Cochrane · systematic review · CD010387
Exercise for treating patellofemoral pain syndrome
van der Heijden, RA, Lankhorst, NE, van Linschoten, R, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
31
No studies
11
Included studies
NR
No studies 11 · 26.2%Ungraded 0 · 0%Very low 31 · 73.8%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Exercise therapy compared with a control strategy (no treatment, placebo or waiting list controls) for patellofemoral pain syndrome
Population: patients with patellofemoral pain syndrome (symptoms > 3 weeks (1 study); symptoms > 1 month (3 studies); symptoms > 2 months (2 studies); symptoms > 3 months (2 studies; symptoms > 6 months (1 study). (Data from a study including participants with patella malalignment are not included here.)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain during activity (short‐term) Scale (0 to 10; higher scores mean worse pain) Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | no estimate extracted | 5 studies · 375 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (short‐term) Scale (0 to 10; higher scores mean worse pain) Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | no estimate extracted | 2 studies · 41 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pain during activity (long‐term) Scale (0 to 10; higher scores mean worse pain) Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | no estimate extracted | 2 studies · 180 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (long‐term) VAS (0 to 10; higher scores mean worse pain) Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | no estimate extracted | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Functional ability (short‐term) Scale (0 to 100; higher scores mean better function) Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | SMD 1.1 [0.58, 1.63] | 7 studies · 483 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Functional ability (long‐term) Scale (0 to 100; higher scores mean better function) Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | SMD 1.62 [0.31, 2.94] | 3 studies · 274 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Recovery (long‐term) Number of patients who had recovered or number of patients no longer troubled by symptoms Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls) | RR 1.35 [0.99, 1.84] | 2 studies · 166 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Supervised exercises compared with home exercises for patellofemoral pain syndrome
Population: patients with patellofemoral pain syndrome (symptoms > 2 months (1 study); not stated (1 study))
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain during activity (short‐term) Supervised exercises vs home exercises | no estimate extracted | NR | No studies |
Usual pain (short‐term) VAS (0 to 10; higher scores mean worse pain) Supervised exercises vs home exercises | no estimate extracted | 2 studies · 59 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pain during activity (long‐term) Supervised exercises vs home exercises | no estimate extracted | NR | No studies |
Usual pain (long‐term) VAS (0 to 10; higher scores mean worse pain) Supervised exercises vs home exercises | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional ability (short‐term) AKPS (0 to 100; higher scores mean better function) Supervised exercises vs home exercises | no estimate extracted | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional ability (long‐term) FIQ (number of patients in top (best function) category 13 to 16) Supervised exercises vs home exercises | RR 1.34 [0.89, 2.03] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Recovery (long‐term) Supervised exercises vs home exercises | no estimate extracted | NR | No studies |
Closed kinetic chain exercises compared with open kinetic chain exercises for patellofemoral pain syndrome
Population: patients with patellofemoral pain syndrome (symptoms > 4 weeks (1 study); symptoms > 6 weeks (1 study); symptoms > 8 weeks (1 study); not stated (1 study))
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain during activity (short‐term) VAS (0 to 10; higher scores mean worse pain) Closed kinetic chain exercises vs open kinetic chain exercises | MD 0.03 | 2 studies · 90 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (short‐term) VAS (0 to 10; higher scores mean worse pain) Closed kinetic chain exercises vs open kinetic chain exercises | MD 0.2 | 3 studies · 122 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pain during activity (long‐term) VAS (0 to 10; higher scores mean worse pain) Closed kinetic chain exercises vs open kinetic chain exercises | MD 2.1 [1.08, 3.12] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (long‐term) VAS (0 to 10; higher scores mean worse pain) Closed kinetic chain exercises vs open kinetic chain exercises | MD 0.8 [0.07, 1.53] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Functional ability (short‐term) AKPS (0 to 100; higher scores mean better function) Closed kinetic chain exercises vs open kinetic chain exercises | no estimate extracted | 2 studies · 90 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Functional ability (long‐term) AKPS (0 to 100; higher scores mean better function) Closed kinetic chain exercises vs open kinetic chain exercises | no estimate extracted | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Recovery (long‐term) Closed kinetic chain exercises vs open kinetic chain exercises | no estimate extracted | NR | No studies |
