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A Review Study on Various Conservative Management Strategies for Patellofemoral Pain Syndrome: What Is the Best Intervention?

Document Type : Review Article

Authors

1 Physical Therapist, PhD Candidate, Department of Sports Medicine, School of Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran

2 Associate Professor, School of Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran

Abstract

Background & Aims: Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders with various conservative therapeutic methods for its management. The aim of this study was to investigate national research regarding the effects of conservative treatment methods of PFPS.
Methods: The review process was performed using the keywords of anterior knee pain, PFPS, quadriceps strengthening exercises, hip muscle strengthening exercises, taping, bracing, orthoses, exercise therapy, manual therapy, and physiotherapy. The search engines used included Islamic World Science Citation Center (ISC), IranMedex, Google Scholar, MedLib, Magiran, Scientific Information Database (SID), and PubMed. Only 15 articles had the study inclusion criteria. The findings related to the effects of conservative therapeutic methods on pain intensity, balance, function and physical ability, and knee joint proprioception in patients with PFPS were extracted from the selected articles.
Results: The majority of articles focused on exercise therapy as an important part of the rehabilitation program. They had reported improvement in patients with PFPS in terms of pain intensity, disability, and proprioception as a result of exercise therapy. Although, other therapeutic methods also had positive effects on these patients, they were not as effective as therapeutic exercise.
Conclusion: Current literature supports the continued use of exercise therapy as an efficient treatment in patients with PFPS. However, designing and implementation of new therapeutic interventions encompassing other treatment methods and evaluation of their long term effects through follow-up assessments is essential.

