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McConnell-therapie versus Coumans-bandage bij patellofemorale pijnklachten [Dutch]
Wijnen LCAM, Lenssen AF, Kuys-Wouters YMS, de Bie RA, Borghouts JAJ, Bulstra SK
Nederlands Tijdschrift voor Fysiotherapie [Dutch Journal of Physical Therapy] 1996 Sep;106(Suppl):12-17
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

AIM: To study the effectiveness of two conservative treatments, McConnell therapy and Coumans bandage, for patellofemoral pain. SUBJECTS: 18 patients (5 men, 13 women), aged 16 to 37 years, who attended the outpatient department between March 1994 and April 1995 for knee pain. The subjects had a mean-pain duration of 32 months. SETTING: Orthopaedic outpatient department, University Hospital Maastricht. STUDY DESIGN: Prospective, randomised partial blinded pilot study. METHODS: Subjects were randomised assigned to one of two groups. The intervention group received 6 weeks physical therapy (2' week) consisting of the McConnell programme. The control group received a 6-week bandage treatment with a modified Coumans bandage, which was changed every 2 weeks. Effectiveness was assessed by scoring ADL function (Kujala and Ranawat scores), pain ascending and descending stairs, pain after prolonged sitting, pain while squatting, isokinetic muscle strength for flexion and extension of the knee, and satisfaction with the treatment and its results. Scoring was done before treatment started within 3 days after completion of treatment. RESULTS: The Kujala and Ranawat scores of both groups improved after treatment, with the increase being higher in the intervention group (McConnell therapy). Scores for pain provoking activities were lower after both treatments, with the intervention group again showing greater improvement. There were no differences between the two groups with respect to the increase in isokinetic muscle strength seen after treatment. Subjects in the intervention group (McConnell therapy) were more satisfied (p <_ 0.05) with their treatment and results than were the subjects in the control group (Coumans bandage). CONCLUSION: McConnell therapy seems to result in improved functioning, lessening of pain complaints, and greater satisfaction about treatment, and would thus seem to be the preferred treatment for patellofemoral pain.

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