Exercise for treating patellofemoral pain syndrome

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Science
• Clinical Trials and Evidence Synthesis

Background:

• Patellofemoral pain syndrome (PFPS), or anterior knee pain, is prevalent in adolescents and young adults.
• Pain occurs during activities involving knee extensor mechanism loading, such as stair climbing, squatting, and running.
• Exercise therapy is a common conservative treatment approach for PFPS.

Purpose of the Study:

• To evaluate the benefits and harms of exercise therapy for PFPS.
• To assess the impact of exercise on knee pain and functional improvement in individuals with PFPS.

Main Methods:

• Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
• Searched multiple databases including Cochrane, MEDLINE, EMBASE, PEDro, CINAHL, and AMED up to May/June 2014.
• Included 31 heterogeneous trials (1690 participants) comparing exercise therapy to control or other interventions.

Main Results:

• Very low-quality evidence suggests exercise therapy reduces short-term and long-term pain and improves functional ability in PFPS.
• Exercise therapy demonstrated a potential for clinically important improvements in pain (MD -1.46) and function (SMD 1.10).
• Hip and knee exercises may offer greater pain reduction compared to knee exercises alone, though evidence quality is very low.

Conclusions:

• Exercise therapy appears to be effective for reducing pain and improving function in PFPS, with potential long-term recovery benefits.
• Insufficient evidence exists to determine the optimal type or 'best' exercise regimen for PFPS.
• Further high-quality, large-scale randomized trials are needed to confirm findings and guide clinical practice.