Table 1.
Clinical exercise trials for patellofemoral pain syndrome (PFPS) using elastic resistance.a
| Study: Design and Sample | Intervention /Elastic Exercises | Outcomes | Implications |
|---|---|---|---|
| Bily et al3 | |||
| Randomized, quasi control, prospective; n = 38, bilateral PFPS | 3 months, 2 groups Group 1: Supervised physical therapy (Thomee20 protocol) Group 2: Supervised physical therapy + electrical stimulation Both groups performed 4 direction kicks with tubing. Specified elastic resistance intensity and progression |
↓ Pain,* both groups ↑ Functional score,* both groups Strength, no significant difference, both groups No significant difference between groups |
Supervised physical therapy including elastic resistance effective at reducing pain and improving function without increasing strength; electrical stimulation provides no additional benefit |
| Doucette and Goble7 | |||
| Pretest/posttest, retrospective; n = 28, lateral patellar compression syndrome | Avg: 8-week treatment Individualized, not standardized Tubing exercises included seated leg press, single and double dips, resisted walking, knee flexion/extension. No specific prescription or progression of elastic exercises |
84% pain-free | Individualized physical therapy program including elastic resistance eliminated pain in 84% of PFPS patients; cause and effect cannot be established because of design |
| Eng et al8 | |||
| Randomized, quasi control, prospective; n = 20 young females, PFPS and poor foot biomechanics | 8 weeks, 2 groups Group 1: Exercise Group 2: Exercise + orthotics Both groups progressed to straight leg raise exercise with weights or elastic looped around ankles; no specific prescription or progression of elastic exercises |
↓ Pain* both groups Exercise + orthotics = significantly more improvement |
Exercise including elastic resistance significantly decreased pain in young females with PFPS; when elastic resistance is combined with orthotics, the reduction is significantly greater |
| Harrison et al9 | |||
| Randomized, quasi control, prospective; n = 113, PFPS | 1 month, 3 groups Group 1: Home exercise program Group 2: Exercise + manual therapy Group 3: Exercise + taping and biofeedback All groups suggested to use tubing hip adduction exercise; no specific prescription or progression of elastic exercises |
↓ Pain,* all groups at 12 months ↑ Clinical score,* all groups at 12 months ↑ Function,* all groups at 12 months Taping and biofeedback more effective than exercise and manual therapy at 1 month |
Home exercise including elastic resistance exercise effective at reducing pain and improving function over long term; short-term relief better when exercise combined with patellar taping and biofeedback |
| Kettunen et al11 | |||
| Randomized, quasi control, prospective; n = 56, chronic PFPS | 8 weeks, 2 groups Group 1: Home exercise program Group 2: Home exercise program + arthroscopic surgery Both groups performed elastic band kicks, leg pulls, and terminal knee extension; no specific prescription or progression of elastic resistance intensity levels (only repetitions are provided) |
↓ Pain,* both groups ↑ Functional score,* both groups ↑ Cost,* surgical group |
Home exercise program including elastic resistance exercise is effective at reducing pain and improving outcomes in PFPS; arthroscopic surgery provides no additional benefit and significantly increases health care costs compared with a home exercise program alone |
| Loudon et al13 | |||
| Quasi randomized, pretest/posttest, controlled, prospective; n = 29, PFPS | 8 weeks, 3 groups Group 1: Home exercise program Group 2: physical therapy clinic exercise Group 3: Control Both exercise groups performed elastic knee curls; no specific prescription or progression of elastic resistance intensity levels (only repetitions are provided) |
↓ Pain,* both exercise groups ↑ Strength* and functional score,* both exercise groups ↓ Pain* in physical therapy group compared to home exercise group |
Both home exercise and supervised physical therapy exercises including elastic resistance decrease pain and improve function and strength |
| Nakagawa et al15 | |||
| Randomized, quasi control, prospective; n = 14, PFPS | 6 weeks, 2 groups, home exercise program Group 1: Quad exercises Group 2: Quad + hip exercises Group 2 included hip rotation, trunk stabilization, and lunges with elastic resistance |
↓ Pain,* group 2 ↑ Muscle activation,* group 2 ↑ Knee strength,* both exercise groups Hip strength, no significant difference, both groups |
Additional hip exercises including elastic resistance are more effective at reducing pain in PFPS compared with knee exercise alone, without an increase in hip strength; however, sample size was small |
| Thomee20 | |||
| Randomized, prospective, no control; n = 40 females, PFPS | 12 weeks Group 1: Isometric exercise (elastic) Group 2: Eccentric exercise Isometric group performed 4-direction elastic band kicks on both legs. Specified elastic resistance intensity and progression |
85% pain-free across all participants ↓ Pain,* both groups ↑ Strength,* both groups |
Both eccentric and isometric exercise including elastic resistance reduced pain and improved strength in females with PFPS; however, cause and effect cannot be established, because no control group was included |
*
Statistically significant.