The role of a biokinetics rehabilitation programme in alleviating anterior knee pain in adolescents
Anterior knee pain is a common condition prevalent within the adolescent population and frequently interferes with sporting and routine activities. The condition is often self-limiting, but can take up to two years to resolve- Surgical intervention is not recommended in this population group, and often there is no demonstrable anatomical abnormality. Conservative treatment should always be the first approach. A questionnaire designed to determine the incidence of anterior knee pain among adolescents was distributed to various local schools, and was completed under the guidance of either a researcher or the parents. Results from the questionnaires indicate that 27.4% of adolescents who participated in the study had experienced non-traumatic anterior knee pain at some time between the ages of 10 and 17 years. Of this group, 42.9% was male and 57.1% was female. Subjects in the intervention section of the study followed a Biokinetics rehabilitation programme which aimed at stabilising the knee joint by stretching and strengthening the involved musculature and improving proprioception and dynamic stability of the lower limb. The programme resulted in significantly reduced subjective ratings of pain and disability in the experimental group (N=18) compared to the control group (N=12). This improvement in condition can be attributed to the increase in strength, flexibility, proprioception and dynamic balance components tested. The decrease in pain as indicated on a Visual Analogue Scale was in the range of 35.3 to 43.0% at the post- and post-post testing in comparison with the initial pain ratings (p<0.01). There was also significant improvement in the ability to perform activities indicated by individual subjects on the Patient-Specific Functional Scale (p<0.01). All subjects in the experimental group indicated improvement in their condition at the post-test. Most of the group reported that their condition was at least as good or better at the post-post test compared with the post-test. There was an increase of between 9.0 and 17.5% in muscle strength in both the quadriceps and hamstring muscle groups at the post- and post-post testing of the experimental group (p<0.01). There was a small but significant improvement of between 2.2 and 4.4% in quadriceps, hamstring and gastrocnemius flexibility of the experimental group at the post- and post-post testing (rxO.Ol). There was also a large significant improvement in both proprioception and dynamic balance of the experimental group at the post- and post-post testing (p<0.01), which is indicative of improved stability of the knee joint complex. Proprioception as measured on a wobbleboard improved by between 49.5 and 50.8%, and dynamic stability scores improved by 37.5 to 53.2% at the post and post-post testing (p<0.01). These variables improved as a consequence of the Biokinetics rehabilitation programme and were maintained or improved further at the one month follow up. In the context of South African health care, a structured Biokinetics rehabilitation programme based on sound clinical and scientific principles has the potential to endear positive outcomes in the treatment of anterior knee pain.
Knee--Abnormalities, Knee--Physical therapy
Networked Digital Library of Theses and Dissertations