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

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

Publisher: FOUNDATION REHABILITATION INFORMATION

: 2018

Journal of Rehabilitation Medicine

: JOURNAL OF REHABILITATION MEDICINE

: J REHABIL MED

: 50

: 5

: 393

: 401

: 9

: 1650-1977

: 1651-2081

DOI: https://doi.org/10.2340/16501977-2295

: https://research.utu.fi/converis/portal/detail/Publication/32074060

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.

anterior knee pain, chondromalacia patellae, Comparative effectiveness research, Conservative Treatment, Patellofemoral Pain Syndrome

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