Table 3.
Study characteristics.
| Author, Year | Participant Characteristics | Interventions/Number of Treatment Sessions | Outcome Measures | Main Findings (Pre vs. after the Treatment) | |||
|---|---|---|---|---|---|---|---|
| n | n F:M | Age (Years) | Diagnosis/Patient’s Condition | ||||
| Argut, S.K. 2021 [66] | IG = 21; CG = 21 | IG = 17:4; CG = 20:1 | IG = 69.3 ± 7.4; CG = 67.5 ± 5.01 | Total knee arthroplasty | IG: 1. Strengthening and stretching lower limb muscles and functional exercises (transfers, stair climbing); 2. Manual therapy including: patellofemoral and tibiofemoral joint glides, soft tissue mobilizations applied to the medial, lateral and posterior surfaces of the knee, and friction massages; CG: the same exercises as the IG (without manual therapy program); Number of treatment sessions: N/S |
NPRS | After the treatment: significant ↓ in pain in IG compared to CG (p = 0.001; d = 6.5); pre vs. after two weeks vs. after two months of the treatment: 8.5 ± 0.4 vs. 1.7 ± 0.2 vs. 0.1 ± 0.2 points; |
| ROM | Knee flexion after the treatment: significant ↑ in ROM in IG compared to CG (p = 0.001; d = 1.4); pre vs. after two weeks vs. after two months of the treatment: 105.2 ± 15.0 vs. 110.2 ± 7.8 vs. 118.5 ± 7.8 degrees; | ||||||
| WOMAC | After the treatment: significant ↓ in average WOMAC total score (pain, stiffness, function) in IG compared to CG (p = 0.006; d = 0.9); pre vs. after two weeks vs. after two months of the treatment: 76.6 ± 11.8 vs. 35.7 ± 12.9 vs. 13.9 ± 5.7 points; | ||||||
| SF-12 MCS | After the treatment: significant ↑ in the mean value of the total quality of life score in the IG compared to CG (p = 0.01; d = 1.1); pre vs. after two weeks vs. after two months of the treatment: 31.2 ± 8.8 vs. 34.7 ± 8.9 vs. 38.8 ± 7.8 points | ||||||
| Cruz-Montecinos, C. 2016 [67] | IG = 8; CG = 8 | IG = 8:0; CG = 8:0 | IG = 64.37 ± 2.9; CG = 61 ± 1.9 | Knee osteoarthritis | IG: soft tissue therapy including: muscular stretching of the psoas iliacus, hamstring, quadriceps, adductors, gastrocnemius and tensor fascia lata, joint mobilizations, and periarticular band tensing; CG: supine position, hands placed around the patella, without exerting pressure or moving the tissue; Single treatment session |
NPRS | After the treatment: significant ↓ in pain in IG compared to (p = 0.018); pre vs. after the treatment: 3.5 ± 0.7 vs. 0 ± 0.2 points; |
| EMG (sEMG) | After the treatment: significant ↓ in activity of the vastus lateralis muscle in IG compared to CG (p = 0.034); pre vs. after the treatment: 2195.14 ± 543.31 vs. 2041.49 ± 568.08; Co-contraction after the treatment: significant ↑ in co-contraction for the biceps femoris and the vastus lateralis muscle in the IG compared to CG (p = 0.014); pre vs. after the treatment: 21.38 ± 10.78 vs. 23.76 ± 11.54 V; |
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| WOMAC | After the treatment: a significant correlation between pain and change in co-contraction for the vastus lateralis muscle was noted in the IG (r = 0.804; p = 0.008); | ||||||
| Stair descent time cycle [s] | After the treatment: significant ↓ in stair descend time in IG compared to CG (p = 0.019); pre vs. after the treatment: 3.43 ± 0.72 vs. 3.04 ± 0.07 s | ||||||
| Goślińska, J. 2020 [68] | EG = 27; MG = 27; CG = 27 | N/S | EG = 65.0 ± 7.4; MG = 66.1 ± 4.7; CG = 63.0 ± 6.6 | Knee osteoarthritis | EG: synergy and balance exercises in a closed kinematic chain; MG: manual therapy including: patella mobilization and deep tissue massage; CG: no intervention (treatment); 10 treatment sessions per 10 days |
Joint position sense (Orthyo System) | After the treatment: significant ↑ in values regarding the end angle in the left knee flexion position in MG compared to the other study groups (p = 0.004); pre vs. after 10 sessions of the treatment: 67.0 ± 9.1 vs. 72.7 ± 9.5 degrees; |
| WOMAC | After the treatment: significant ↓ in average WOMAC total score (pain, stiffness, function) in EG and MG compared to CG (p < 0.05); pre vs. after 10 sessions of the treatment: 45.9 ± 13.7 vs. 39.7 ± 12.8 points for EG and 46.3 ± 19.0 vs. 40.1 ± 21.7 points for MG; there was no significant difference between EG and MG; | ||||||
| VAS | After the treatment: significant ↓ in pain in both lower limbs in EG and MG (p < 0.01); there was no significant difference in results between EG and MG | ||||||
| Telles, G. 2016 [69] | MG = 9; EG = 9 |
N/S | MG = 63.3 ± 12.1 EG = 61.8 ± 17.3; |
