Effects of Physical Therapist Guided Quadriceps Strengthening Exercises for the Treatment of Patellofemoral Pain Syndrome

The objective of this study was to summarize the evidence for physical therapist guided quadriceps strengthening exercises as a treatment for patellofemoral pain syndrome (PFPS). Even though quadriceps strengthening is frequently included in the plan of care for PFPS, a systematic review published in 2003 determined that there was only limited evidence that exercise is more effective than no exercise for this common condition. Pubmed, Embase/Medline, and Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception to the 9th of January 2014 were searched for randomized controlled trials (RCTs) comparing the use of quadriceps strengthening exercises to interventions consisting of advice/information, or placebo. Outcomes of interest were pain measures and function as measured with self-report questionnaires. The methodological quality of the RCTs was assessed with the Physiotherapy Evidence Database (PEDro) scale. Results were summarized using a best evidence synthesis and graphically illustrated using forest plots without meta-analysis. Seven studies were included in the literature review. These studies suggested that there is strong evidence that isolated quadriceps strengthening is more effective in reducing pain and improving function than advice and information alone. In addition, compared to advice and information, or placebo, there is strong evidence that quadriceps strengthening exercises combined with other interventions, is more effective in reducing pain immediately post-intervention and at 12 months; however, not in improving function.

The literature provides strong evidence for the use of quadriceps strengthening exercises, with other interventions or alone, for the treatment of PFPS.