OBJECTIVE To assess the effectiveness of supervised exercise therapy compared with usual care with respect to recovery, pain, and function in patients with patellofemoral pain syndrome. DESIGN Open-tabel randomized controlled trial. Setting General practice and sports medicine practice. PARTICIPANTS Patients with a new episode of patellofemoral pain syndrome recruited by their general practitioner or sports physician. INTERVENTIONS The intervention group received a standardized exercise programme for 6 weeks tailored to individual performance and supervised by a physiotherapist, and were instructed ti practise the tailored exercises at home for 3 months. The control group were assigned usual care, which comprised a 'wait and see' approach of rest during periods of pain anc refraining from pain-provoking activities. Both groups of patients received written information about patellofemoral pain syndrome and general instructions for quadriceps exercises. MAIN OUTCOME MEASURES The primary outcomes were self-reported recovery (7-point Likert scale), pain during rest and activity (0 to 10 point numerical rating scale), and function (0 to 100 point Kujala patellofemoral score) after 3 months and 12 months of follow-up. RESULTS A total of 131 participants were included in the study: 65 in the intervention group and 66 in the control group. After 3 months, the intervention group showed better outcomes than the control group with regard to pain at rest (adjusted difference -1.07, 95% confidence interval -1.92 to -0.22; effect size 0.471, pain on activity -1.00, 95% CI -1.91 to -0.08; effect size 0.45), and function (4.92, 95% CI 0.14 to 9.72; effect size 0.34). At 12 months, the intervention group continued to show better outcomes than the control group with regard to pain (adjusted difference in pain at rest -1.29, 95% CI -2.16 to -0.42; effect size 0.56; pain on activity -1.19, 95% CI -2.22 to -0.16; effect size 0.54), but not function (4.52, 95% CI -0.73 to 9.76). A higher proportion of patients in the intervention group than in the control group reported recovery (41.9% versus 35.0% at 3 months and 62.1% versus 50.8% at 12 months), although the differences in self-reported recovery between the two groups were not statistically significant. Predefined subgroup analyses revealed that while patients recruited by sports physicians (n = 301 did not benefit from the intervention, those recruited by general practitioners (n = 101) did, showing significant and clinically relevant improvements in pain and function. CONCLUSION Supervised exercise therapy resulted in less pain and better function at short-term and long-term follow-up compared with usual care in patients with patellofemoral pain syndrome in general practice. Exercise therapy did not result in a significant difference in the rate of self-reported recovery.

There are no links to full text for this record.