Core Training for Pain Management and Functional Improvement in Patients With Patellofemoral Pain Syndrome: A Systematic Review and Meta-analysis

Am J Phys Med Rehabil. 2024 Dec 1;103(12):1094-1103. doi: 10.1097/PHM.0000000000002513. Epub 2024 Apr 30.

Abstract

Objective: The aim of the study is to investigate the effects of core strengthening exercises on pain, mobility, and lower limb muscle strength in patients with patellofemoral pain syndrome.

Design: Six databases were searched from inception until August 11, 2023. Pain, function, and muscle strength-related outcomes were extracted and the quality of the studies was assessed using the PEDro scale and the level of evidence was assessed using the GRADE.

Results: Nineteen studies involving 1138 patients were included. Very low-grade evidence supported the short-term pain-relieving effect of core training (standardized mean difference = -0.60, 95% confidence interval [-0.95, -0.25]), high-grade evidence supported the short-term functional improvement effects of core training (weighted mean difference = 3.61, 95% confidence interval [1.44, 5.78]), which was similarly significant within 3-12 mos of follow-up. The results of the subgroup analyses suggested that hip-knee training was most advantageous in relieving pain and enhancing motor function.

Conclusions: Although training that includes trunk core is clearly superior to knee strengthening alone, the effectiveness of hip-knee training, which is also a core training program for pain and function, is more pronounced. The available evidence supports that hip-knee training is the most valuable treatment option for patients with patellofemoral pain syndrome.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Exercise Therapy / methods
  • Humans
  • Muscle Strength* / physiology
  • Pain Management* / methods
  • Patellofemoral Pain Syndrome* / physiopathology
  • Patellofemoral Pain Syndrome* / rehabilitation
  • Patellofemoral Pain Syndrome* / therapy
  • Resistance Training / methods