Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis

Abstract

Objective: Previous research suggests that muscle strength exercise is the most effective rehabilitation methods in patients with patellofemoral pain (PFP). This systematic review with meta-analysis compared the effects of Hip&Knee, Hip-only and Knee-only exercise programs on pain relief, muscle strength, and functional performance in patients with PFP. Methods: Literature searches of PubMed, PEDro and CINAHL databases revealed twentyone studies included in the final descriptive review, thirteen of which were included in the meta-analysis. Data extraction included baseline and post-intervention means and standard deviations of all eligible outcome measures both for the intervention and control groups, participants baseline demographics and intervention characteristics. Results: The results showed that Hip&Knee and Hip-only exercise programs were comparatively effective, while the Knee-only exercise programs proved to be inferior to the above-mentioned approaches. The Hip&Knee exercise programs showed the greatest pain relief (mean difference = −1.71 (−3.11, −0.30); p = 0.02; I 2 = 96%) and functional improvement (standardized mean difference = 1.28 (0.45, 2.12); p = 0.003; I 2 = 84%), although the subgroup analysis did not show any significant difference compared to Hip-only exercise programs (p > 0.05). Conclusion: Overall, Hip&Knee exercise programs appear to reduce pain and improve function more than other exercise programs and could be used as a primary rehabilitation approach in patients with PFP. However, the difference between the subgroups in most outcome measures suggests that Hip&Knee exercise programs are no more effective than Hip-only exercise programs.

Socratic Lectures 8

“…We used the updated PRISMA 27-item checklist to conduct the critical appraisal of the selected systematic review by Manojlović et al (2021). Since the updated PRISMA statement was published in the same year as the mentioned systematic review, the authors could not had followed the new guidelines.…”

“…Conclusions The systematic review by Manojlović et al (2021) adequately assessed the effectiveness of hip and/or knee exercise programs for pain relief and functional performance in PFP, however their conclusions on effectiveness for muscle strength were not based on sufficient discussion. The review was satisfactorily conducted according to the PRISMA checklist with few items not reported or reported insufficiently due to discrepancies between the former and updated PRISMA statement.…”

Critical Appraisal of a Systematic Review on Effectiveness of Trunk, Hip and Knee Exercise Programs in Patellofemoral Pain

“…The critical appraisal of a selected systematic review (Manojlović et al, 2021) was conducted according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Page et al, 2021) using the PRISMA 27-item checklist. We removed the section "abstract" from the checklist.…”

Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: A randomized controlled trial

“…To be included in the study, the patient should experience anterior/retro patellar knee pain during activities, with insidious onset of symptoms not linked to trauma, pain persisting for no less than 4 weeks, pain on patellar facets palpation, as well as pain upon descending a 25-cm step or while performing a double-legged squat. [15][16][17] Patients with recent lower limb fractures or dislocations, knee/hip joint surgery, signs, symptoms, or radiological findings of intra-articular pathologies, such as effusion, ligamentous or meniscal involvement, were excluded from the study. Those with indications of patellar apprehension, referred pain from the hip, back, or sacroiliac joint, acute knee strain or sprain, patients on medication such as NSAIDs or corticosteroids, and those with degenerative and infectious arthritis were also excluded.…”