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Vol. 21. Num. 2.
Pages 77-152 (01 March 2017)
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Vol. 21. Num. 2.
Pages 77-152 (01 March 2017)
Original Research
DOI: 10.1016/j.bjpt.2017.03.009
Different pain responses to distinct levels of physical activity in women with patellofemoral pain
Ronaldo V. Briani, Marcella F. Pazzinatto, Danilo De Oliveira Silva, Fábio M. Azevedo
Corresponding author

Corresponding author at: Rua Roberto Simonsen 305, Presidente Prudente - SP - Brazil CEP 19060-900.
Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia (FCT), Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Presidente Prudente, SP, Brazil

  • Intense physical activity can lead to higher levels of PFP.

  • Asymptomatic women were not influenced by the PFJ loading protocol.

  • The PFJ loading protocol has the capability to equalize pain in women with PFP.

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Figures (1)
Tables (4)
Table 1. Mean and standard deviation values of electromyographic data before and after the patellofemoral joint loading protocol for both control and PFP groups.
Table 2. Anthropometric data of the subjects.
Table 3. Mean and standard deviation values of VAS for both control and PFP groups.
Table 4. Linear regression model with IPAQ and VAS for PFP groups.
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Physical activity levels seem to play a role in patellofemoral pain (PFP); however, few studies have been conducted to confirm this hypothesis.


To determine the reported pain levels of women with and without PFP who maintain different levels of physical activity; to determine the capability of these levels to predict pain; and to test the capability of two stair-negotiation protocols, with and without external load, to equalize pain between groups.


Four groups were divided based on the women's physical activity levels: moderate activity PFP group (28), moderate activity control group (23), intense activity PFP group (22), and intense activity control group (22). All participants were asked to perform 15 repetitions of stair negotiation with and without external load on a seven-step staircase on two separate days. Pain levels were reported using a visual analog scale at five distinct moments: previous month, before stair negotiation, after stair negotiation, before patellofemoral joint (PFJ) loading protocol, and after PFJ loading protocol.


The intense activity PFP group showed higher levels of pain than the moderate activity PFP group (F(8,158)=11.714, p=0.000, η2=0.30). The PFJ loading protocol was able to equalize and exacerbate pain in the PFP groups.


Intense physical activity seems to have a higher association with knee pain than moderate physical activity. A PFJ loading protocol may be an alternative to equalize pain in women with PFP during clinical assessments.

Knee pain
Physical activity level
Physical therapy


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