Restorative effects of exercise rehabilitation and bracing on females with lateral displacement of patella

BACKGROUND: This investigation compared the effects of exercise rehabilitation and bracing on muscle flexibility and strength as well as knee proprioception and pain in female sufferers of lateral displacement of patella (LDP). MATERIALS AND METHODS: Twenty-two females with unilateral LDP were randomly divided into two groups to receive exercises (n = 12) or patellar brace (n = 10). Both groups were evaluated before and after 8 weeks with isokinetic dynamometer (Biodex System 3 Pro) for muscle strength and proprioception, with SLR, Active Knee Flexion, and Sit and Reach tests for flexibility assessment and with a visual analog scale for pain. RESULTS: Muscle flexibility in both exercise and bracing groups improved (F((1,20))≥5.99 and P ≤ 0.024), whereas improvement in bracing group was not significant. Significant interaction was observed in favor of exercise group in 2 strength tests of knee flexion and knee extension (F((1,20))≥6.564 and P ≤ 0.019). For proprioception, a significant interaction was observed in favor of bracing group (F((1,20)) =7.944 and P = 0.011). Also the results showed both exercise rehab and brace decreased significantly pain severity during stair ascending and descending. CONCLUSION: These results suggest that better flexibility and more strength in exercise group somehow reduced the stress on patellofemoral joint and it, in turn, alleviated the symptoms and pain. It is also likely that relieving effects of brace and improvement of proprioception by it allows patients to be more physically active and it could have, more or less, effects similar to exercise. Therefore both exercise and brace could be prescribed for patients with LDP. It seems application of the patellar brace combined with exercise might be a better treatment for these patients, because they could improve strength, flexibility and proprioception.