|LETTER TO THE EDITOR
|Year : 2014 | Volume
| Issue : 1 | Page : 53-54
Response of therapeutic exercise and patellar taping on patella position and pain control in the patellofemoral pain syndrome
Sachin Upadhyay1, Mayank Chansoria2
1 Department of Orthopaedics, Traumatology and Rehabilitation, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
2 Department of Anaesthesiology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
|Date of Web Publication||15-Mar-2014|
Assistant Professor Orthopaedics, 622, "Poonam" Sneh Nagar, State Bank Colony, Jabalpur - 482 002, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Upadhyay S, Chansoria M. Response of therapeutic exercise and patellar taping on patella position and pain control in the patellofemoral pain syndrome. Indian J Pain 2014;28:53-4
|How to cite this URL:|
Upadhyay S, Chansoria M. Response of therapeutic exercise and patellar taping on patella position and pain control in the patellofemoral pain syndrome. Indian J Pain [serial online] 2014 [cited 2019 Dec 6];28:53-4. Available from: http://www.indianjpain.org/text.asp?2014/28/1/53/128902
We read with great interest the recently published article  entitled " Response of therapeutic exercise and patellar taping on patella position and pain control in the patellofemoral pain syndrome". Although we applaud the work, we wish to draw the attention of the authors to certain critical points which need to be clarified.
- The use of inclusion and exclusion criteria as a means of eliminating confounding variables was poor in the present study. The current research did not include adequate inclusion and exclusion criteria. As a result, the study has limited reliability and validity, as the statistics may not be reflective of the patellofemoral pain syndrome (PFPS) population. We would like to clarify from the authors regarding this issue.
- A research should be large enough to have a chance of detecting a statistically significant, worthwhile outcome if it exists. The present small sample sizes research prevents the generalization of the finding and typically lead to type-II errors - the mistaken conclusion that an intervention has no effect.  In view of this, how does the author used the lines as "taping should be included as a compulsory part of the conservative treatment for PFPS along with the CKC exercises"? We would appreciate their comment regarding this critical concern.
- Authors of the present study used same techniques of taping the patella in each and every case. Literature  showed that before the patella can be taped, thorough assessment of its components of orientation, that is, glide component, tilt component, and rotation component is critical for optimal application of taping. Each of these components must be corrected sufficiently so as to encourage the patient for the training schedule in pain free manner. Did the authors thoroughly assess these components before taping? They have not articulated well in the present study.
- Another thing that concerns us is the same protocol schedule. We want to know from the authors "Is the same treatment protocol applicable to all group of patients?" If yes then we feel that blanket treatment some time may not be worthwhile as some patient may have any tight structures (iliotibial band (ITB) or lateral structures) and in those conditions he/she was taught to stretch the tight component first. We think that the treatment protocol for each patient should be designed according to the findings from the examination.
- Were the subjects educated well about the taping procedure? Sometimes the patients tape their own knees without proper instruction or assessment; hence, there will likely possibility of an ineffective taping technique. This may affect the critical analysis. We would appreciate author's comment concerning the education of the patients.
- The authors of the present study did not assess the outcome measure using the anterior knee pain scale (AKPS) as it was seen to be one of the most valid and responsive outcome measures for PFPS.  We would like to clarify from the authors regarding this issue.
- The authors failed to mention any use of blinding as a result chances of bias cannot be overlooked. We feel at least the authors should incorporate blinding of assessors so as to enhance the reliability of the research.
- Furthermore the lack of follow-up of patients and dynamic functional testing procedure decrease the validity and reliability of the present study.
| Acknowledgement|| |
We want to acknowledge the doctors and senior colleagues for providing fruitful and critical comments on the draft of this paper.
| References|| |
|1.||Manzer MH, Zutshi K, Mandal P. Response of therapeutic exercise and patellar taping on patella position and pain control in the Patellofemoral pain syndrome. Indian J Pain 2013;27:75-9. |
|2.||Greenhalgh T. Assessing the methodological quality of published papers. BMJ 1997;315:305-8. |
|3.||McConnell J. The management of chondromalacia patellae: A long term solution. Aust J Physiother 1986;32:215-23. |
|4.||Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: Which are reliable and valid? Arch Phys Med Rehabil 2004;85:815-22. |