Anterior Knee Pain: A Clinical Comparison of Rehabilitation Methods

Roush, M. B.; Sevier, Thomas L.; Wilson, Julie K.; Jenkinson, D. McEwan; Helfst, Robert H.; Gehlsen, Gale M.; Basey, Adriana L.

doi:10.1097/00042752-200001000-00005

Cited by 40 publications

(32 citation statements)

References 23 publications

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“…Several trials 8,15,20,52 have investigated the use of a combined treatment approach in the management of PFPS. Except for 1 trial, 15 each demonstrated a relatively short-term treatment effect in improving pain and function 20,52 or the rate of discharge from physical therapy based on patient satisfaction.…”

Section: Combined Treatmentsmentioning

confidence: 99%

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Systematic Review of the Quality of Randomized Controlled Trials for Patellofemoral Pain Syndrome

Bizzini¹,

Childs²,

Piva³

et al. 2003

J Orthop Sports Phys Ther

127

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4Study Design: Systematic review of the literature. Objectives: To develop a grading scale to judge the quality of randomized clinical trials (RCTs) and conduct a systematic review of the published RCTs that assess nonoperative treatments for patellofemoral pain syndrome (PFPS). Background: Systematic reviews of the quality and usefulness of clinical trials allow for efficient synthesis and dissemination of the literature, which should facilitate clinicians' efforts to incorporate principles of evidence-based practice in the clinical decision-making process. Methods and Measures: Using a scale based on criteria in the Cochrane Collaboration Handbook, we sought to critically appraise the methodology used in RCTs related to the nonoperative management of PFPS, synthesize and interpret our results, and report our findings in a user-friendly fashion. A scale to assess the methodological quality of trials was designed and pilot tested for its content and reliability. Published RCTs identified during a literature search were then selected and rated by 6 raters. We used predefined cutoff scores to identify specific weaknesses in the clinical research process that need to be improved in future clinical trials.Results: The quality scale we developed was demonstrated to be sufficiently reliable to warrant interpretation of the reviewers' findings. The percentage of trials that met a minimum level of quality for each specific criterion ranged from a low of 25% for the adequacy of the description of the randomization procedure to a high of 95% for the description and standardization of the intervention. Conclusions: Based on the results of trials exhibiting a sufficient level of quality, treatments that were effective in decreasing pain and improving function in patients with PFPS were acupuncture, quadriceps strengthening, the use of a resistive brace, and the combination of exercises with patellar taping and biofeedback. The use of soft foot orthotics in patients with excessive foot pronation appeared useful in decreasing pain. In addition, at a short-term follow-up, patients who received exercise programs were discharged earlier from physical therapy. Unfortunately, most RCTs reviewed contained qualitative flaws that bring the validity of the results into question, thus diminishing the ability to generalize the results to clinical practice. These flaws were primarily in the areas of randomization procedures, duration of follow-up, control of cointerventions, assurance of blinding, accountability and proper analysis of dropouts, number of subjects, and the relevance of outcomes. Also, given the limited number of high-quality clinical trials, recommendations about supporting or refuting specific treatment approaches may be premature and can only be made with caution.

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Section: Combined Treatmentsmentioning

confidence: 99%

“…Except for 1 trial, 15 each demonstrated a relatively short-term treatment effect in improving pain and function 20,52 or the rate of discharge from physical therapy based on patient satisfaction. 8 Two of the 4 trials 8,20 also had quality scores that exceeded 70 points (Table 5).…”

Section: Combined Treatmentsmentioning

confidence: 99%

Systematic Review of the Quality of Randomized Controlled Trials for Patellofemoral Pain Syndrome

Bizzini¹,

Childs²,

Piva³

et al. 2003

J Orthop Sports Phys Ther

127

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“…In the literature, researchers demonstrated that patients with PFPS can benefit from isometric quadriceps exercises and straight leg raise exercises (31,32). Roush et al investigated the effects of the modified straight leg raises exercises (called the 'Muncie method') for patients with PFPS (32).…”

Section: Open Kinetic Chain Exercisementioning

confidence: 99%

“…Roush et al investigated the effects of the modified straight leg raises exercises (called the 'Muncie method') for patients with PFPS (32). The authors evaluated pain, functional level and isokinetic strength of the quadriceps muscle at the beginning and end of the treatment (32). They noticed that patients who performed the quadriceps-strengthening home exercises programme and modified straight leg raises exercises reported significantly improvements regarding pain and functional level (32).…”

Section: Open Kinetic Chain Exercisementioning

confidence: 99%

“…The authors evaluated pain, functional level and isokinetic strength of the quadriceps muscle at the beginning and end of the treatment (32). They noticed that patients who performed the quadriceps-strengthening home exercises programme and modified straight leg raises exercises reported significantly improvements regarding pain and functional level (32). These results showed that patients with patellofemoral pain syndrome can benefit from isometric quadriceps-strengthening and straight leg raises exercises.…”

Section: Open Kinetic Chain Exercisementioning

confidence: 99%

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How Can We Strengthen the Quadriceps Femoris in Patients with Patellofemoral Pain Syndrome?

2011

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SummaryPurpose: the aim of this article was to review the clinical approach of quadriceps strengthening programmes. Methods: a literature search was carried out from 1980 up to September 2011. Eligible studies were those that: (1) evaluated the patients with patellofemoral pain syndrome (not healthy or asymptomatic subjects) (2) examined the effect of kinetic chain exercises (3) examined the effect of weight-bearing exercises (4) compared the effect of the combined exercises programme in the treatment of patients with patellofemoral pain syndrome. Results and conclusion: patients with patellofemoral pain syndrome may tolerate a closed kinetic chain exercises programme better than open kinetic chain. Weight-bearing and non-weight-bearing quadriceps exercises can significantly improve subjective and clinical outcomes in patients with patellofemoral pain syndrome. Combining treatments as an initial approach to treating patellofemoral pain but developing individualized more functional, global treatments are essential.

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