Assessment of Physical Tests
Tenderness, pain
ANTERIOR, CONTRACTION
Physical test outcomes were collected successively on the same day after the patients completed the VISA-P questionnaire. The coordinating investigator (S.J.B.) assessed the physical test results at baseline and 12 and 24 weeks. A description of the specific physical tests is provided below and shown in (A) Maximal isometric voluntary contraction (MVC) of the quadriceps muscles was measured with the participant in a seated position on the examination table with both legs hanging over the edge of the table. A fixation band and a plurimeter were used to perform the measurements. Participants were asked to have a straight back and to put both hands on their shoulders. Once the knee flexion angle was at 60° (measured by a plurimeter), the fixation belt was fixed at this position. Participants were asked to put pressure on the dynamometer by contracting their quadriceps while the examiner stabilized the dynamometer. (B) MVC of the hip abductor muscles was measured with the participant in a side-lying position, with the contralateral leg at 90° of flexion. The participant was asked to support his or her head with one hand, and the other hand was used to grasp the edge of the examination table. The participants was asked to put pressure on the dynamometer by contracting the hip abductor muscles against the resistance of the examiner. (C) Quadriceps flexibility was conducted in a prone position. The examiner identified the maximum passive knee flexion angle. Anterior pelvic tilt motion was prevented. (D) Hamstring flexibility was performed in a supine position. The maximum active knee extension angle was dictated by the patient, with a fully extended contralateral leg. (E and F) Participants were asked to lunge in front of the wall. The maximum ankle dorsiflexion range of motion was measured. Soleus flexibility was measured when participants were asked to lunge the knee and touch the wall as far as possible without lifting the heel. The gastrocnemius flexibility was measured by straightening the knee with the ankle at the maximum dorsiflexion angle, still without lifting the heel. (G and H) Participants were asked to wear an adjusted belt connected by a piece of rope before performing 3 trials of the vertical jump. Then, they were asked to land on the mat and report their visual analog scale (VAS) score for maximum pain afterward. The height (cm) was shown on the screen of the device. (I) The single-leg squat was conducted on a 25° decline board. Participants were asked to keep an upright trunk and squat up to 90° of knee flexion. Their VAS score for maximum pain was reported afterward. (J) Tenderness by palpation was assessed using patellar tilting and palpation with the other hand.