Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily tasks such as climbing and descending stairs and squatting. This systematic review aimed to find evidence, in the literature, of squat movements that can cause or worsen PFPS. This work was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and its protocol was registered in PROSPERO (CRD42019128711). From the 6570 collected records, 37 were included. From these 37 articles, 27 present a causal relationship between knee flexion and PFPS, 8 describe a relationship, considering the greater existence of muscle contractions, and one article did not describe this relationship in its results. The main limitations stem from the fact that different studies used different evaluation parameters to compare the force exerted on the patellofemoral joint. Furthermore, most studies are focused on sports populations. After analysing the included works, it was concluded that all squat exercises can cause tension overload in the knee, especially with a knee flexion between 60° and 90° degrees. The main causal/worsening factors of PFPS symptoms are the knee translocation forward the toes (on the same body side) when flexing the knee, and the muscle imbalance between the thigh muscles.

Occupational-specific classifications of musculoskeletal disorders (MSD) are scarce and do not answer specific clinical questions. Thus, a specific classification was developed and proposed, covering criteria applicable to daily clinical activity. It was considered that the disorder development process is the same across all work-related MSDs (WRMSDs). Concepts of clinical pathology were applied to the characteristics of WRMSDs pathophysiology, cellular and tissue alterations. Then, the correlation of the inflammatory mechanisms with the injury onset mode was graded into four levels (MSDs 0–3). Criteria of legal, occupational and internal medicine, semiology, physiology and orthopaedics, image medicine and diagnostics were applied. Next, the classification was analysed by experts, two occupational physicians, two physiatrists and occupational physicians and one orthopaedist. This approach will allow WRMSD prevention and improve therapeutic management, preventing injuries from becoming chronic and facilitating communication between occupational health physicians and the other specialities. The four levels tool relate aetiopathogenic, clinical, occupational and radiological concepts into a single classification. This allows for improving the ability to determine a WRMSD and understanding what preventive and therapeutic measures should be taken, avoiding chronicity. The developed tool is straightforward, easy to understand and suitable for WRMSDs, facilitating communication between occupational physicians and physicians from other specialities.

Ação Ergo, vol.16, n1, e202209, 2022

Background: Patellofemoral Pain Syndrome (PFPS) represents anterior knees’ diseases. The PFPS is a multifactorial disease, with high prevalence. It presents a direct relationship of deterioration through the act of squatting, descending and climbing stairs, interfering both in working and daily activities. The main purpose of the study will be to find evidence of the direct relationship between the variations of squatting during muscular daily physical exercises and the patellofemoral disease. Methodology: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) Statement was used to elaborate the adequate research guidelines to address the research objective. Seven databases will be accessed (Academic Search Complete, Scopus, Science Direct, Web of Science, PubMed, Informaworld by Taylor & Francis, and Medline via PMC) and, at least, 10 keywords will be combined. Study appraisal and synthesis methods: One author will independently screen titles and abstracts against the eligibility criteria at first, and full-texts of potentially eligible records at a second phase, followed by extraction of data from qualifying studies. Two review authors will also assess the risk of bias and the quality of evidence, using the Cochrane Collaboration’s Tool, Rob 2.0. This protocol is registered in PROSPERO under the code CRD42019128711.