Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In this randomized controlled trial of patients with patellofemoral pain (PFP), home-based exercise resulted in less pain, better function, and higher knee muscle strength compared with no exercise.

Evidence Rating Level: 1 (Excellent)

PFP, a common knee disorder characterized by diffuse retropatellar pain, affects many aspects of daily life in both athletic and nonathletic populations. Exercise therapy, especially hip and knee-targeted programs, is beneficial in managing PFP. Home-based programs have gained significance, particularly during the COVID-19 pandemic. This randomized controlled trial conducted between March and October 2022 aims to evaluate the efficacy of a six-week home-based program’s impact on pain, knee function, and muscle strength in PFP patients. 38 patients with PFP were recruited and randomized in a 1:1 ratio to the intervention (home-based exercise with health education) or control group (included only patient health education but no exercise). At 6 weeks, the intervention group experienced significant improvements in pain intensities for worst pain and pain with activities of daily living (ADL) from baseline (% improvement 42% and 52%, respectively; P < 0.01), while the control group only showed significant improvement in worst pain (4%, P = 0.02). When comparing groups, delta analysis revealed significantly greater improvements in the intervention group for both measures (P < 0.01). With regards to the Anterior Knee Pain Scale (AKPS), a 13-item self-report questionnaire that assesses mobility capacity across six activities and related symptoms of PFP, there was a significant improvement in AKPS from baseline in the intervention group (15%, P < 0.01), while the control group showed no significant change. The between-group difference was statistically significant with a P-value of <0.01 favouring the intervention group. Over six weeks, the intervention group significantly improved knee extensor strength (11%, P < 0.01), while knee flexor strength showed no significant change (P = 0.68). The control group demonstrated no strength improvements. The intervention group demonstrated superior improvement in knee extensor strength (P < 0.01) compared to the control group, when comparing groups. Overall, these findings suggest that a six-week home-based exercise and health education program significantly improved pain intensity, function, and knee extensor strength compared with no exercise for patients with PFP.

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