Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review

Abstract

Objectives: The purpose of this study was to conduct a review of randomized controlled trials (RCTs) to determine the treatment effectiveness of the combination of manual therapy (MT) with other physical therapy techniques. Methods: Systematic searches of scientific literature were undertaken on PubMed and the Cochrane Library (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014). The following terms were used: "patellofemoral pain syndrome," "physical therapy," "manual therapy," and "manipulation." RCTs that studied adults diagnosed with patellofemoral pain syndrome (PFPS) treated by MT and physical therapy approaches were included. The quality of the studies was assessed by the Jadad Scale. Results: Five RCTs with an acceptable methodological quality (Jadad ≥ 3) were selected. The studies indicated that MT combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles. Conclusions: The different combinations of MT and physical therapy programs analyzed in this review suggest that giving more emphasis to proximal stabilization and full kinetic chain treatments in PFPS will help better alleviation of symptoms. (J Chiropr Med 2017;16:139-146)

2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017

“…Figure 1 summarises the updated consensus process. We identified two low-quality systematic reviews15 16 and three moderate-quality RCTs17–19 on exercise therapy; one low-quality systematic review20 and one moderate-quality RCT21 on combined interventions; one high-quality22 and two low-quality23 24 systematic reviews and two RCTs (one high-quality,25 one low-quality26) on patellar taping and bracing; and two high-quality,27 28 three moderate-quality18 29 30 and two low-quality31 32 RCTs on other adjunctive interventions. No new systematic reviews or RCTs were identified that related to foot orthoses.…”

Effectiveness of a psychoeducational intervention for caregivers of People With Dementia with regard to burden, anxiety and depression: A systematic review

“…The Jadad scale ranges from 0–5. If the Jadad score was ≥3 points, the trial was considered high‐quality research, whereas if the Jadad score was ≤2 points, the study was considered a low‐quality trial (Espí‐López, Arnal‐Gómez, Balasch‐Bernat, & Inglés, ; Jadad et al, ; Seminario‐Amez, López‐López, Estrugo‐Devesa, Ayuso‐Montero, & Jané‐Salas, ; Zhang, Lan, Pen, & Li, ).…”

Both ipsilateral and contralateral localized vibratory stimulations modulated pain-related sensory thresholds on the foot in mice and humans

“…Numerous treatment strategies have been developed for chronic pain, including medications,19 massage,20 acupuncture,21 stretching,22 physical medicine,23 cognitive-behavioral therapy,24 and alternative therapies 25. In these treatments, especially, the mechanical stimulation (eg, thermal stimulation, pinch, or electrostimulation), which is contained in either the physical medicine or the alternative therapies, has already been reported to have an inhibitory effect on pain 26–28.…”