Effects of Attentional Focus Strategies During Isokinetic Quadriceps Training on Strength and Functional Performance in Individuals With Patellofemoral Pain Syndrome.

Effects of Attentional Focus Strategies During Isokinetic Quadriceps Training on Strength and Functional Performance in Individuals With Patellofemoral Pain Syndrome.

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.

Inclusion Criteria:

• 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).
• Willing to regularly participate in the 6-week program throughout the study period.

Exclusion Criteria:

• History of patellar subluxation or dislocation.
• Anterior or posterior cruciate ligament insufficiency.
• Lower extremity fractures.
• Neurological or systemic musculoskeletal disorders.
• Rheumatoid arthritis or other inflammatory joint diseases.
• History of knee surgery, meniscal injury, or any other underlying musculoskeletal condition that would prevent the participant from performing the exercises.
• Pregnancy or postpartum period.
• Participation in a similar exercise program within the last 3 months.
• Radiographic evidence of osteoarthritis classified as Kellgren-Lawrence grade 2 or higher.