Core Stability Exercises Versus Proprioceptive Training on Pain and Function in Patients With Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is one of the most prevalent musculoskeletal disorders causing anterior knee pain, particularly during activities that increase patellofemoral joint stress such as squatting, stair climbing, running, or prolonged sitting .Core stability exercises play a fundamental role in maintaining the kinetic chain alignment between the trunk, pelvis, and lower limb. Dysfunction of the lumbopelvic-hip complex can lead to compensatory movement patterns, increasing stress on the knee joint. Strengthening the core muscles, particularly the transversus abdominis, multifidus, and gluteal muscles, enhances postural control and optimizes force transmission during dynamic activities. Proprioceptive training, on the other hand, targets sensorimotor control by enhancing afferent feedback and neuromuscular coordination. Individuals with PFPS often present with impaired joint position sense and delayed neuromuscular responses around the knee, which may contribute to joint instability and persistent pain. Proprioceptive exercises, including balance, perturbation, and kinesthetic training, improve joint stability and coordination by stimulating mechanoreceptors and enhancing central processing of sensory input.Therefore, this study will aim to fill an important gap in the current literature by directly comparing the effects of core stabilization exercises and proprioceptive training on pain intensity, pain pressure threshold, quadriceps muscle strength, and proprioceptive acuity of knee, knee joint range of motion and functional ability in patients with PFPS

Inclusion criteria

• A confirmed diagnosis of Patellofemoral Pain Syndrome (PFPS) based on clinical and radiographic examination, with no evidence of other knee pathologies, as verified by an orthopaedic physician
• Presence of unilateral PFPS for a minimum duration of three months, indicating a chronic condition
• Age between 18 and 40 years, representing the typical symptomatic population affected by PFPS
• Body Mass Index (BMI) less than 30 kg/m², ensuring exclusion of obesity as a confounding factor.
• Report of increased anterior knee pain during at least two of the following patellofemoral stress-provoking activities: stair ascent or descent, squatting, kneeling, running, or prolonged sitting
• A positive patellar grind test (Clarke's sign) confirming involvement of the patellofemoral joint

Exclusion criteria

• Presence of chronic pain conditions unrelated to Patellofemoral Pain Syndrome (PFPS) as Rheumatoid arthritis, Chronic neuropathic pain, chronic low back pain and knee and hip osteoarthritis.
• Pregnancy or history of recent trauma affecting the pelvic or knee region
• History of corticosteroid injection in the affected knee
• Presence of ankle arthritis or gouty arthritis, which may alter lower-limb biomechanics
• History of previous surgical intervention involving the lumbar spine, hip, knee, or foot
• Presence of lower-limb structural deformities, including pes planus, knee valgus, or knee varus deformities