Motor Control Retraining vs Close Kinetic Chain Exercises for Pain, Function and Vastus Medialis Oblique Strength in Patients With Patellofemoral Pain Syndrome

This study compares two treatments - motor control retraining and close kinetic chain exercises - to improves the pain, VMO strength, knee function. Fifty participants out of which 4 dropped out; will be randomly assigned to receive either motor control retraining or close kinetic chain exercises training for 45 minutes per session, three times per week, for six weeks. Pain intensity will be measured using the visual analogue scale. Knee function will be measured using Kujala anterior knee pain scale. Vastus medialis oblique strength will be measured using digital dynamometer. Dynamic knee valgus will be measured using Kinovea-2D video analysis. Q-angle will be measured using manual goniometer. Patellar maltracking will be measured using combined assessment of dynamic knee valgus and q-angle. This study aims to determine which treatment produces greater improvements, which may help physiotherapists choose more effective treatments for patient with patellofemoral pain syndrome in Pakistan.

Inclusion Criteria: * Age between 18 and 40 years old. * Both genders male \& female. * Clinically diagnosed PFPS patients. * Anterior knee pain \>3 on VAS for \> 2 weeks. * Retropatellar pain during at least 3 of the following activities, i.e., jumping, kneeling, ascending \& descending stairs, squatting, running, prolonged sitting. * BMI range from 18.5 - 24.9 kg/m² . * Not receiving previously knee physiotherapy. * Insidious onset of symptoms unrelated to trauma. * Patellar compression test positive. * Clarke's test positive. * Snapps questionnaire score 6 or greater. Exclusion Criteria: * Age \> 40 years old. * Knee joint effusion . * BMI \< 18 \& \> 29 kg/m². * Any other significant injury that affect lower limb . * Any history of previous knee surgery. * Having referred pain from the lumbar, hip, ankle, feet, and SIJ . * Any history of knee pathology, including OA, meniscus injury, ligament injury, tendon injury, cartilage injury, iliotibial band involvement, intra articular pathology, patellar instability, osgood-schlatter syndrome, pes anserine pain, RA of knee . * Any history of neurological condition . * Pregnant females . * Any condition affected muscle strength, i.e., gout, DM, RA . * History of head injury, vestibular disorder within 6 months. * Any history of patellar dislocation or subluxation . * Signs and symptoms \< 1 month. * Use of corticosteroids, anti-inflammatory \& intra-articular injections. * Heart condition that precluded performing exercises.