A2 Refereed review article in a scientific journal

Effectiveness of conservative treatment for patellofemoral pain syndrome: A systematic review and meta-analysis




AuthorsMikhail Saltychev, Rebecca A. Dutton, Katri Laimi, Gary S. Beaupre, Petri Virolainen, Michael Fredericson

PublisherFOUNDATION REHABILITATION INFORMATION

Publication year2018

JournalJournal of Rehabilitation Medicine

Journal name in sourceJOURNAL OF REHABILITATION MEDICINE

Journal acronymJ REHABIL MED

Volume50

Issue5

First page 393

Last page401

Number of pages9

ISSN1650-1977

eISSN1651-2081

DOIhttps://doi.org/10.2340/16501977-2295

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/32074060


Abstract
Objective: To evaluate the evidence regarding the effectiveness of conservative treatment in reducing patellofemoral pain.Data sources: CENTRAL, MEDLINE, CINAHL, and PE-Dro databases.Study selection: Adults with patellofemoral pain, randomized controlled trials only, any conservative treatment compared with placebo, sham, other conservative treatment, or no treatment. Two independent reviewers.Data extraction: Data were extracted from the full-text of the articles, based on Cochrane Collaboration recommendations. The outcome of interest was the difference between groups regarding change in pain severity.Data synthesis: The majority of studies were underpowered. More than 80% of the 37 trials did not show a clinically significant benefit. Clinically significant effects of different sizes were found for 7 trials (6 studies out of 7 had short follow-ups). These effects were found for: (i) pulsed electromagnetic fields combined with home exercise -33.0 (95% CI -45.2 to -20.8); (ii) hip muscle strengthening -65.0 (95% CI -87.7 to -48.3) and -32.0 (-37.0 to -27.0); (iii) weight-bearing exercise -40.0 (95% CI -49.4 to -30.6); (iv) neuromuscular facilitation combined with aerobic exercise and stretching -60.1 (95% CI -66.9 to -54.5); (v) postural stabilization -24.4 (95% CI -33.5 to -15.3); and (vi) patellar bracing -31.6 (95% CI -35.2 to -28.0).Conclusion: There is no evidence that a single treatment modality works for all patients with patellofemoral pain. There is limited evidence that some treatment modalities may be beneficial for some subgroups of patients with patellofemoral pain.

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