Patellofemoral pain syndrome | MG: 1. Exercises to strengthen hip muscles, home exercises; 2. Myofascial release applied to the rectus femoris and tensor fascia lata muscle, and iliotibial band; EG: the same exercises as the MG (without myofascial release); 10 treatment sessions per five weeks |
NPRS | After the treatment: significant ↓ in pain in MG compared to EG (p = 0.01; d = 0.35); pre vs. after the treatment: 6.5 ± 2.6 vs. 3.4 ± 2.8 points; |
| LEFS | After the treatment: significant ↑ in physical function score in MG compared to EG (p = 0.008; d = 0.30); pre vs. after the treatment: 45.3 ± 15.4 vs. 56.2 ± 14.3 points | ||||||
| Donoso-Ubeda, E. 2018 [70] | IG = 8;CG = 8 | N/S | IG = 39 ± 13.02; CG = 42.38 ± 14.15 |
Hemophilic arthropathy of the knee | IG: myofascial therapy including: superficial sliding anterior and posterior part of the leg combined with active flexion and extension movements of the foot, popliteal fascia, hands crossed technique applied to the anterior compartment of the knee, and degravitation and slight traction of the lower limb; CG: no intervention (treatment); Three treatment sessions per three weeks |
ROM | Knee flexion after the treatment: significant ↑ in ROM of both lower limbs in IG compared to CG (p < 0.05); pre vs. after the treatment: 107.00 ± 32.44 vs. 110.75 ± 33.83 degrees for the right knee, and 111.63 ± 29.17 vs. 117.25 ± 30.55 degrees for the left knee; Knee extension after the treatment: ignificant ↑ in ROM of the right lower limb in IG compared to CG (p = 0.041); pre vs. after the treatment: 5.0 ± 6.50 vs. 3.25 ± 6.04 degrees; |
| VAS | After the treatment: significant ↓ in pain of the right lower limb in IG compared to CG (p < 0.050); pre vs. after the treatment: 1.25 ± 1.28 vs. 0.75 ± 1.36 points | ||||||
| E Silva, D.C.C.M. 2018 [71] | 33 | 22:11 | 68.2 ± 7.85 | Total knee arthroplasty | Myofascial release including: gluteal fascia, posterior fascia lata, posterior crural fascia, and plantar fascia; Single treatment session |
ROM | Knee flexion after the treatment: significant ↑ in ROM (p = 0.01); pre vs. after the treatment: 54.7 vs. 60.4 degrees; |
| EMG (sEMG) | After the treatment: significant ↑ in activity of the biceps femoris (p = 0.037) and the rectus femoris muscle (p = 0.167); pre vs. after the treatment: 0.088 ± 0.066 vs. 0.101 ± 0.085 V for the biceps femoris, and 0.077 ± 0.052 vs. 0.083 ± 0.055 V for the rectus femoris muscle; | ||||||
| VAS | 22 study participants reported no pain before treatment; After the treatment: eight patients reported a 56.9% reduction in pain; two patients reported no change in pain; one patient reported an increase in pain |
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| Padrelli, A. 2009 [72] | 18 | 5:13 | 29.2 | Patellar tendinopathy | Fascial manipulation including CC points: AN-GE, ER-GE, IR-GE, LA-GE, ME-GE, and RE-GE; Single treatment session |
VAS | After the treatment: significant ↓ in pain (p < 0.001); pre vs. after the treatment: 67.8/100 vs. 25.6/100 points |
| Winslow, J. 2014 [73] | 4 | 4:0 | 27–43 | Lateral knee pain syndrome | Soft tissue mobilization technique including: anterior and posterior border of the iliotibial band, vastus lateralis, biceps femoris, distal end of the hamstring, and gastrocnemius; Three treatment sessions per week for three weeks |
KEA | After the treatment: ↑ in flexibility of the hamstring and iliotibial band; |
| LEFS | After the treatment: ↑ in physical function score; three athletes who were able to run without pain improved their overall performance by 9–19 points; | ||||||
| GRCS | After the treatment: ↑ in overall athlete score by three to five points (improved); | ||||||
| NPRS | After the treatment: ↓ in pain; two athletes reported no pain at all, one athlete rated his pain as 1/10 points; one subject experienced lateral knee pain after running 0.3 miles, which he rated as 9/10 points | ||||||
n—number of participants, f—females, m—males, EG—Exercise Group, IG—Intervention Group, MG—Manual Group, N/S—Not Stated, CC—Centre of Coordination, AN-GE—ante-genu, ER-GE—extra-genu, IR-GE—intra-genu, LA-GE—latero-genu, ME-GE—medio-genu, RE-GE—retro-genu, EMG—Electromyography, sEMG—surface Electromyography, GRCS—Global Rating of Change Scale, KEA—Knee Extension Angle, LEFS—Lower Extremity Functional Scale, NPRS—Numeric Pain Rating Scale, ROM—Range of Motion, SF-12 MCS—Short Form-12 Mental Components, VAS—Visual Analog Scale, WOMAC—Western Ontario and McMaster Universities Osteoarthritis Index, d—effect size, p—value, r—correlation coefficient, ↓—decrease, ↑—increase.