Patellofemoral joint problems constitute a significant portion of knee pain and injuries. Patellofemoral pain, which is among these problems, is a common musculoskeletal disorder with a poor long-term prognosis in the community. Disturbances in M. quadriceps femoris muscle function have been observed in individuals with patellofemoral pain. M. Quadriceps femoris dysfunction includes arthrogenic muscle inhibition (AKI). Abnormal joint afferent discharge, which is the cause of AMI, affects the excitability of the spinal and supraspinal tracts by limiting muscle activation and can have strong effects on the central nervous system. Therefore, not only spinal reflex pathways but also corticomotor and intracortical pathways are involved in the neurophysiological mechanism of AKI. Transcranial magnetic stimulation (TMS) of the motor cortex is used to evaluate the integrity of the motor pathways and to obtain information about the connections of the relevant brain regions. The limited number of studies examining the changes in corticomotor excitability of M. Quadriceps femoris with TMS in individuals with patellofemoral pain, and the differences in results, and changes in corticomotor excitability at different angular values of the knee joint during active movement have not been examined in studies to date, so it will be applied to individuals with patellofemoral pain by knowing more about central neuromuscular involvement. The aim of this study is to compare central neuromuscular involvement in individuals with patellofemoral pain with healthy individuals, and to compare the isometric muscle strength of the M. Quadriceps femoris muscle, force sense, knee joint function, quality of life, physical activity and kinesiophobia levels by comparing them with healthy individuals of the same age and gender.
In the study, corticomotor involvement of M.Quadriceps femoris with TMS, isometric muscle strength with Lafayette Manual Muscle Tester, force sense with pressurized biofeedback unit, knee joint function with Kujala Patellofemoral Scale, quality of life with Short Form-36, physical activity with International Physical Activity Questionnaire, kinesiophobia l will be assessed with the Brief Fear of Movement Scale.
Eligibility
Sex
ALL
Min age
18 Years
Max age
40 Years
Healthy volunteers
Accepted
Inclusion Criteria:
Inclusion Criteria for Study Group:
1. Volunteer to participate in the study,
2. Be between the ages of 18 and 40,
3. Having been diagnosed with patellofemoral pain,
4. Unilateral or bilateral non-traumatic anterior knee pain provoked by at least 2 activities such as prolonged sitting, climbing stairs, squatting, running for at least the last 3 months,
5. At least 3/10 pain descriptions during activities according to the Numerical Pain Scale,
6. Pain on palpation in medial and lateral patellar facets and positive patellar grinding test.
Inclusion Criteria for Control Group :
1. Demographic characteristics (age and gender) similar to the study group
2. Not having any diagnosis related to the knee joint
Exclusion Criteria:
1. Having any additional pathology (meniscal, ligamentous or tendinous problems) concerning the knee joint,
2. Having a history of surgery involving the knee,
3. Having a neuromuscular and/or metabolic disease,
4. Having an additional pathology involving the lumbar spine and/or lower extremity,
5. Presence of any disease affecting lower extremity circulation, foot pronation deformities pathologies, congenital patella subluxation/dislocation
6. Having a history of deep vein thrombosis and peripheral vascular disease,
7. Presence of endothelial dysfunction,
8. Presence of diseases that will cause endothelial dysfunction (Hypertension, cardiovascular diseases, neurological diseases, systemic inflammation, obesity, diabetes, atherosclerosis, advanced age.), I. Presence of active infection
j. Being a cancer patient.
Primary outcome measure(s)
transcranial magnetic stimulation — 1 day Transcranial magnetic stimulation will be used to assess corticomotor excitability. TMS is a non-invasive method in which variable magnetic fields are used to stimulate neural tissues (cerebral cortex, spinal roots, cranial and spinal neurons) and the responses to these stimuli are recorded with an electromyography (EMG) device and is used for prognostic and evaluation purposes.
Lafayette Manuel Muscle Tester — 1 day It will be used to evaluate the isometric muscle strength of the M. Quadriceps femoris.
Chattanooga Stabilizer Pressure Biofeedback — 1 day The Pressure Biofeedback Device is an indicator that shows the air-filled pressure bag and the pressure value attached to it. It consists of an inflation apparatus for inflating the bag. It is a simple device that records changes in an air-filled pressure bag that allows body movements. It will be used in the evaluation of the force sense.
Kujala Patellofemoral Score Questionnaire — 1 day The Kujala Patellofemoral Score Questionnaire, developed specifically for patellofemoral pain, is a scale that evaluates knee function. It consists of a total of 13 problems. The total score ranges from 0 to 100, with high scores indicating less limitations and symptoms of patellofemoral pain.
Short Form-36 — 1 day Individuals quality of life; It will be evaluated with Short Form-36. Short-Form 36; It consists of 36 items for the measurement of 8 dimensions such as physical, mental and general health. In the scale, which is evaluated between 0 and 100, a high score indicates a good quality of life.
International Physical Activity Questionnaire - Short Form — 1 day The short form of the International Physical Activity Questionnaire, consisting of 7 questions, will be used to determine the physical activity levels of the individuals participating in our study. In the questionnaire, the participants will be asked how much time they spend on sitting, walking, vigorous and moderate activities in the last 7 days and how many days a week they do these activities.
Brief Fear of Movement Scale — 1 day This scale, which evaluates fears associated with pain or previous injury, consists of six questions. The minimum score is 6 and the maximum score is 24. High scores indicate more kinesiophobia.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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