The effect of heat application on the proprioceptive level of knee in Patellofemoral Pain Syndrome

Purpose: The purpose of this study was to evaluate the effect of using hot as a treatment on proprioception in patients with PFPS.Material and Methods: 40 patients with a clinical diagnosis of unilateral PFPS and external control group formed from 20 normal volunteers were included in this study. Patients divided into two groups formed from 20 patients. All of the patients in both groups were tested with active Joint Position Sense (JPS) at four different target angles (15º, 30º, 45º, 60º) and with vibration at the time of first physical examination and these proprioception measurements compared with the measurements of the normal control group. Then only exercise (group 1) to one group and exercise+hot treatment (group 2) to the other group were given for 6 weeks. Every 3 weeks proprioception measurements repeated in the same way with the first physical examination. At the same time clinical outcomes of the patients evaluated with the modified Lysholm score and visual analog scala filled by the patients at the time of first physical examination, 3rd and 6th weeks. Wilcoxon signed rank test used for the comparisons within each groups. Mann-Whitney U test used for the comparisons between two groups. NCSS 2004/PASS 2002 used for power analysis of this study.Findings: The patients had lesser reproduction errors tested with JPS (15º, 30º, 45º, 60º) and their vibration feeling time were longer, after putting one dose of hot to their pathologic knee, than before using hot. This finding was significant at the greater angles of knee flexion. Also lesser reproduction errors tested with JPS at the greater angles of opposite knee flexion. We found that meaurements got better for both of the groups, giving 6 weeks of treatment (exercise or exercise+hot) and taking measurements with 3 weeks of interval using JPS and vibration. This finding was significant at the greater angles of knee flexion. Also lesser reproduction errors tested with JPS at the greater angles of opposite knee flexion. The results of the exercise+hot treatment was significantly better than the results of the treatment given as only exercise. The results of the measurements taken with using vibration showed similarity with the JPS for the follow up of clinical PFPS patients.Results: Putting only one dose of hot heals the proprioception in the pathologic knee of the clinical PFPS patients. This healing is significant at the greater angles of knee flexion. Putting only one dose of hot also provide healing in the opposite knee at the greater angles of knee flexion. Also exercise or exercise+hot treatment heals proprioception in pathologic knee. This healing is significant at the greater angles of knee flexion. These treatments also heal proprioception in the opposite knee at the greater angles of knee flexion. Periodically putting hot to the knee heals the proprioception in the pathologic knee. This healing is significant at the greater angles of knee flexion. It also provides healing in the opposite knee at the greater angles of knee flexion. Vibration is a good method for the use of the proprioception measurements in knee joint.