There was no difference in the short-term effectiveness between patient education combined with either knee- or hip-focused exercise and free physical activity for patients with patellofemoral pain, according to recently published results.
“The limited effect size for the whole study population raises the question whether
the observed improvement represents a natural course of improvement or a regression to the mean,” the authors wrote. “We cannot draw conclusions about long-term effectiveness.”
They added, “Guided exercises improved muscle strength but did not translate to additional gains in other outcomes over the control group.”
In the single-blind, randomized controlled trial of 112 patients aged 16 to 40 years old who had a clinical diagnosis of patellofemoral pain and had symptoms for more than 3 months, investigators assigned 37 patients to a 6-week intervention with patient education combined with isolated hip-focused exercise; 39 patients to patient education combined with traditional knee-focused exercise; and 36 patients to patient education combined with free physical activity. The anterior knee pain scale score at 3 months was the primary outcome. Other outcomes included the visual analog scale score for pain, Tampa Scale for Kinesiophobia, knee self-efficacy scale, EuroQoL score and step-down and isometric strength.
At 3 months, the outcomes were not significantly different between the three treatment groups apart from hip abduction strength and knee extension strength. At 3 months, the between group differences for the anterior knee pain scale scores for knee vs. control, hip vs. control and hip vs. knee were 0.2, 1 and 0.8, respectively. Apart from the knee extension strength, all patients saw improvements in all outcomes. – by Monica Jaramillo
D isclosures: Hott reports research support from DePuy and Smith & Nephew. Please see the full study for a list of all other authors’ relevant financial disclosures.