The effect of taping, quadriceps strengthening and stretching prescribed separately or combined on patellofemoral pain

Abstract

Background and purpose: Quadriceps strengthening, quadriceps stretching and patellar taping are commonly prescribed together for patellofemoral pain patients. This study aimed to examine the effectiveness of each of these techniques in isolation for one week and in combination for one week.

Methods: A prospective double-blind randomized control study was designed involving 41 subjects with 60 knees diagnosed with patellofemoral pain. The knees were randomized in onto one of four groups (n = 15): infrapatellar taping, quadriceps strengthening, quadriceps stretching and control. The taping was worn continually for the week; the strengthening group followed a programme of non-weight-bearing terminal range quadriceps exercises, the stretching group performed rectus femoris stretches. The control group did not receive treatment. All subjects received advice. Seven pre- and post-treatment measures included isokinetic quadriceps strength, quadriceps length, pain measured during four activities and maximum eccentric, posturally controlled, pain-free knee flexion angle during a step-down. Results showed significant changes over time (p < 0.01) in two out of seven measures for the taping group, in five out of seven for the strengthening group and five out of seven for the stretching group and none in the control group. When the three modalities were combined for one week, (n = 60) all seven measures improved significantly (p < 0.01).

Conclusion: In isolation, quadriceps stretching and quadriceps strengthening resulted in more improvements than taping. Combining these treatments is recommended as the initial approach to treating patellofemoral pain but further individualized more functional, global treatment is essential.