Target of exercise: hip + knee versus knee exercises for treating patellofemoral pain syndrome
Population: patients with patellofemoral pain syndrome (symptoms > 1 month (3 studies); symptoms > 2 months (1 study); symptoms > 3 months (2 studies); not stated (1 study))
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain during activity (short‐term) Scale (0 to 10; higher scores mean worse pain) Target of exercise: hip + knee vs knee exercises | no estimate extracted | 3 studies · 104 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (short‐term) VAS (0 to 10; higher scores mean worse pain) Target of exercise: hip + knee vs knee exercises | no estimate extracted | 2 studies · 46 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pain during activity (long‐term) NPRS (0 to 10; higher scores mean worse pain) Target of exercise: hip + knee vs knee exercises | no estimate extracted | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (long‐term) Target of exercise: hip + knee vs knee exercises | no estimate extracted | NR | No studies |
Functional ability (short‐term) Scale (0 to 100; higher scores mean better function) Target of exercise: hip + knee vs knee exercises | SMD 0.61 | 4 studies · 174 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Functional ability (long‐term) Scale (0 to 100; higher scores mean better function) Target of exercise: hip + knee vs knee exercises | SMD 1.49 | 2 studies · 78 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Recovery long‐term Number of patients at least moderately better Target of exercise: hip + knee vs knee exercises | RR 1.34 [0.93, 1.94] | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Target of exercise: hip versus knee exercises for treating patellofemoral pain syndrome
Population: patients with patellofemoral pain syndrome (symptoms > 1 month (1 study); symptoms > 6 months (1 study))
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain during activity (short‐term) VAS (0 to 10; higher scores mean worse pain) Target of exercise: hip vs knee exercises | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (short‐term) Target of exercise: hip vs knee exercises | no estimate extracted | NR | No studies |
Pain during activity (long‐term) VAS (0 to 10; higher scores mean worse pain) Target of exercise: hip vs knee exercises | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Usual pain (long‐term) Target of exercise: hip vs knee exercises | no estimate extracted | NR | No studies |
Functional ability (short‐term) Scale (0 to 100; higher scores mean better function) Target of exercise: hip vs knee exercises | SMD 0.85 [0.3, 1.4] | 2 studies · 58 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Functional ability (long‐term) WOMAC (0 to 96; inverted scores so that higher scores mean better function) Target of exercise: hip vs knee exercises | MD 16.22 [9.17, 23.27] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Recovery (long‐term) Target of exercise: hip vs knee exercises | no estimate extracted | NR | No studies |
High‐intensity versus low‐intensity exercise programmes for patellofemoral pain syndrome
Population: patients with patellofemoral pain syndrome (untreated PFPS of over 2 months in duration)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain during activity (short‐term) High‐intensity vs low‐intensity exercise programmes | no estimate extracted | NR | No studies |
Usual pain (short‐term) VAS (0 to 10; higher scores mean worse pain) High‐intensity vs low‐intensity exercise programmes | no estimate extracted | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Pain during activity long‐term High‐intensity vs low‐intensity exercise programmes | no estimate extracted | NR | No studies |
Usual pain (long‐term) VAS (0 to 10; higher scores mean worse pain) High‐intensity vs low‐intensity exercise programmes | no estimate extracted | 1 study · 28 participants | Very low Downgraded: risk of bias, imprecision |
Functional ability (short‐term) FIQ modified (0 to 16; higher scores mean better function) High‐intensity vs low‐intensity exercise programmes | MD 3.7 [1.59, 5.81] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Functional ability (long‐term) FIQ modified (0 to 16; higher scores mean better function) High‐intensity vs low‐intensity exercise programmes | MD 3.9 [1.72, 6.08] | 1 study · 28 participants | Very low Downgraded: risk of bias, imprecision |
Recovery (long‐term) High‐intensity vs low‐intensity exercise programmes | no estimate extracted | NR | No studies |