Background and Aims: Patellofemoral Pain Syndrome is a common chronic condition causing anterior knee pain, with a significant impact on daily activities and athletic performance. The intensity of symptoms increases during activities such as descending stairs and squatting. PFPS is particularly common among adolescents and women and constitutes a substantial share of knee pain patients in both primary care and sports clinic. The pathophysiology involves anatomical and biomechanical factors of the patellofemoral joint, including patellar maltracking, muscle weakness and knee valgus. The aim was to evaluate the effectiveness of quadriceps and/or hip muscle strengthening exercises in individuals with PFPS through a systematic review and meta-analysis. The findings aim to provide updated evidence to support individualised, evidence-based rehabilitation strategies, guide clinical decision-making, and inform future conservative treatment approaches. Methods: The present systematic review evaluated the effectiveness of muscle-strengthening therapies for patellofemoral pain syndrome (PFPS) based on a comprehensive search of electronic databases. Included were prospective trials focusing on strengthening of the quadriceps and/or hip muscles; studies targeting other muscle groups or with retrospective designs were excluded. Following a thorough screening process and a risk of bias assessment, a network meta-analysis was conducted to assess the efficacy of interventions on primary outcomes such as pain (VAS, NRS) and function (AKPS). Secondary outcomes, including functional ability, quality of life (as measured by KOOS-QoL and SF-36), and long-term effects on pain and mobility, were evaluated qualitatively. Results: All strengthening interventions, whether targeting the hip, quadriceps, or both, led to a statistically significant reduction in pain compared to control groups. The most substantial pain reduction was observed in combined hip and knee strengthening protocols. Regarding the Anterior Knee Pain Scale only the combined approach demonstrated a statistically significant improvement, isolated hip or quadriceps training did not reach significance despite observable trends. Conclusion: Targeted strengthening exercises have been shown to be an effective way to reduce pain in individuals with PFPS, with the most consistent benefits being seen when training both the hip and the quadriceps together. It was found that functional improvements were only significant when both muscle groups were addressed. These results support the integration of both proximal and local strengthening in PFPS rehabilitation. Future research should explore long-term adherence, gender-specific adaptations, and personalised exercise strategies.
Exercise induced Hypoalgesia: the effects of quadriceps and/or hip muscle training on patients with patellofemoral pain syndrome
Aichmann, E. (Autor/-in). 2025
Studienabschlussarbeit: Diplomarbeit