BACKGROUND AND PURPOSE: This systematic review and meta-analysis was accomplished to determine whether exercise therapy is an effective intervention to reduce pain and patient-reported measures of activity limitations and participation restrictions (PRMALP) in patients with patellofemoral pain. DATA SOURCES AND STUDY SELECTION: Randomized controlled trials in English and German languages published in the Medline, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform, and Cochrane databases were searched. Eligibility was assessed in 2 stages. The methodological quality of the studies was rated using the PEDro scale. Data were pooled using random-effects meta-analysis, allowing for variability among studies. For clinical use, overall estimates were re-expressed in the original visual analog scale scores. Significance was set at 5%. DATA EXTRACTION AND DATA SYNTHESIS: Fifteen studies, with a total of 748 participants, were included and pooled for the meta-analysis. Six studies compared the effect of exercise therapy with a control group receiving neither exercise therapy nor another intervention. Four studies compared the effect of exercise therapy versus additive therapy, and 5 studies compared different exercise interventions. In both comparisons, exercise therapy resulted in strong pain reduction and improvement of PRMALP effects. Significant short-term effects (<= 12 weeks) of exercise therapy were found for pain and PRMALP, whereas long-term effects (>= 26 weeks) were observed for PRMALP only. LIMITATIONS AND CONCLUSION: The 15 studies included in this analysis were of variable quality. Large-scale, high-quality randomized controlled trials are needed to further the evaluation of the possible effects of different exercise therapy modalities on patellofemoral pain. This meta-analysis presents evidence that exercise therapy has a strong pain-reducing effect and decreases PRMALP in patients with patellofemoral pain. However, the question of which exercise modality yields the strongest reducing effect on pain and PRMALP remains unanswered.

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