Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011:4:383-92.
doi: 10.2147/JMDH.S24595. Epub 2011 Oct 31.

A systematic review of randomized controlled trials on exercise parameters in the treatment of patellofemoral pain: what works?

Daniel Harvie  1 , Timothy O'Leary, Saravana Kumar
Affiliations

A systematic review of randomized controlled trials on exercise parameters in the treatment of patellofemoral pain: what works?

Daniel Harvie et al. J Multidiscip Healthc. 2011.

Abstract

Purpose: There is research evidence which supports the effectiveness of exercise in reducing pain and increasing function in patients with patellofemoral pain syndrome. However, what is unclear are the parameters underpinning this intervention. This has led to uncertainty when operationalizing exercises for patients with patellofemoral pain syndrome in clinical practice. The aim of this review was to evaluate the parameters of exercise programs reported in primary research, to provide clinicians with evidence-based recommendations for exercise prescription for patellofemoral pain.

Methods: A systematic review of randomized controlled trials was undertaken. Only trials that identified exercise to be effective in treating patellofemoral pain were included. Appropriate databases and reference lists were searched using established keywords. Data relating to common exercise parameters such as the type of exercise, length, and frequency of intervention, intensity, repetitions, sets, and specific technique were extracted, along with details of co-interventions that may have been used.

Results: A total of ten randomized controlled trials were included in this review and from these trials 14 interventions arms were evaluated. All 14 interventions focused on active exercises, all but two of which also included a passive stretching component. The current body of evidence demonstrates positive results with exercise interventions such as knee extension, squats, stationary cycling, static quadriceps, active straight leg raise, leg press, and step-up and down exercises for patients with patellofemoral pain syndrome. A progressive regime of daily exercises of two to four sets of ten or more repetitions over an intervention period of 6 weeks or more, combined with exercises to address flexibility of the lower limb musculature was commonly used.

Conclusion: Currently, the primary research on this topic supports the use of closed kinetic chain, strengthening exercises for musculature of the lower limb, combined with flexibility options. The current evidence base supports a prescription of daily exercises of two-four sets of ten or more repetitions over a period of 6 weeks or more.

Keywords: PFPS; lower limb; musculature; patellofemoral pain syndrome; repetitions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards of Reporting Trials) diagram summarizing search and selection process. Abbreviation: RCT, randomized controlled trial.
Figure 2
Figure 2
Graph showing PEDro scores for each of the included studies.
See this image and copyright information in PMC

References

    1. McConnell J. The management of chondromalacia patellae: a long term solution. Aust J Physiother. 1986;32(4):215–223. - PubMed
    1. McConnell J. What are effective therapies for anterior knee pain. In: Wright JG, editor. Evidence Based Orthopaedics: The Best Answers To Clinical Questions. Philadelphia, PA: Saunders Elsevier Inc; 2009. pp. 634–639.
    1. Fagan V, Delahunt E. Patellofemoral pain syndrome: a review on the associated neuromuscular deficits and current treatment options. Br J Sports Med. 2008;42(10):789–795. - PubMed
    1. Witvrouw E, Danneels L, van Tiggelen D, et al. Open versus closed kinetic chain exercises in patellofemoral pain: a 5-year prospective randomized study. Am J Sports Med. 2004;32(5):1122–1130. - PubMed
    1. Mascal C, Landel R, Powers C. Management of patellofemoral pain targeting hip, pelvis and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther. 2003;33(11):647–660. - PubMed