An Individualized Kinetic-Chain–Based Physiotherapy Protocol for Patellofemoral Pain: A Prospective Interventional Study

Abstract

Background: Patellofemoral pain (PFP) is one of the most common causes of anterior knee pain in physically active individuals and young adults. Altered lower-limb biomechanics, proximal muscle weakness, poor neuromuscular control, and faulty movement patterns along the kinetic chain contribute to abnormal patellofemoral joint loading. Conventional physiotherapy approaches focusing solely on the knee may fail to address these contributing factors.
Objective: To evaluate the effectiveness of an individualized kinetic-chain–based physiotherapy protocol on pain intensity, functional capacity, and movement quality in individuals with patellofemoral pain.
Methods: A prospective interventional study was conducted on 40 participants aged 18–35 years diagnosed with patellofemoral pain. Participants underwent a 6-week individualized kinetic-chain–based physiotherapy protocol focusing on hip and trunk strengthening, lower-limb alignment, movement retraining, and patellar loading control. Outcome measures included the Numerical Pain Rating Scale (NPRS), Kujala Anterior Knee Pain Scale (AKPS), and single-leg squat quality assessment. Pre- and post-intervention scores were analyzed using paired statistical tests.
Results: A significant reduction in pain intensity (NPRS) and improvement in functional outcomes (AKPS) were observed post-intervention (p < 0.05). Movement quality during single-leg tasks showed marked improvement, with reduced dynamic knee valgus and better trunk control.
Conclusion: An individualized kinetic-chain–based physiotherapy protocol is effective in reducing pain and improving function and movement quality in individuals with patellofemoral pain. Addressing proximal and distal contributors within the kinetic chain enhances rehabilitation outcomes beyond knee-focused interventions alone.