Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome.

Quadriceps weakness and morphological alteration is a documented phenomenon that can have a major impact on strength and functional performance of PFPS patients. An effective and trustworthy non-invasive technique for measuring the quadriceps muscle's anatomy and architecture is B- Mode Ultrasonography. The aim of the study is to assess and compare the effectiveness of neuromuscular electrical stimulation application, quadriceps strengthening and in combination on the quadriceps muscle architecture and functional capacity in patients with Patello femoral pain syndrome. One hundred and twenty-four participants aged 18 - 40 years old with anterior knee pain were included. Participants were randomly allocated into four groups. Group A participants were given NMES, group B were given QS, group C were given combination therapy (NMES+QS) and group D was control group. Cross sectional area, Fascicle length and pennation angle were measured using B-Mode (2D) ultrasound for Quadriceps Femoris muscle. Knee function and pain were assessed using Kujala score and VAS. All parameters were evaluated before and after the intervention. The mean age, weight, height and BMI of control, NMES, QS and NMES+QS were not statistically significant (P = 0.881, 0.960, 0.951 and 0.953) which shows that the control and experimental groups were homogenous. Combination group showed significant improvement when compared to QS group followed by NMES group. Control group did not show any improvement. Neuromuscular Electrical Stimulation in combination with quadriceps strengthening showed a better outcome than in isolation on quadriceps muscle architecture after 10 weeks.