What is the evidence for foot or knee orthoses in the treatment of patellofemoral pain syndrome?
AMSTAR Rating
Summary
Patient Population:
50.3% of participants in the identified studies were female. The mean reported age of the study participants was 25.8 years. Duration of complaints ranged from 2 weeks to 15 years.
Intervention:
Exercise therapy with the addition of orthotic devices (patellar bracing, patellar taping and foot orthoses). Various exercise interventions were employed – all used quadriceps stretching techniques; several used hamstring and iliotibial band, gastrocnemius and hip flexors stretching techniques. Home exercise was used in addition to supervised exercise in 4 studies (and instead of supervised exercise in one study).
Comparison:
There were 8 studies identified for inclusion in the present review. Risk of bias was rated as low in 3 studies and high in the remaining 5 studies. No studies reported adequate blinding of patient, therapist or of outcome assessor to the experimental condition. Overall, there were 325 participants enrolled in the studies. The authors did not attempt any pooled analyses due to heterogeneity of interventions, outcome measures and time to follow-up assessment.
Outcome:
- Knee Braces: No effect on pain (moderate evidence), conflicting evidence on function.
- Taping: No long-term effects (moderate evidence), conflicting evidence for short term outcomes when combined with exercise.
- Foot Orthotics: No effect on pain in the long term when combined with exercise (moderate evidence), conflicting evidence for short term outcomes when combined with exercise.
