Home-based exercise program effective for improving outcomes in patients with patellofemoral pain

1. In this randomized controlled trial of patients with patellofemoral pain (PFP), home-based exercise resulted in less pain, better function, and higher knee muscle strength compared with no exercise. 

Evidence Rating Level: 1 (Excellent)

PFP, a common knee disorder characterized by diffuse retropatellar pain, affects many aspects of daily life in both athletic and nonathletic populations. Exercise therapy, especially hip and knee-targeted programs, is beneficial in managing PFP. Home-based programs have gained significance, particularly during the COVID-19 pandemic. This randomized controlled trial conducted between March and October 2022 aims to evaluate the efficacy of a six-week home-based program’s impact on pain, knee function, and muscle strength in PFP patients. 38 patients with PFP were recruited and randomized in a 1:1 ratio to the intervention (home-based exercise with health education) or control group (included only patient health education but no exercise). At 6 weeks, the intervention group experienced significant improvements in pain intensities for worst pain and pain with activities of daily living (ADL)  from baseline (% improvement 42%  and 52%, respectively; P < 0.01), while the control group only showed significant improvement in worst pain (4%, P = 0.02). When comparing groups, delta analysis revealed significantly greater improvements in the intervention group for both measures (P < 0.01). With regards to the Anterior Knee Pain Scale (AKPS), a 13-item self-report questionnaire that assesses mobility capacity across six activities and related symptoms of PFP, there was a significant improvement in AKPS from baseline in the intervention group  (15%, P < 0.01), while the control group showed no significant change. The between-group difference was statistically significant with a P-value of <0.01 favouring the intervention group. Over six weeks, the intervention group significantly improved knee extensor strength (11%, P < 0.01), while knee flexor strength showed no significant change (P = 0.68). The control group demonstrated no strength improvements. The intervention group demonstrated superior improvement in knee extensor strength (P < 0.01) compared to the control group, when comparing groups. Overall, these findings suggest that a six-week home-based exercise and health education program significantly improved pain intensity, function, and knee extensor strength compared with no exercise for patients with PFP.

Click to read the study in BMC Musculoskeletal Disorders

Image: PD

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