NEUROMUSCULAR, DYNAMIC POSTURAL CONTROL AND PAIN REPSONSES TO A THERAPEUTIC PATELLOFEMORAL TAPING TECHNIQUE

Open Access
Author:
Baumgarten, Jeremy Eric
Area of Honors:
Kinesiology
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
  • Nicole Mc Brier, Thesis Supervisor
  • Nicole M Mc Brier, Thesis Supervisor
  • Stephen Jacob Piazza, Honors Advisor
  • Giampietro Luciano Vairo, Faculty Reader
Keywords:
  • Patellofemoral
  • tape
  • Postural Control
  • Pain
Abstract:
ABSTRACT Neuromuscular, Dynamic Postural Control and Pain Responses to a Therapeutic Patellofemoral Taping Technique Baumgarten JE†, Vairo GL†, DeBellis NM†, Bosha PJ§, Millard RL§, McBrier NM†: Athletic Training Research Laboratory, Department of Kinesiology†, Department of Orthopaedics and Rehabilitation§, The Pennsylvania State University, University Park, PA Context: Evidence has suggested patellofemoral joint taping to be an effective intervention for decreasing pain and improving dynamic postural control in patellofemoral pain patients (PFPS). Investigators have hypothesized that quadriceps neuromuscular facilitation plays a significant role in these outcomes. However, the exact biophysical mechanisms explaining this phenomenon are unknown. Objective: To profile quadriceps neuromuscular activity, dynamic postural control and pain responses following a therapeutic patellofemoral taping technique in PFD patients. It was hypothesized taping would decrease pain, increase quadriceps neuromuscular activity and improve dynamic postural control. Design: Pretest-posttest control group true experimental design. Setting: Controlled laboratory environment. Patients or Other Participants: 20 (twelve men, eight women) patients diagnosed with acute PFD by an orthopaedic sports medicine physician (age = 21.9 ± 4.0 years, height = 171.5 ± 10.1 cm, mass = 67.4 ± 8.7 kg, BMI = 22.9 ± 1.5, Kujala Score = 80.32 ± 9.31) and 20 (twelve men, eight women) healthy matched controls (age = 21.5 ± 2.7 years, height = 171.4 ± 10.7 cm, mass = 69.0 ± 11.7 kg, BMI = 23.3 ± 1.7) volunteered for this research study. No participants to either group presented with a history of previous lower extremity injury. Interventions: The independent variable was a therapeutic patellofemoral taping technique (medial patellar glide). We measured surface electromyography (SEMG) of the vastus medialis and vastus lateralis while participants performed a single-leg anterior reach balance task. Patient pain was also recorded using a standard visual analog scale. One-tail dependent and independent t-tests were computed to analyze within patient and between participant differences. Comparisons were made for the following conditions: patient involved to uninvolved knee; patient involved pre-tape to involved post-taped knee; patient involved post-taped to healthy matched control knee. Main Outcome Measures: Pre and post-tape measures were recorded for patients. A 48-hour rest period separated pre and post-tape testing conditions. Testing the involved and uninvolved knees of patients was randomized to control for an order effect. Healthy control participants performed one testing session. Surface electromyography was analyzed for 3 s, normalized to maximal volitional isometric contraction (MVIC), averaged for each condition and expressed as a %MVIC. Averaged maximum reach distances for the single-leg anterior reach balance task were normalized to the non-stance leg-length (%MAXD). Results: Patients had a reduction in pain with the post-tape (0.50 ± 0.77 cm) compared to pre-tape (1.51 ± 1.88 cm) conditions (P = 0.005). However, there were no significant differences in quadriceps neuromuscular activity. Significant differences were found between uninvolved (85.34 ± 6.33) and involved (72.32 ± 4.15) conditions (P =0.049) and involved pre-tape (83.37 ± 5.22) and involved post-tape (85.78 ± 6.70) conditions (P = 0.042) performing a dynamic postural control task. Conclusion: Our findings indicate that patellofemoral taping reduces pain in acute PFD patients and improves dynamic postural control but does not facilitate quadriceps activity. Given the results of this experiment, further research is necessary to determine efficacy of this treatment in acute PFD patients to improve dynamic postural control. Word Count: 476