Effects of proprioceptive exercises and strengthening on pain and functionality for patellofemoral pain syndrome in women: A randomized controlled trial

Abstract

Objective: The objective of this study was to verify the effects of resisted and proprioceptive exercises program for the treatment of patients diagnosed with patellofemoral pain syndrome (PFPS). Design method: Randomized Controlled Trial e level of evidence, II. Methods: Sixty female patients, clinically diagnosed with PFPS, were allocated into two experimental groups. The exercise group (ExG) underwent 6 weeks of a resisted and proprioceptive exercises for the trunk muscles, abductors and lateral hip rotators and knee extensors. The Guidance Group (GG) received educational, cognitive and behavioral guidance on healthcare. Before and after the program implementation period, all participants were evaluated in relation to the injured limb for pain assessment, subjective functionality, maximum isometric strength and 2D biomechanical analysis. Results: After a six-week follow-up, ExG showed significant improvement in the Numerical Pain Rating Scale, Anterior Knee Pain Scale and Knee Outcome Survey-Activities of Daily Living Scale when compared to the control group (p 0,05). The ExG also proved superior for increased muscle strength of knee extensors, hip abductors, decreased dynamic knee valgus and pelvic drop in relation to GG (p 0.05). However, when we consider the strength of the hip lateral rotator muscles there was no difference between the two interventions (p > 0.05). Conclusion:Resisted and proprioceptive exercises yielded superior results to those of a treatment focused on educational, cognitive and behavioral guidance in improving pain and lower limb function for women with PFPS.

Is Postural Control Affected in People with Patellofemoral Pain and Should it be Part of Rehabilitation? A Systematic Review with Meta-analysis

“… Risk of bias: The mean PEDro score was 3.6 (1.8), with 50% presenting low RoB ( n = 7), 14% moderate RoB ( n = 2), and 36% presenting high RoB ( n = 5) (Additional file 6 ). Pain data (14 studies [ 28 , 31 , 32 , 61 , 107 , 113 , 114 , 122 – 128 ] ): low-level evidence indicated that balance interventions were largely effective to improve pain compared to non-balance interventions (SMD 0.82, 95% CI 0.30–1.33, Fig. 15 and Table 3 ).…”

“…The Egger’s test was not significant for publication bias ( p = 0.054); however, as we found a marginal p value, we performed the sensitivity analyses which showed different results. Trim-and-fill analysis indicated that balance interventions have no effect on pain (low-level evidence, SMD 0.38, 95% CI − 0.28–1.03; Table 3 ) and the analysis by removing the outliers [ 61 , 125 , 128 ] indicated that balance interventions have a small effect in improving pain in people with PFP compared to non-balance interventions (low-level evidence, SMD 0.40, 95% CI 0.04–0.76; Table 3 ) (Additional file 3 ). Subgroup and meta-regression analyses did not indicate possible sources of heterogeneity (Additional file 7 ).…”

“…Subgroup and meta-regression analyses did not indicate possible sources of heterogeneity (Additional file 7 ). Function data : considering patient-reported outcome measures (10 studies [ 28 , 31 , 32 , 61 , 113 , 122 – 124 , 126 , 127 ]), moderate level evidence indicated that balance interventions have a small effect in improving function compared to non-balance interventions (SMD 0.45, 95% CI 0.13–0.78, Fig. 16 and Table 3 ).…”

“…The data from two studies [ 57 , 58 ] were extracted from graphs using the web-based programme WebPlotDigitizer [ 59 , 60 ], as the respective authors did not respond to our request. Two studies presented the data on central tendency as median [ 61 , 62 ] and one study presented the dispersion as quartiles [ 62 ]. For these cases, mean and standard deviation were estimated using the Box-Cox method [ 63 ].…”

Análise da síndrome da dor patelofemoral em indivíduos do sexo feminino praticantes de crossfit: estudo transversal

“…A SDPF é caracterizada por uma dor na região anterior do joelho, da região retropatelar ou peripatelar. Tendo como consequência crepito, instabilidade da marcha e dores na articulação do joelho, dificultando ações como a flexão, agachamento, subir e descer escadas e após longos períodos de repouso (Clifford, et al, 2022;Silva, et al, 2021;Ferreira, et al, 2020).…”