Assessment of knee extensor mechanism function and the manipulation of that function

Dysfunction of the knee extensor mechanism resulting in patellofemoral pain (PFP)presents a significant challenge to those clinicians working in musculoskeletalmedicine. The presence of the condition is believed to be related to changes ininternal joint loading as a result of alteration in the position and tracking of thepatellofemoral joint. One of the first challenges when assessing and treating thiscondition faced by the clinician is how to reliably and validly assess patella position.Papers presented within this thesis have established a reliable and valid method ofachieving this. Repositioning of the patella through external means such as taping orinternal means through facilitation of muscle contraction of the principle stabiliser ofthe patella; vastus medialis oblique (VMO) have been proposed as treatment of thiscondition. Papers presented within this thesis have established that patella tapingsignificantly reduces pain, improves quadriceps function but does not facilitate theaction of VMO or change patella position. Further work has established that taping'smode of action is likely to be related to changing internal joint loading. Many authorshave suggested various means to facilitate the contraction of VMO; papers presentedwithin the thesis suggest that it is not possible to facilitate an improvement in thecontraction status of VMO in isolation from the rest of the quadriceps.A number of the papers presented have detailed either improvement in the currentmodes of assessment in order to make them valid and reliable or offer unique methodsof assessment which may negate the need for invasive, expensive or time consumingmeans of assessments. The condition of PFP is one frequently cited as difficult to treatwith poor long term outcomes. From the works presented possible explanations couldbe hypothesised as to why the current conventional conservative management mayhave failed to produce positive outcomes in some patients.

Level dc:type.qualificationlevel

Doctoral (Level 8)

Year dc:date.issued

2007

Author dc:creator

• Herrington, LC

Language dc:language

en

Identifier

oai:salford-repository.worktribe.com:1337119

OAI identifier oai:identifier

oai:salford-repository.worktribe.com:1337119