EMG Biofeedback as Treatment for Patellofemoral Pain Syndrome*

Patellofemoral pain syndrome may be classified as a dysfunction of the patella's ability to track in the femoral groove. This study identifies an effective treatment approach for patellofemoral pain syndrome. The approach integrates the concept of improved patellar tracking through selective enhancement of the vastus medialis oblique muscle with conventional exercise regimens for patellofemoral pain syndrome. Six patellofemoral pain syndrome patients were enrolled in a three-phase electromyographic biofeedback and exercise program: 1) biofeedback orientation and instruction in isometric quadriceps contractions, straight leg raises, and a home program; 2) biofeedback training for vastus medialis oblique enhancement with isometric quadriceps contractions, straight leg raises, terminal knee extensions, and progressive resistive exercises; and 3) incorporation of increased vastus medialis oblique activity in functional patterns of movement. All six patients learned to alter their vastus medialis oblique activity through the use of this treatment approach. The alteration of vastus medialis oblique activity resulted in an apparent change in the patellofemoral forces and a concomitant decrease in the patients' complaints of pain. These patients were able to return to pain-free functional activities in only six to nine treatment sessions within a 4- to 6-week period. The use of electromyographic biofeedback coupled with a graded exercise program is an efficient and effective treatment approach for patellofemoral pain syndrome patients.J Orthop Sports Phys Ther 1984;6(2):95-103.