Treatment Success of Combined Intervention with Exercise, Foot Orthoses, and Patellar Taping in Individuals with Patellofemoral Pain Syndrome: Development of Clinical Prediction Rules

Objectives: The effective management of patellofemoral pain syndrome (PFPS) remains a significant clinical challenge. While various interventions demonstrate short-term efficacy, long-term outcomes are often suboptimal, potentially due to insufficient understanding of the patient characteristics that predict treatment success. This study aimed to identify clinical predictors of successful outcomes following a six-week combined intervention, consisting of exercise therapy, patellar taping, and prefabricated orthoses, in individuals with PFPS. Methods: Fifty patients (۳۰ females, ۲۰ males; mean age, ۲۹.۴ years) diagnosed with PFPS were assessed for demographic, pain-related, biomechanical, and functional variables. Treatment success was defined as a ≥۲-point reduction in the Visual Analog Scale (VAS) score for pain during daily activities and a ≥۸-point increase in the Anterior Knee Pain Scale (AKPS) score postintervention. Results: Logistic regression analysis identified several significant predictors of treatment success. A higher body mass index (BMI) and greater maximum pain intensity at baseline were associated with a lower probability of a successful outcome (OR = ۰.۴۲۷, p = ۰.۰۴۳; OR = ۰.۳۱۷, p = ۰.۰۲۷, respectively). Conversely, higher baseline Anterior Knee Pain Scale (AKPS) scores (indicating better function), as well as greater isometric hip internal rotator strength, hip extensor strength, hip abductor strength, and hip external rotator strength, were positively associated with treatment success (ORs ranging from ۲.۵۸۳ to ۳.۸۵۸, all p < ۰.۰۵). Furthermore, hamstring shortness negatively impacted treatment outcomes (OR = ۰.۴۹۷, p = ۰.۰۳۴). Conclusion: The study findings suggest that a combination of anthropometric measures, pain and functional status, hip muscle strength, and hamstring length can serve as valuable clinical predictors for identifying individuals with PFPS who are more likely to benefit from a combined physiotherapy approach. These identified predictors may assist clinicians in tailoring treatment strategies and improving long-term outcomes for this challenging patient population. Level of evidence: III

کلیدواژه ها:

knee pain ، Physical exam ، prediction factor ، Treatment