What is the evidence for rehabilitation interventions in the treatment of patellofemoral pain syndrome?
Summary
Patient Population:
No information on the patient population was provided.
Intervention:
Exercise (closed vs. open kinetic chain exercise, and strength training), mixed modality physiotherapy, manual therapy and electrotherapy.
Comparison:
43 manuscripts were included after quality assessment (72 were excluded on the grounds of poor methodological quality). Measure of body, structure and function were used most often to assess outcome in the studies identified for inclusion.
Outcome:
- Exercise: This was the most commonly researched type of intervention. In general, it was noted to have some effectiveness across all knee conditions in which it has been studied. There was one study identified that examined the use of closed kinetic chain vs. open kinetic chain exercise in the rehabilitation of individuals with patellofemoral pain. In that study, individuals receiving CKC exercise experienced less locking, clicking and pain. A single study examining the use of strengthening exercise also enrolled participants with PFPS – gains in terms of pain reduction, step test and HRQOL were associated with strengthening exercise.
- Mixed modality PT: 3 studies examining the use of mixed modality PT for individuals with PF pain were identified. In these, mixed modality PT was more effective than placebo, no-treatment or quadriceps strengthening alone. Outcomes assessed included stair descent, various step tests and pain.
- Manual therapy: There was one study identified and included that examined the use of manual therapy in participants with PFPS. There were reported improvements associated with manual therapy (range of motion and step test); however, the authors question the clinical significance of the finding and note weakness in study design.
- Electrotherapy: One study examine the use of electrotherapy in this patient group, but did not report significant between group differences in outcome. The authors note limited research of limited quality in this area overall.