Keywords

References
  1. Mazloum V, Rahnama N. Comparison of the effects of therapeutic exercise and Pilates training on function and proprioception in patients with knee osteoarthritis: a randomized controlled trial. J Rehab 2014; 15(1): 53-62. [In Persian].
  2. Mazloum V, Rahnama N, Khayambashi K. Effects of therapeutic exercise and hydrotherapy on pain severity and knee range of motion in patients with hemophilia: a randomized controlled trial. Int J Prev Med 2014; 5(1): 83-8.
  3. Gorman McNerney ML, Arendt EA. Anterior knee pain in the active and athletic adolescent. Curr Sports Med Rep 2013; 12(6): 404-10.
  4. Coppack RJ, Etherington J, Wills AK. The effects of exercise for the prevention of overuse anterior knee pain: a randomized controlled trial. Am J Sports Med 2011; 39(5): 940-8.
  5. Naslund J, Naslund UB, Odenbring S, Lundeberg T. Sensory stimulation (acupuncture) for the treatment of idiopathic anterior knee pain. J Rehabil Med 2002; 34(5): 231-8.
  6. Myer GD, Ford KR, Barber Foss KD, Goodman A, Ceasar A, Rauh MJ, et al. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech (Bristol, Avon) 2010; 25(7): 700-7.
  7. Fagan V, Delahunt E. Patellofemoral pain syndrome: a review on the associated neuromuscular deficits and current treatment options. British Journal of Sports Medicine 2008; 42(10): 489-95.
  8. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports 2010; 20(5): 725-30.
  9. Earl JE, Hoch AZ. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med 2011; 39(1): 154-63.
  10. Wood L, Muller S, Peat G. The epidemiology of patellofemoral disorders in adulthood: a review of routine general practice morbidity recording. Prim Health Care Res Dev 2011; 12(2): 157-64.
  11. Baquie P, Brukner P. Injuries presenting to an Australian sports medicine centre: a 12-month study. Clin J Sport Med 1997; 7(1): 28-31.
  12. Barton CJ, Munteanu SE, Menz HB, Crossley KM. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med 2010; 40(5): 377-95.
  13. McCarthy MM, Strickland SM. Patellofemoral pain: an update on diagnostic and treatment options. Curr Rev Musculoskelet Med 2013; 6(2): 188-94.
  14. Pattyn E, Mahieu N, Selfe J, Verdonk P, Steyaert A, Witvrouw E. What predicts functional outcome after treatment for patellofemoral pain? Med Sci Sports Exerc 2012; 44(10): 1827-33.
  15. Sheehan FT, Derasari A, Fine KM, Brindle TJ, Alter KE. Q-angle and J-sign: indicative of maltracking subgroups in patellofemoral pain. Clin Orthop Relat Res 2010; 468(1): 266-75.
  16. Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med 2013; 47(4): 193-206.
  17. Pal S, Draper CE, Fredericson M, Gold GE, Delp SL, Beaupre GS, et al. Patellar maltracking correlates with vastus medialis activation delay in patellofemoral pain patients. Am J Sports Med 2011; 39(3): 590-8.
  18. Thomee R, Renstrom P, Karlsson J, Grimby G. Patellofemoral pain syndrome in young women. II. Muscle function in patients and healthy controls. Scand J Med Sci Sports 1995; 5(4): 245-51.
  19. Mason M, Keays SL, Newcombe PA. The effect of taping, quadriceps strengthening and stretching prescribed separately or combined on patellofemoral pain. Physiother Res Int 2011; 16(2): 109-19.
  20. White LC, Dolphin P, Dixon J. Hamstring length in patellofemoral pain syndrome. Physiotherapy 2009; 95(1): 24-8.
  21. Piva SR, Goodnite EA, Childs JD. Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2005; 35(12): 793-801.
  22. Hudson Z, Darthuy E. Iliotibial band tightness and patellofemoral pain syndrome: a case-control study. Man Ther 2009; 14(2): 147-51.
  23. Callaghan M, Oldham J. Quadriceps atrophy: to what extent does it exist in patellofemoral pain syndrome? Br J Sports Med 2004; 38(3): 295-9.
  24. Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med 2000; 28(4): 480-9.
  25. Christopher M, Powers P. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. Journal of Orthopaedic & Sports Physical Therapy 2003; 33(11): 639-46.
  26. Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med 2009; 37(11): 2108-16.
  27. Fulkerson JP. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 2002; 30(3): 447-56.
  28. Wilson NA, Press JM, Koh JL, Hendrix RW, Zhang LQ. In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am 2009; 91(3): 558-66.
  29. Souza RB, Draper CE, Fredericson M, Powers CM. Femur rotation and patellofemoral joint kinematics: a weight-bearing magnetic resonance imaging analysis. J Orthop Sports Phys Ther 2010; 40(5): 277-85.
  30. Dursun N, Dursun E, Kilic Z. Electromyographic biofeedback-controlled exercise versus conservative care for patellofemoral pain syndrome. Arch Phys Med Rehabil 2001; 82(12): 1692-5.
  31. Witvrouw E, Werner S, Mikkelsen C, van Tiggelen D, van den Berghe L, Cerulli G. Clinical classification of patellofemoral pain syndrome: guidelines for non-operative treatment. Knee Surg Sports Traumatol Arthrosc 2005; 13(2): 122-30.
  32. Barton CJ, Webster KE, Menz HB. Evaluation of the scope and quality of systematic reviews on nonpharmacological conservative treatment for patellofemoral pain syndrome. J Orthop Sports Phys Ther 2008; 38(9): 529-41.
