. J Athl Train 2002; 37(3): 256.
  23. Selhorst M, Rice W, Degenhart T ,  Jackowski M, et al. Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. IJSPT 2015; 10(2): 178.
  24. Mascal C.L, R. Landel, C. Powers. Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther 2003; 33(11): 647-660.
  25. Kiesel K, P.J. Plisky, M.L Voight. Can serious injury in professional football be predicted by a preseason functional movement screen?. NAJSPT 2007; 2(3): 147.
  26. Cook G, L Burton, B Hoogenboom. Pre-participation screening: the use of fundamental movements as an assessment of function-part 1. NAJSPT 2006; 1(2): 62-72.
  27. Cook G, L Burton, B Hoogenboom, Pre-participation screening: the use of fundamental movements as an assessment of function-part 2. NAJSPT 2006;1(3):132-139.
  28. Conroy M, M Lehr. Clinical Reasoning and Utilization of a Literature Review during the Management of Patellofemoral Syndrome: A Case Report. Res Sports Med 2017; 2(1): 1015.
  29. Shirazi Z.R, M.B Moghaddam, A. Motealleh. Comparative evaluation of core muscle recruitment pattern in response to sudden external perturbations in patients with patellofemoral pain syndrome and healthy subjects. Arch Phys Med Rehabil 2014; 95(7): 1383-1389.
  30. Chevidikunnan M. F, Al Saif A, Gaowgzeh R. A, Mamdouh K.A. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome. Phys Ther Sci 2016; 28(5): 1518-1523.
  31. Earl, J.E, Hoch. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med 2011; 39(1): 154-163.
  32. Cruz J. C, Liberali R, Cruz T. M. F. D, Netto M.I.A. The Pilates method in the rehabilitation of musculoskeletal disorders: a systematic review. Fisioterapia em Movimento, 2016; 29: 609-622.
  33. Di Lorenzo C.E. Pilates: what is it? Should it be used in rehabilitation? Sports health 2011; 3(4): 352-361.
  34. Owsley A. An introduction to clinical Pilates. IJATT 2005; 10(4): 19-25.
  35. Laws A, S. Williams, C. Wilson. The Effect of clinical Pilates on functional movement in recreational runners. Am J Sports Med 2017; 38(10): 776-780.
  36. de Oliveira L.C, R.G de Oliveira, D.A. de Almeida Pires-Oliveira. Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial. Phys Ther Sci 2015; 27(3): 871-876.
  37. 37.Phrompaet S, Paungmali A, Pirunsan U, Sitilertpisan P. Effects of pilates training on lumbo-pelvic stability and flexibility. As JSM 2011; 2(1): 16.
  38. Heintjes E. M, Berger M.Y, Bierma-Zeinstra S, Bernsen R.M.D, et al. Exercise therapy for patellofemoral pain syndrome (Cochrane Review). Cochrane Database of Systematic Reviews 2003; (4):1-1.
  39. Zamboti C.L, Silva R.A. D, Gobbi C, ShigakiL, et al. Analysis of pain, functional capacity, muscular strength and balance in young women with Patellofemoral Pain Syndrome. Physical Therapy in Movement 2017; 30: 433-441.
  40. O'Harra T. Relating Functional Movement Screen (FMS) Scores to Cross-Country Ski Performance. 2020, Alaska Pacific University.
  41. Yazici A.G, M. Mohammadi.The effect of pilates exercise on improvement of functional tests in young male with patello-femoral pain syndrome. IJSETS 2017; 3(2): 39-43.
  42. Razmi V, M. Soleimanifarrokh. The effect of 8 weeks pilates training on the treatment of patellofemoral pain syndrome. International journal of research pedagogy and technology in education and movement sciences 2013; 2(04).
  43. Levine B, B Kaplanek, W.L. Jaffe. Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report. Clin Orthop Relat Res 2009; 467(6): 1468-1475.
  44. Peterson K, T. Palmer. Can Less PFPS Pain Leads to Higher FMS Scores? Undergraduate Scholarly Showcase 2019.
  45. Yu J.H, G.C. Lee. Effect of core stability training using pilates on lower extremity muscle strength and postural stability in healthy subjects. Isokinetics and exercise science 2012; 20(2): 141-146.
  46. Kim J.-e, J. Yim. Selective Functional Movement Assessment (SFMA)-based therapeutic corrective exercises reduces knee joint pain in a patient with patellofemoral pain syndrome after pregnancy (case study). Int J Biol Sci 2016; 8(6): 83-92.
  47. Safarzadeh M, Daneshjoo A. H, Hosseinpor A, & Bamorovat F. Relationship between functional movement screen whit risk factors and its ability to predict sport injuries. J Paramed Sci 2019; 8(1): 83-92.
  48. Teyhen D.S, Shaffer S.W, Lorenson C. L, Halfpap J.P, et al. The functional movement screen: a reliability study. J Orthop Sports Phys Ther 2012; 42(6): 530-540.
  49. Shahrzad Zandi, Mohammad Hosein Mirzarah, Hamideh Montazeri Taleghani. injury in Recreational Sports Using Functional Movement Screening Tests J Sports Sci. Med 2018; 9(2): 259-268. [Persian]
  50. 50.Rostami zalani F, Rahnama N, Mahdavinejad R, karimi M T, et al. The Effect of Strengthen Core Stability and Quadriceps Muscle Strengthening Training on Pain and Function in Patients with Patellofemoral Pain Syndrom jornal of Iran.  J. Babol Univ. Medical Sci 2018; 25(5): 79-90. [Persian]