Effectiveness of Exercise Therapy in Treatment of Patients With Patellofemoral Pain Syndrome: A Systematic Review and Meta-Analysis

Clijsen, Ron and Fuchs, Janine and Taeymans, Jan (2015) Effectiveness of Exercise Therapy in Treatment of Patients With Patellofemoral Pain Syndrome: A Systematic Review and Meta-Analysis. In: 20th anual congress of the european college of sport sciences, 24-27 June 2015, Malmö Sweden. (Submitted)

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Abstract

Introduction This systematic review and meta-analysis was accomplished to determine whether exercise therapy is an effective intervention to reduce pain and patient reported measures of activity limitations and participation restrictions (PRMALP) in patients with patellofemoral pain. Methods Randomized controlled trials in English and German language, published in Medline, PEDro and Cochrane databases were searched. Eligibility was assessed in two stages. The methodological quality of the studies was rated using the PEDro scale. Data were pooled using random-effects meta-analysis allowing for variability among studies. For clinical use, overall estimates were re-expressed in the original VAS scores. Significance was set at 5%. Results Fifteen studies with a total of 748 participants were included and pooled for a meta-analysis. Six studies compared the effect of exercise therapy with a control group neither receiving exercise therapy nor another intervention. Four studies compared the effect of exercise therapy versus additive therapy while five papers compared different exercise interventions. In both comparisons exercise therapy resulted in strong pain reduction and improvement of PRMALP effects. Significant short-term effects (≤12 weeks) of exercise therapy were found for pain and PRMALP while long-term effects (≥26 weeks) were observed for PRMALP only. Conclusion This meta-analysis presents evidence that exercise therapy has a strong pain reducing effect and decreases PRMALP in patients with patellofemoral pain. However, the question, which exercise modality yields the strongest reducing effect on pain and PRMALP, remains unrevealed. The 15 studies included in this analysis were of variable quality. Large, high quality RCTs are needed to further the evaluation of the possible effects of different exercise therapy modalities on patellofemoral pain. References Clijsen R, Fuchs J, Taeymans J. (2014), Phys Ther, Dec;94(12):1697-708. doi: 10.2522/ptj.20130310. Epub 2014 Jul 31. Contact ron.clijsen@supsi.ch

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