Effectiveness of different exercises and stretching physiotherapy on pain and movement in patellofemoral pain syndrome: a randomized controlled trial

Abstract

Objective: To compare the effectiveness of proprioceptive neuromuscular facilitation combined with exercise, classic stretching physiotherapy intervention, and educational intervention at improving patient function and pain in patients with patellofemoral pain syndrome. Design: Randomized, controlled, blind trial over four months. Setting: Urban population, Spain. Participants: Patients undergoing primary care for retropatellar pain. Intervention: Subjects were allocated on three different treatment options: a proprioceptive neuromuscular facilitation and aerobic exercise group, a classic stretching group, and a control treatment were applied over four months under the supervision of a physiotherapist. Main outcome: Knee Society Score, pain reported (Visual analogue scale) and knee range of motion. Assessments were completed at baseline and after four months. Results: 74 patients were enrolled in the study and distributed between groups. Both the proprioceptive neuromuscular facilitation and classic stretching group showed significant changes in all variables after four months intervention (p < 0.001). The difference in mean Kujala knee score changes between groups (classic stretching group vs. proprioceptive neuromuscular facilitation group vs. control group) at four months was −24.05 (95% confidence interval (CI) −30.19, −17.90), p ≤ 0.001; vs. −39.03 (95% confidence interval (CI) −42.5, −35.5), p ≤ 0.001; vs. −0.238 (95% confidence interval (CI) −1.2, 0.726), p = 0.621, respectively. Conclusions: A proprioceptive neuromuscular facilitation intervention protocol combined with aerobic exercise showed a better outcome than a classic stretching protocol after four months.