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

Herrington, LC

Abstract

Dysfunction of the knee extensor mechanism resulting in patellofemoral pain (PFP)
presents a significant challenge to those clinicians working in musculoskeletal
medicine. The presence of the condition is believed to be related to changes in
internal joint loading as a result of alteration in the position and tracking of the
patellofemoral joint. One of the first challenges when assessing and treating this
condition 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 of
achieving this. Repositioning of the patella through external means such as taping or
internal means through facilitation of muscle contraction of the principle stabiliser of
the patella; vastus medialis oblique (VMO) have been proposed as treatment of this
condition. Papers presented within this thesis have established that patella taping
significantly reduces pain, improves quadriceps function but does not facilitate the
action of VMO or change patella position. Further work has established that taping's
mode of action is likely to be related to changing internal joint loading. Many authors
have suggested various means to facilitate the contraction of VMO; papers presented
within the thesis suggest that it is not possible to facilitate an improvement in the
contraction status of VMO in isolation from the rest of the quadriceps.
A number of the papers presented have detailed either improvement in the current
modes of assessment in order to make them valid and reliable or offer unique methods
of assessment which may negate the need for invasive, expensive or time consuming
means of assessments. The condition of PFP is one frequently cited as difficult to treat
with poor long term outcomes. From the works presented possible explanations could
be hypothesised as to why the current conventional conservative management may
have failed to produce positive outcomes in some patients.

Citation

Herrington, L. Assessment of knee extensor mechanism function and the manipulation of that function. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Aug 18, 2021
• Award Date: Sep 1, 2007