The Effect of a Treatment Protocol Focused on Neuromuscular Control Exercises on Pain and Function in a Subgroup of Individuals With Patellofemoral Pain

Patellofemoral Pain (PFP) is one of the most common causes of knee pain and is significantly present in recreational athletes who have previously been categorized as being in a subgroup of PFP. Understanding which intervention is most appropriate for this subgroup could give us important information about subgroup-based treatments, which are not yet described in the literature. Therefore, the aim of this study is to analyze the effect of two exercise interventions in a PFP subgroup: one focusing on neuromuscular control exercises and the other focusing on muscle strengthening.This study will recruit 10 individuals to each exercise group, and will assess pain, function, muscle activity and joint kinematics pre and post intervention. Mixed Model ANOVA tests will be used to determine the responses to the two interventions between the two groups over a 6-week treatment time.

Inclusion Criteria Men and women aged 18-40 years old that can give informed written consent. Clinical diagnosis of unilateral or bilateral PFP longer than 3 months (exemplified in the following sections). Anterior or retropatellar pain reported on at least two of the following activities: prolonged sitting, ascending or descending stairs, running, kneeling and hopping/jumping. At least two of the three following clinical examination findings: * Pain during resisted isometric quadriceps contraction * Pain with palpation of the posterior borders of the patella * Pain during squatting Classified as being within the strong subgroup of PFP (exemplified in the following sections). Exclusion Criteria * Individuals who are not part of a PFP group * Previous knee surgery and participants awaiting surgery for another lower limb joint problems * Ligamentous instability and/or internal pathology * History of patella subluxation or dislocation * Joint effusion when the midpatellar girth is 5% or more than the non-involved knee * True knee joint locking and/or giving way * Coexistent acute illness or chronic disease * Bursitis, patella or iliotibial tract tendinopathy, Osgood-Schlatter's disease, -Sinding-Larsen-Johansson Syndrome, muscle tears or symptomatic knee plicae * Pregnancy or breast feeding