  33. Moyano FR, Valenza MC, Martin LM, Caballero YC, Gonzalez-Jimenez E, Demet GV. Effectiveness of different exercises and stretching physiotherapy on pain and movement in patellofemoral pain syndrome: a randomized controlled trial. Clin Rehabil 2013; 27(5): 409-17.
  34. Kettunen JA, Harilainen A, Sandelin J, Schlenzka D, Hietaniemi K, Seitsalo S, et al. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial. BMC Medicine 2007; 5: 38.
  35. Crossley K, Bennell K, Green S, Cowan S, McConnell J. Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med 2002; 30(6): 857-65.
  36. Derasari A, Brindle TJ, Alter KE, Sheehan FT. McConnell taping shifts the patella inferiorly in patients with patellofemoral pain: a dynamic magnetic resonance imaging study. Phys Ther 2010; 90(3): 411-9.
  37. Lun VM, Wiley JP, Meeuwisse WH, Yanagawa TL. Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clin J Sport Med 2005; 15(4): 235-40.
  38. Denton J, Willson JD, Ballantyne BT, Davis IS. The addition of the Protonics brace system to a rehabilitation protocol to address patellofemoral joint syndrome. J Orthop Sports Phys Ther 2005; 35(4): 210-9.
  39. Bolgla L, Boling MC. An update for the conservative management of patellofemoral pain syndrome: a systematic review of the literature from 2000 to 2010. Int J Sports Phys Ther 2011; 6(2): 112-25.
  40. Maher CG, Moseley AM, Sherrington C, Elkins MR, Herbert RD. A description of the trials, reviews, and practice guidelines indexed in the PEDro database. Phys Ther 2008; 88(9): 1068-77.
  41. Mostamand J. Physical therapies for subjects with patellofemoral pain syndrome: A review study. J Res Rehabil Sci 2012; 7(4): 588-98. [In Persian].
  42. Ebrahimi Atri A, Dehghani Tafti M, Khoshraftare Yazdi N, Dehghani Tafti V. The effects of patellar taping on dynamic balance and reduction of pain in athletic women with Patellofemoral Pain Syndrome (PFPS). J Shaheed Sadoughi Univ Med Sci 2012; 20(3): 332-9. [In Persian].
  43. Minoonejad H, Rajabi R, Ebrahimi-Takamjani E, Alizadeh MH, Jamshidi AA, Azhari A, et al. Combined open and closed kinetic chain exercises for patellofemoral pain syndrome: a randomized controlled trial. World Journal of Sport Sciences 2012; 6(3): 278-85.
  44. Khayambashi K, Mohammadkhani Z, Ghaznavi K, Lyle MA, Powers CM. The effects of isolated hip abductor and external rotator muscle strengthening on pain, health status, and hip strength in females with patellofemoral pain: a randomized controlled trial. J Orthop Sports Phys Ther 2012; 42(1): 22-9.
  45. Mazloum V, Mahdavinejad R. Effects of Swedish massage techniques and therapeutic exercise on patellofemoral pain syndrome. J Res Rehabil Sci 2012; 8(2): 363-71. [In Persian].
  46. Mousavi SM, Khayambashi K, Nejadian S, Moradi H. The effects of kinesiotape and strength training on knee pain and quadriceps strength in people with Patellofemoral Pain Syndrome (PFPS). J Isfahan Med Sch 2011; 29(159): 1657-68. [In Persian].
  47. Bagheri S, Bayat MR, Halabchi F. The effect of 8-week exercise program on patellofemoral pain syndrome. J Res Rehabil Sci 2011; 7(3): 357-67. [In Persian].
  48. Mazidi M, Alizadeh MH, Rajabi R. The effects of one period of exercise therapy program on Q and popliteal angle in athlethes with Pattellofemoral pain syndrome. J Res Rehabil Sci 2011; 7(2): 206-14. [In Persian].
  49. Akbari A, Naroii S, Karami S, Shahraki H. The effect of low-level LASER on pain improvement and function in patients affected anterior knee pain. J Shahrekord Univ Med Sci 2015; 13(5): 11-9. [In Persian].
  50. Baluchi R, Giasi A, Naderi A. A survey of selective movement therapy effectiveness on dynamic postural control of patients with patellofemoral pain syndrome. J Ilam Univ Med Sci 2011; 19(1): 17-25. [In Persian].
  51. Sokhangooei Y, Anbarian M, Khanlari Z, Rahimi A. The effect of open and closed kinetic chain exercises on patellofemoral syndrome patients. World Journal of Sport Sciences 2010; 3(1): 7-10.
  52. Sharafi M, Ghasemi MS, Kamali M, Saeedi H. Effects of neoprene palumbo and geno direxa stable orthoses on pain and daily activities of patients with patello femoral pain syndrome. J Gorgan Uni Med Sci 2010; 12(1): 20-6. [In Persian].
  53. Razeghi M, Etemadi Y, Taghizadeh SH, Ghaem H. Could hip and knee muscle strengthening alter the pain intensity in patellofemoral pain syndrome? Iran Red Crescent Med J 2010; 12(2): 104-10.
  54. Nejati P, Forugh B, Kuhpayezade J, Moeineddin R, Nejati M. Effects of foot orthoses on knee pain and function of female athletes with patellofemoral pain syndrome. J Zanjan Univ Med Sci 2009; 17(66): 49-60. [In Persian].
  55. Rafiaei M, Saidi H, Ebrahimi E, Kamali M. The effect of inferapatellar and cho-pat straps on knee strength and ROM in patients with anterior knee pain syndrome. J Res Rehabil Sci 2007; 3(2): 43-50. [In Persian].
  56. Forough B, Pourghasem A, Saedi H, Rahimi F. The effects of functional foot orthoses on quality of life for individual with patellofemoral pain syndrome. J Guilan Univ Med Sci 2007; 16(61): 81-9. [In Persian].
  57. Nakagawa TH, Serrao FV, Maciel CD, Powers CM. Hip and knee kinematics are associated with pain and self-reported functional status in males and females with patellofemoral pain. Int J Sports Med 2013; 34(11): 997-1002.
  58. Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther 2009; 39(1): 12-9.
