Patellofemoral pain syndrome (PFPS) is a multifactorial musculoskeletal condition that is common particularly among young and physically active individuals, negatively affecting activities of daily living and physical performance. Although exercise therapy is considered the gold standard in the management of PFPS, there is limited evidence regarding the effectiveness of motor learning strategies applied during exercise. This study aims to shed light on how motor learning approaches can be optimized in clinical rehabilitation by comparing the effects of internal and external focus strategies used during exercise on muscle activation, functional performance, and pain.
This research will make a methodological contribution to the literature through the objective evaluation of muscle mechanical properties using isokinetic assessment and the MyotonPRO device. The findings are expected to clarify the effects of attentional focus strategies on therapeutic outcomes in PFPS rehabilitation and have the potential to provide an evidence-based guide for physiotherapy practice. In this way, the study may contribute to the development of new approaches aimed at improving both clinical effectiveness and patient adherence.
Aged between 18 and 45 years.
Diagnosed with patellofemoral pain syndrome (PFPS).
Anterior or retropatellar knee pain persisting for at least four weeks with a VAS score > 3.
Pain exacerbated by at least two functional activities (e.g., squatting, stair climbing, prolonged sitting).
History of patellar subluxation or dislocation.
Anterior or posterior cruciate ligament insufficiency.
Lower extremity fractures.
Neurological or systemic musculoskeletal disorders.
Parallel
Internal focus group
Other interventionInternal focus refers to directing attention to one's own body movements or muscle activity while performing a task (e.g., focusing on contracting a specific muscle). During isokinetic strength exercises, this group is instructed with commands such as: "Tighten your quadriceps" and "Straighten your knee."
External focus
Other interventionExternal focus refers to directing attention to the effect of a movement on the environment or an external object, rather than on the body itself. During isokinetic exercise, this group is given the instruction: "Increase and maintain the performance indicator on the screen."
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
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