Effectiveness of chiropractic management for patellofemoral pain syndrome's symptomatic control phase: a single subject experiment.

Chiropractic management of patellofemoral pain syndrome has not been well documented. A time-series experimental design was employed to assess the effectiveness of chiropractic care during the symptomatic control phase in a patient with bilateral knee pain. Treatment consisted of long axis tibiofemoral adjustment, passive patellofemoral mobilization, and continuous ultrasound. Mediating variables, derived from physical examination findings, were subject to periodic randomized observation sampling by a second observer who was blinded to the first observer, but unblinded to the experimental phases. Strong interexaminer reliability (K = 0.78, p less than .005) was observed for patellar tracking jitter. Poor agreement (K = 0.31, NS) was observed for the patellar grinding test graded on an oridinal scale, but moderate interexaminer agreement (K = 0.52; p less than .01) was obtained with the test on a nominal scale. Clinical outcome measures of pain, patellar tracking, and patellar grinding tests were observed to visually covary throughout the experiment. A reliable 3-4 wk lag was observed between treatment phases and demonstrable changes in the patient's signs and symptoms.