The effect of patellar taping combined with isometric strength training on pain, muscle strength, and functional performance in patients with patellofemoral pain syndrome: a randomized comparative study

Abstract

Background: Patellar taping and quadriceps strengthening exercises are commonly used in physiotherapy to manage patellofemoral pain syndrome (PFPS). However, previous research has reported inconsistent findings regarding quadriceps strength gains at specific knee angles during strength training in individuals with PFPS.

Objectives: This study investigated the efficacy of patellar taping and quadriceps isometric strength training (quadriceps-IST) at 60° knee flexion on quadriceps strength, pain, and functional performance in female patients with PFPS.

Methods: A two-arm, parallel-group, randomized comparative design was employed. Sixty adult females with PFPS were randomly assigned to either the experimental group (n = 30), which received patellar taping combined with quadriceps strength training at 60°, or the control group (n = 30), which received placebo taping with the same training. Both interventions lasted six weeks. Pain intensity, quadriceps muscle strength, and functional performance were assessed using the numeric pain rating scale (NPRS), maximum voluntary isometric contraction (MVIC) at 60° knee flexion, single leg triple hop (SLTH) test, and anterior knee pain scale (AKPS). For within and between groups comparison, a Wilcoxon signed-rank test and a Mann-Whitney U tests was employed, with confidence interval (α) set at 95%.

Results: Within-group analysis showed significant improvements in NPRS and MVIC at 60° knee flexion, SLTH, and AKPS scores post-intervention (p < 0.05). Between-group comparisons revealed that the experimental group had significantly greater improvements in all outcomes at six weeks post-intervention. Additionally, the pre-to-post changes (i.e., mean difference scores) were larger in the experimental group compared to the control group, which confirmed the superiority of the experimental group over the control group.

Conclusions: The study demonstrates that patellar taping combined with quadriceps -IST at a 60° knee flexion improves pain, muscle strength, and functional performance compared to placebo taping combined with quadriceps-IST. These findings suggest that incorporating this combined approach may enhance rehabilitation outcomes for patients with PFPS, providing a valuable addition to clinical practice.

Trial registration: This study was registered prospectively in the ClinicalTrials.gov PRS under a trial identifier NCT05168332 and last updated date 15/03/2024.

Keywords: Anterior knee pain scale (AKPS); Knee pain; Maximum voluntary isometric contraction (MVIC); Numeric pain rating scale; Pain; Patellofemoral pain syndrome; Strength.

Figure 1. A CONSORT (2010) flow diagram depicts the study procedures.

Figure 2. SLTH test measurements.

Figure 3. Taping application method.

Figure 4. Comparison of NPRS mean score (pre vs. post) among groups.

Figure 5. Comparison of STN mean score (pre vs. post) among groups.

Figure 6. Comparison of SLTH mean scores (pre vs. post) among groups).

Figure 7. Comparison of AKPS mean score (pre vs. post) among groups.

Figure 8. Comparison of pre-to-post changes (mean differences score) for all outcome variables in each group.