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

Steven Dischiavi, Alexis A. Wright, Daniel T Tarara, C M Bleakley

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)
208 Downloads (Pure)


ObjectivesCurrent 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.

DesignSystematic review: a systematic survey of RCTs

MethodsPubMed, 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.

Results19 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.

ConclusionsThe 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
Pages (from-to)229-240
Number of pages12
JournalJournal of Science and Medicine in Sport
Issue number3
Early online date10 Sept 2020
Publication statusPublished (in print/issue) - 1 Mar 2021

Bibliographical note

Funding Information:
There has been no financial assistance with this review article.

Publisher Copyright:
© 2020 Sports Medicine Australia

Copyright 2021 Elsevier B.V., All rights reserved.


  • Exercise
  • Hip
  • Knee
  • Patellofemoral Pain
  • Proximal Muscle Rehabilitation
  • Sports
  • Patellofemoral pain
  • Proximal muscle rehabilitation


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