title: Effects of static stretching of knee musculature on patellar alignment and knee functional disability in male patients diagnosed with knee extension syndrome: A single-group, pretest-posttest trial.
abstract: BACKGROUND
  Knee extension (Kext) syndrome is based on movement system impairments and is described as knee pain associated with quadriceps stiffness.
  
  
  OBJECTIVE
  To investigate the effects of 3 times per week for 4 weeks static stretching of knee musculature on patellar alignment and knee functional disability in male Kext syndrome patients.
  
  
  METHODS
  A single-group, pretest-posttest clinical trial.
  
  
  METHODS
  Hazrat-e-Rasoul Akram Hospital.
  
  
  METHODS
  Forty-six male Kext syndrome patients aged 18-35 years.
  
  
  METHODS
  Knee functional disability was assessed by the Kujala questionnaire. Patellar tilt was assessed using the skyline view X-ray. In addition, patella alta was assessed by X-ray using the Insall-Salvati ratio. After intervention, changes in knee flexion-extension range of motion (ROM) and hip adduction were assessed by goniometer and inclinometer. Changes in patellar tilt and patella alta were evaluated. Correlations between muscles length, patellar tilt and knee functional disability were also evaluated.
  
  
  RESULTS
  The mean of patellar tilt in male Kext syndrome patients was 15.19°. Only the correlation between rectus femoris shortness and patellar tilt (P = 0.002) and the correlation between rectus femoris shortness and knee functional disability (P = 0.037) were significant. Patella alta was not severe in male Kext syndrome patients (1.28 ± 0.10). Knee flexion-extension ROM and femoral adduction increased significantly after a 12-session stretching programme (P < 0.0001).
  
  
  CONCLUSIONS
  The results demonstrated that rectus femoris shortness had higher correlation with patellar tilt and knee functional disability than iliotibial band and hamstring shortness. Stretching was effective in reducing patellar tilt, patella alta, knee functional disability, increasing knee ROM and hip adduction in these patients.
authors.affiliation: Physical Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Pourahmadi
authors.affiliation: Physical Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran. Electronic address: dr_i_ebrahimi@yahoo.com.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ebrahimi Takamjani
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences and Health Services, Shiraz, Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Hesampour
authors.affiliation: Orthopaedic Department, Hazrat-e-Rasoul Akram General Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran.
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Shah-Hosseini
authors.affiliation: Physical Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.
authors.forename: Ali Ashraf
authors.initials: AA
authors.lastname: Jamshidi
authors.affiliation: Rehabilitation and Sport Medicine Department, School of Paramedicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Mohammad Bagher
authors.initials: MB
authors.lastname: Shamsi
mesh_terms: D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D006801:Humans; D007492:Iran; D007718:Knee Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D008297:Male; D052580:Muscle Stretching Exercises; D057071:Patellofemoral Joint / Q000503:physiopathology*; D052097:Quadriceps Muscle / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D055815:Young Adult
keywords: Knee extension syndrome; Knee functional disability; Patella alta; Patellar tilt