Article: Kitagawa T, Ozaki N, Aoki Y. Effect of physical therapy on the flexibility of the infrapatellar fat pad: A single-blind randomised controlled trial. PLoS One. 2022 Mar 17;17(3):e0265333.
Study Design: Randomized Controlled Trial
Abstract: The infrapatellar fat pad (IPFP) plays a biomechanical role in the knee joint. After knee injury or surgery, its dynamics decrease because of an inflammatory response. Physical therapy might be one of the valuable treatments for the recovery of knee joint mobility. This study aimed to evaluate the immediate effect of physical therapy on the dynamics of the infrapatellar fat pad in healthy participants using ultrasonography. In this prospective, single-blind, randomised controlled trial, 64 healthy young participants were enrolled and randomly assigned to one of the following three interventions: manual therapy, hot pack treatment, and control. Ultrasound images of the infrapatellar fat pad were obtained before and after the intervention. The thickness change ratio of the infrapatellar fat pad was calculated to compare the changes between and within groups before and after the intervention. No significant intergroup differences were observed. The effect sizes were relatively small. Manual therapy or hot pack intervention might not have an immediate effect on infrapatellar fat pad flexibility in healthy participants. Thus, it is necessary to consider more intensive treatments to change the dynamics of the infrapatellar fat pad.
NIH Risk of Bias Score: 11/14 (Low Risk of Bias) Key Findings of the Study:
1. Manual therapy and hot packs demonstrated almost no immediate effect on IPFP flexibility changes in healthy participants.
2. It is necessary to consider more intensive treatments to change the dynamics of the IPFP.
Reviewer Summary: This study shows that the type of interventions and/or the intensity with which they were done didn’t elicit a large change in the flexibility of the IPFP (minimal changes observed). Because research in this specific area is lacking, other studies would need to replicate the current study to see if these interventions only cause minimal changes in the IPFP. Many conservative treatments are available to address IPFP stiffness, such as physical therapy, taping, muscle training, gait training, and injections. Most of these interventions fall under the scope of practice for physical therapists and could be worth exploring in research to see if they have an effect in on IPFP flexibility.
