Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 20036
  Title Myofascial trigger points in the quadriceps femoris muscle of patellofemoral pain syndrome subjects assessed and correlated with NRS-101, algometry, and piloted patellofemoral pain severity and myofascial diagnostic scales
URL http://www.acatoday.org/JacaDisplay1.cfm?CID=2759
Journal JACA Online. 2008 Mar;45(2):Online access only p 16-28
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes Objective: The purpose of this study was to investigate the possible association between myofascial trigger points (TrPts) of the quadriceps femoris (QF) muscle in the clinical presentation of patellofemoral pain syndrome (PFPS). Current literature suggests TrPts in the QF may present as or aggravate PFPS. In this study, TrPts in the QF of PFPS patients were correlated with NRS-101 (NRS), algometry, and piloted patellofemoral pain severity and myofascial diagnostic scales (PPSS and MDS). Analysis of the correlated data may lead to improved diagnosis and treatment of PFPS.

Methods: This study was structured as a non-intervention clinical assessment that included 80 participants (N=80) from Durban, South Africa. All participants gave informed consent. A clinical diagnosis of PFPS was required. Data were collected at the first consultation. Measurements included NRS, algometry, and the MDS to determine presence of tender or myofascial trigger points. The PPSS, a modified Likert scale with face validation, provided mixed subjective and objective readings. Descriptive, probability, and correlation statistics were run at 95% and, using the non-validated MDS and PPSS (with preliminary face validation), a 99% confidence level using Spearman’s rank correlation coefficient (r) at a significance of p = 0.05 and p = 0.01.

Results: In this study of PFPS, NRS (generally mild or severe pain) correlated with the MDS p= 0.000 (increased TrPts) and NRS (pain) correlated with the PPSS at p= 0.05 to p= 0.000 (pain around or behind the kneecap made worse by increased activities, deep knee squats, kneeling, and mild or severe pain). The most common locations of active TrPts were in the mid-belly of the vastus lateralis, distal muscular portion of the vastus lateralis, and distal muscular portion of the vastus medialis p= 0.000.

Conclusion: In this study, NRS correlated with an increase in TrPts determined by the MDS and with questions making up the PPSS. While correlation does not infer causation, these data support the possibility that trigger points in the quadriceps femoris may be a factor in the etiology, aggravation, and/or treatment of PFPS. Additionally, further research is required to determine the reliability and validity of the MDS and PPSS.

This abstract is reproduced with permission of the publisher. Full text is available by subscription.

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