Supervised Exercise Therapy is Effective at Reducing Knee Pain

A study of 131 patients with severe knee pain has shown that supervised exercise therapy is more effective at reducing knee pain and improving function than usual care. General advice is to rest during periods of knee pain and to avoid pain provoking activities, which is considered usual care.

Patellofemoral pain syndrome is a condition in which knee pain occurs during or after exercise and is more likely to affect women than men. Patellofemoral pain syndrome is located at the front of the knee and symptoms usually start during adolescence when participation in sporting activities is high.

A recent study reported only limited evidence for the effectiveness of exercise therapy with respect to knee pain reduction, while there is conflicting evidence with respect to functional improvement.

Researchers investigated the effectiveness of supervised exercise therapy compared with usual care in 131 patients aged between 14 and 40 years with patellofemoral pain syndrome.

Of the 131 participants included in the study, 65 were assigned to a supervised exercise program (intervention group) and 66 to usual care (control group). Both groups received similar written information about the syndrome and similar instructions for home exercises, as well as advice to refrain from painful activities.

 

Patients rated their recovery, pain at rest, pain on activity, and function scores at the start of the study and again at three and 12 months.

After three months, the intervention group reported significantly less knee pain and better function than the control group. At 12 months, the intervention group continued to show better outcomes than the control group with regard to pain at rest and pain on activity, but not function.

A higher proportion of patients in the exercise group than in the control group reported recovery (42% v 35% at three months and 62% v 51% at 12 months), but these results were not significantly different between the two groups.

This study provides evidence that supervised exercise therapy for patellofemoral pain syndrome in general practice is more effective than usual care for pain at rest, pain on activity, and function at three and 12 months, say the authors. However, supervised exercise therapy had no effect on perceived recovery.
References:
1. R van Linschoten, et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. BMJ 2009;339:b4074.