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Is multi-joint or single joint strengthening more effective in reducing pain and improving function in women with patellofemoral pain syndrome? A systematic review and meta-analysis
Scali K, Roberts J, McFarland M, Marino K, Murray L
International Journal of Sports Physical Therapy 2018 Jun;13(3):321-334
systematic review

BACKGROUND: Patellofemoral pain syndrome is one of the most common causes of knee pain, especially in the female population. Conflicting evidence exists on whether a multi-joint strengthening program produces a greater outcome when compared to a single joint approach. PURPOSE: The aim of this systematic review and meta-analysis was to investigate the effectiveness of a multi-joint strengthening program compared to a traditional single joint strengthening program in reducing pain and improving function in females diagnosed with patellofemoral pain syndrome. STUDY DESIGN: Systematic Review and Meta-Analysis. METHODS: A computer-based search (population: women with patellofemoral pain syndrome, intervention: multi-joint strengthening exercises, comparator: single joint strengthening exercises, outcome: pain and function) was performed. Databases including PubMed, CINAHL, SPORTDiscus, Cochrane, PEDro, and Scopus were searched up to May 23, 2017 for randomized clinical trials published since 2004. A hand search of relevant articles and exploration of Grey Literature (including ClinicalTrials.gov, Grey Literature Report, and Open Grey) was also completed. Data was extracted for the following information: exercises prescribed, outcome measures, and overall results from the study. RESULTS: Five studies, each of high quality based on the PEDro scale, met the inclusion criteria for this systematic review and meta-analysis. Statistically different outcomes were found that favored the multi-joint intervention group for short-term and long-term self-reported pain and functional pain, short-term functional performance, and long-term self-reported function. CONCLUSION: The results of this review show that statistically significant data are available that favor implementing a multi-joint exercise program in comparison to a single joint program for the reduction of pain in females with patellofemoral pain syndrome. Limited statistical evidence, however, is available to support a multi-joint program over a single joint program in the improvement of short-term functional performance and long-term self-reported function in females with patellofemoral pain syndrome. LEVEL OF EVIDENCE: 1a.

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