Effectiveness of Neuromuscular Exercise in Patellofemoral Pain Syndrome

Primary outcomes

1. Kujala Patellofemoral Score Scale

   Time frame: 14 weeks

   Kujala patellofemoral scoring is a tool that allows functional evaluation of knee complaints related to the patellofemoral structure. Different scoring systems have been developed for knee-specific symptoms; however, only a few of these are focused on patellofemoral pain.The Kujala Patellofemoral Score Scale is graded on a scale of 0 to 100, with 100 being the highest possible score.

2. Lysholm Knee Scoring Scale

   Time frame: 14 weeks

   The Lysholm knee scoring scale is a global assessment tool that reflects overall functional outcome and physical activity level. The Lysholm scale is an 8-item questionnaire originally designed to assess knee function after knee ligament injuries. It was later confirmed for other knee conditions. Items evaluated according to the Lysholm scale include pain, type of support, instability, locking, swelling, limping, climbing stairs, and squatting. All items are scored to yield a score of 1, ranging from 0 to 100, with a higher Lysholm score indicating a lower level of symptoms and a higher level of functioning (91-100 = excellent, 84-90 = good, 65-83 = fair).

3. International Physical Activity Survey

   Time frame: 14 weeks

   Provides information on time spent walking, moderate and vigorous activities, and time spent sitting. Calculation of the total score of the short form includes the sum of the duration (minutes) and frequency (days) of walking, moderate-intensity activity, and vigorous activity. The energy required for activities is calculated with the metabolic equivalent(MET) -minute score. Standard metabolic equivalent (MET) values have been established for these activities.

4. Pittsburgh Sleep Quality Index

   Time frame: 14 weeks

   The pittsburgh Sleep Quality Index is a quantitative measure of sleep quality to define good and bad sleep. It includes 24 questions in total. The self-assessment questions include various items related to sleep quality. The total score is between 0-21. A high total score indicates poor sleep quality. The index does not indicate the presence of sleep disturbances or the prevalence of sleep disturbances. However, a pittsburgh Sleep Quality Index total score of five or more indicates poor sleep quality

5. Y Balance Test

   Time frame: 14 weeks

   Y balance test is a simple but reliable test used to measure dynamic balance. The Y balance test is a dynamic test performed in a one-legged stance that requires strength, flexibility, core control and proprioception. It has been used to evaluate physical performance, demonstrate functional symmetry, and identify athletes at higher risk for lower extremity injury. With the test complete and all performances recorded, the test administrator can then calculate the athlete's Y Balance Test performance scores using any of, or all of, the following three equations:

   Absolute reach distance (cm) = (Reach 1 + Reach 2 + Reach 3) / 3 Relative (normalised) reach distance (%) = Absolute reach distance / limb length * 100 Composite reach distance (%) = Sum of the 3 reach directions / 3 times the limb length * 100

6. 30 Second Sit and Stand Test

   Time frame: 14 weeks

   It is a test that evaluates the patient's sitting and standing activity, lower extremity strength and dynamic balance. The number of times the patient sits and stands within 30 seconds gives the score of the test. For this test performed to determine leg strength; A straight-backed chair with a seating height of 43.18cm (12-in) and no armrests is used. The individual is asked to sit in the middle of the chair with his back upright, his feet on the ground, and his arms crossed in front of his chest (right hand on the left shoulder, left hand on the right shoulder). While in this position, the individual starts the test with the start command and takes off as fully as he can during 30 seconds. The number of complete starts he makes during 30 seconds constitutes the subject's score.