title: Effectiveness of goosestep training or its modification on treating patellar malalignment syndrome: clinical, radiographic, and electromyographic studies.
abstract: BACKGROUND
  Imbalanced soft tissue tension between medial and lateral para-patellar structures is the most common pathogenic cause of patellar malalignment syndrome. Despite the fact that an effective technique has not been developed, this disorder is usually treated conservatively. This prospective study tried to identify an effective alternative treatment for patellar malalignment syndrome.
  
  
  METHODS
  Forty female patients (age, 20-40 years) with bilateral patellar malalignment syndrome were randomly divided into two groups. Forty knees in 20 patients were treated with goosestep training without forcefully striking the ground, and 40 knees in other 20 patients were treated with goosestep training with forcefully striking the ground.
  
  
  RESULTS
  After 1 month, significant clinical improvement was observed in 72.5% of all patients (P < 0.001). Congruence or lateral patellofemoral angles and VMO/VL (vastus medialis obliquus/vastus lateralis) ratio significantly improved within 1 or 3 months in both groups (P < 0.001 for each comparison).
  
  
  CONCLUSIONS
  Goosestep training with or without forcefully striking the ground is a feasible method for treating patellar malalignment syndrome. The main advantages include its convenience, simplicity, lack of cost, and demonstrated effectiveness.
authors.affiliation: Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. ccwu@mail.cgu.edu.tw
authors.forename: Chi-Chuan
authors.initials: CC
authors.lastname: Wu
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Chou
authors.forename: Wei-Hsien
authors.initials: WH
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D004576:Electromyography; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D046788:Patellofemoral Pain Syndrome / Q000175:diagnosis / Q000628:therapy*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D055815:Young Adult