Role of Clamshell Exercises on Pain and Functional Outcomes in Patients with Patellofemoral Pain Syndrome

Abstract

Background: Patellofemoral Pain Syndrome is often linked to abnormal biomechanics of the patellofemoral joint, which can result from weakened hip abductors and external rotators. Targeted strengthening exercises, like the clamshell, can help restore proper alignment and movement patterns in early rehabilitation. Objective: To assess the role of clamshell exercises on pain and functional outcomes in patients with patellofemoral pain syndrome. Methodology: This cross-sectional study was conducted during a six-month duration after approval of the topic, from July to December 2022. Data was collected from Ghurki Trust Teaching Hospital, Lahore, Pakistan, Physiogic Physical Therapy Clinic, Lahore, Pakistan, and Revive Spine & Pain Relief PT Clinic, Lahore, Pakistan. Patients aged between 19 and 44 years diagnosed with Patellofemoral Pain Syndrome resulting from hip musculature weakness, must had a Kujala score of less than 33, were included in the study. Individuals with a previous history of patellar dislocation, fracture, bursitis, knee surgery, ligamentous laxity, meniscal injury, pes anserine bursitis, and iliotibial band syndrome were excluded. The Kujala Anterior Knee Pain Scale was used to assess functional outcome, and the Numeric Pain Rating Scale was used to assess pain in patients with patellofemoral pain syndrome. The study variables were expressed in the form of descriptive statistics (tables, graphs, frequencies, and percentages). The age and total score of the AKPS were expressed through a histogram, and the total score of the NPRS was expressed using a pie chart, while gender and marital status were expressed using a bar chart. Results: The mean score of functional outcomes of 73 patients receiving clamshell exercises measured using the Kujala Anterior Knee Pain Scale was 66.88±18. On the Numeric pain rating scale, 1(1.4%) patients had no pain, 28(38.4%) patients had mild and an equal number of patients had a moderate level of pain, while 16(21.9%) patients still experienced severe pain. Conclusion: Pain and functional outcomes significantly improved after receiving clamshell exercise for six weeks. The pain was reduced between mild to moderate, and the functional outcome was improved to a moderate level. The greater the score on the Kujala Anterior Knee Pain Scale better the functional outcomes.