EVIDENCE-BASED REHABILITATION APPROACHES FOR PATELLOFEMORAL PAIN SYNDROME: A SYSTEMATIC REVIEW

Abstract

Background

Patellofemoral Pain Syndrome (PFPS) is one of the most common musculoskeletal disorders affecting adolescents, physically active individuals, and athletes. It is characterized by anterior knee pain aggravated by activities such as running, stair climbing, squatting, and prolonged sitting. Despite the widespread use of rehabilitation interventions, uncertainty remains regarding the most effective evidence-based rehabilitation strategies for managing PFPS.

Objective

To systematically evaluate and synthesize evidence published between April, 2015 and April, 2025 regarding the effectiveness of rehabilitation interventions for Patellofemoral Pain Syndrome.

Methods

A systematic review was conducted according to PRISMA guidelines. Electronic databases including PubMed, Scopus, PEDro, Web of Science, and Google Scholar were searched for studies published between 2015 and 2025. Randomized controlled trials, clinical trials, cohort studies, and systematic reviews investigating rehabilitation interventions for PFPS were included. Methodological quality was assessed using the PEDro scale. Data were synthesized narratively due to heterogeneity in intervention protocols and outcome measures.

Results

A total of 34 studies involving more than 2,000 participants met the inclusion criteria. Combined hip and knee strengthening interventions demonstrated the most consistent evidence for reducing pain and improving functional performance. Neuromuscular training and gait retraining also showed favorable effects on movement quality, lower limb biomechanics, and functional outcomes. Patellar taping and foot orthoses provided moderate short-term symptomatic benefits when combined with exercise therapy. Passive modalities, including ultrasound and electrical stimulation, demonstrated limited evidence for sustained long-term effectiveness when used independently.

Conclusion

Exercise-based rehabilitation remains the most effective conservative management approach for PFPS. Multimodal rehabilitation programs integrating hip and knee strengthening, neuromuscular training, and movement retraining produce superior clinical outcomes compared to isolated interventions. Individualized rehabilitation strategies targeting biomechanical and functional impairments are recommended for optimal management of PFPS