OBJECTIVE: Previous research suggests that muscle strength exercise is the most effective rehabilitation methods in patients with patellofemoral pain (PFP). This systematic review with meta-analysis compared the effects of hip and knee, hip-only and knee-only exercise programs on pain relief, muscle strength, and functional performance in patients with PFP. METHOD(S): Literature searches of PubMed, PEDro and CINAHL databases revealed twenty-one studies included in the final descriptive review, thirteen of which were included in the meta-analysis. Data extraction included baseline and post-intervention means and standard deviations of all eligible outcome measures both for the intervention and control groups, participants baseline demographics and intervention characteristics. RESULT(S): The results showed that hip and knee and hip-only exercise programs were comparatively effective, while the knee-only exercise programs proved to be inferior to the above-mentioned approaches. The hip and knee exercise programs showed the greatest pain relief (mean difference -1.71 (-3.11 to -0.30); p = 0.02; I2 = 96%) and functional improvement (standardized mean difference 1.28 (0.45 to 2.12); p = 0.003; I2 = 84%), although the subgroup analysis did not show any significant difference compared to Hip-only exercise programs (p > 0.05). CONCLUSION(S): Overall, hip and knee exercise programs appear to reduce pain and improve function more than other exercise programs and could be used as a primary rehabilitation approach in patients with PFP. However, the difference between the subgroups in most outcome measures suggests that hip and knee exercise programs are no more effective than hip-only exercise programs.

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