Effect of Proximal Stabilization on Recruitment of the Core & Vasti in Patellofemoral Arthritis During Descending Stairs

Purpose: to investigate the effect of proximal stability on PF OA. Methods: Thirty patients with PF OA will be recruited. Patients will be randomly assigned into two groups, group A and group B . Patients in both groups will receive a traditional physical therapy treatment, but group (B) will receive additional proximal stability exercise. All patients will be evaluated for muscular recruitment strategies (onset and duration) of multifidus, transversus abdominus (TrA), gluteus medius (GM), and vasti measured by quantitative Electromyography during stair descent. pre and post-treatment.

Inclusion Criteria:Anterior- or retro-patellar knee pain aggravated by at least two activities that load the PFJ (eg; stair ambulation, squatting and/or rising from sitting) .Pain during these activities presented on most days during the past month and their pain severity was ≥ 4 on an 11 point numerical pain scale during aggravating activities .,A grade less than (2) from postero-anterior views on the Kellgren - Lawrence (KL) grading scale.Exclusion Criteria:concomitant pain from tibiofemoral joint or other knee structures .current or previous pain in the hip, lumbar spine or foot that had lasted longer than 3 months and/or required intervention.a history of lower extremity, pelvis or spine fractures; spine, hip, knee or foot surgeries; hip or patellar subluxation/ dislocation.injury to any of knee ligaments or meniscus.systemic diseases (e.g. rheumatoid arthritis), neurological conditions or fibromyalgia .The professional athletes; people who exercise more than two hours a day or every other day, will be excluded.