  59. Souza RB, Powers CM. Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain. Am J Sports Med 2009; 37(3): 579-87.
  60. Noehren B, Pohl MB, Sanchez Z, Cunningham T, Lattermann C. Proximal and distal kinematics in female runners with patellofemoral pain. Clin Biomech (Bristol, Avon ) 2012; 27(4): 366-71.
  61. Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. J Orthop Sports Phys Ther 2008; 38(8): 448-56.
  62. Bolgla LA, Malone TR, Umberger BR, Uhl TL. Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. Int J Sports Phys Ther 2011; 6(4): 285-96.
  63. Paoloni M, Fratocchi G, Mangone M, Murgia M, Santilli V, Cacchio A. Long-term efficacy of a short period of taping followed by an exercise program in a cohort of patients with patellofemoral pain syndrome. Clin Rheumatol 2012; 31(3): 535-9.
  64. Aminaka N, Pietrosimone BG, Armstrong CW, Meszaros A, Gribble PA. Patellofemoral pain syndrome alters neuromuscular control and kinetics during stair ambulation. J Electromyogr Kinesiol 2011; 21(4): 645-51.
  65. Cavazzuti L, Merlo A, Orlandi F, Campanini I. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Gait Posture 2010; 32(3): 290-5.
  66. Owings TM, Grabiner MD. Motor control of the vastus medialis oblique and vastus lateralis muscles is disrupted during eccentric contractions in subjects with patellofemoral pain. Am J Sports Med 2002; 30(4): 483-7.
  67. Brindle TJ, Mattacola C, McCrory J. Electromyographic changes in the gluteus medius during stair ascent and descent in subjects with anterior knee pain. Knee Surg Sports Traumatol Arthrosc 2003; 11(4): 244-51.
  68. Boling MC, Bolgla LA, Mattacola CG, Uhl TL, Hosey RG. Outcomes of a weight-bearing rehabilitation program for patients diagnosed with patellofemoral pain syndrome. Arch Phys Med Rehabil 2006; 87(11): 1428-35.
  69. Nakagawa TH, Muniz TB, Baldon RM, Dias MC, de Menezes Reiff RB, Serrao FV. The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil 2008; 22(12): 1051-60.
  70. Herrington L, Al-Sherhi A. A controlled trial of weight-bearing versus non-weight-bearing exercises for patellofemoral pain. J Orthop Sports Phys Ther 2007; 37(4): 155-60.
  71. Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther 1996; 24(3): 136-41.
  72. Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil 2002; 81(11): 807-13.
  73. Ferber R, Kendall KD, Farr L. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome. J Athl Train 2011; 46(2): 142-9.
  74. Mesfar W, Shirazi-Adl A. Knee joint biomechanics in open-kinetic-chain flexion exercises. Clin Biomech (Bristol, Avon ) 2008; 23(4): 477-82.
  75. Song CY, Lin JJ, Jan MH, Lin YF. The role of patellar alignment and tracking in vivo: the potential mechanism of patellofemoral pain syndrome. Phys Ther Sport 2011; 12(3): 140-7.
  76. Overington M, Goddard D, Hing W. A critical appraisal and literature critique on the effect of patellar taping: is patellar taping effective in the treatment of patellofemoral pain syndrome? New Zealand Journal of Physiotherapy 2006; 34(2): 66-80.
  77. Aminaka N, Gribble PA. Patellar taping, patellofemoral pain syndrome, lower extremity kinematics, and dynamic postural control. J Athl Train 2008; 43(1): 21-8.
  78. Pfeiffer RP, de Beliso M, Shea KG, Kelley L, Irmischer B, Harris C. Kinematic MRI assessment of McConnell taping before and after exercise. Am J Sports Med 2004; 32(3): 621-8.
  79. Hetsroni I, Finestone A, Milgrom C, Sira DB, Nyska M, Radeva-Petrova D, et al. A prospective biomechanical study of the association between foot pronation and the incidence of anterior knee pain among military recruits. J Bone Joint Surg Br 2006; 88(7): 905-8.
  80. Barton CJ, Bonanno D, Levinger P, Menz HB. Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther 2010; 40(5): 286-96.
  81. Thijs Y, de Clercq D, Roosen P, Witvrouw E. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners. Br J Sports Med 2008; 42(6): 466-71.
  82. Barton CJ, Levinger P, Menz HB, Webster KE. Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review. Gait Posture 2009; 30(4): 405-16.
  83. Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ 2008; 337: a1735.
  84. Fatemy E, Bakhtiyari AH, Alizadeh A, Ghasemi F, Mahmoudi S, Ghorbani R. The effect of Swedish massage on knee osteoarthritis. Quarterly Annals of Military and Health Sciences Research 2010; 8(3): 200-5. [In Persian].
  85. Chatchawan U, Thinkhamrop B, Kharmwan S, Knowles J, Eungpinichpong W. Effectiveness of traditional Thai massage versus Swedish massage among patients with back pain associated with myofascial trigger points. Journal of Bodywork and Movement Therapies 2005; 9(4): 298-309.
  86. Fikácková H, Dostálová T, Navrátil L, Klaschka J. Photomedicine and laser surgery. Photomedicine and Laser Surgery 2007; 25(4): 297-303.
  87. Dundar U, Evcik D, Samli F, Pusak H, Kavuncu V. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study. Clin Rheumatol 2007; 26(6): 930-4.
  88. Djavid GE, Mehrdad R, Ghasemi M, Hasan-Zadeh H, Sotoodeh-Manesh A, Pouryaghoub G. In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial. Aust J Physiother 2007; 53(3): 155-60.
Journal of Kerman University of Medical Sciences
Volume 23, Issue 1
January and February 2016
Pages 116-136
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