"For patients with patellofemoral pain syndrome, exercise supervised by a physical therapist was more effective for pain and function than the traditional treatment of rest and avoidance of stress on the knee, a randomized Dutch study found.
But over the long run, patients perceived no difference between the two approaches.
After three months, the exercise group had an adjusted difference in pain at rest of −1.07 (95% CI −1.92 to −0.22, P=0.01, effect size 0.47) compared with controls, according to Robbart van Linschoten, MD, of Erasmus University Medical Center in Rotterdam, and colleagues.
Pain on activity also improved after three months, with an adjusted difference of −1 (95% CI −1.91 to −0.08, P=0.03, effect size 0.45) as did function, with an adjusted difference of 4.92 (95% CI 0.14 to 9.72, effect size 0.34), the researchers reported online in the British Medical Journal.
However, there were no statistically significant differences between the exercise and control groups on patients' self-perceived recovery after either three or 12 months.
There is no agreement on either the etiology or treatment of patellofemoral pain syndrome -- pain around the knee during or after high loaded flexion and extension of the joint -- but a "wait and see" approach involving rest and avoidance of provoking activity is advised in Dutch national guidelines and is considered usual care."