Do exercises for patellofemoral pain reflect common injury mechanisms?: A systematic review

Steven Dischiavi, Alexis A. Wright, C M Bleakley

Research output: Contribution to journalArticle

Abstract

Objectives: Current best evidence has reported that therapeutic exercise programs that are
designed to treat patellofemoral pain (PFP) should include both hip and knee specific exercises.
The purpose of this review was to 1) examine the quality/comprehensiveness of exercise
reporting in this field; 2) quantify the extent to which individual exercises comprised task-specific
elements (single limb stance; eccentric control of the hip; rotational z-axis control) most likely to
address key pathomechanics associated with PFP.
Design: Systematic review: a systematic survey of RCTs
Methods: PubMed, CINAHL, Medline, Physiotherapy Evidence Database (PEDro) and SPORT
Discus databases were searched for randomized controlled trials that addressed PFP utilizing a
proximal control hip focused rehabilitation paradigm. The therapeutic exercise programs were
evaluated, and each individual exercise was extracted for analysis. Quality assessments included
the PEDro Scale and the Consensus on Exercise Reporting Template (CERT) was utilized to
score the reporting of the interventions.
Results: 19 studies were included in the final analysis. 178 total exercises were extracted from
the proximal hip and knee rehabilitation programs. The exercises were analyzed for the inclusion
of elements that align with reported underlying biomechanical mechanisms.
Conclusions: The vast majority of the exercises were sagittal plane, concentric, non-weight
bearing exercises, whereas multiplanar exercises, single limb weightbearing, and exercises where
loading was directed around the longitudinal z-axis, were considerably under-represented.
Current exercises for PFP utilize simplistic frameworks that lack progression into more task
specific exercise, and are not reflective of the complex injury etiology.
Original languageEnglish
JournalJournal of Science and Medicine in Sport
Publication statusAccepted/In press - 1 Sep 2020

Keywords

  • Exercise
  • Hip
  • Knee
  • Patellofemoral Pain
  • Proximal Muscle Rehabilitation
  • Sports

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