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To assess the effectiveness of manual therapy (MT) alone or as an adjunct therapy as compared to the sham or standard treatment to improve self-report function and reduce pain among the persons with patellofemoral pain (PFP).
Patellofemoral pain
(PFP) is one of the most severe conditions involving the lower extremity
characterized by peripatellar knee pain. The number of systemic reviews
recommended the manual physical therapy (MT) to address the multiple
impairments of the lower extremity, but the evidence is needed to determine the
role MT can play in the rehabilitation of individuals with PFP. Therefore, the
present review showed that MT might be helpful short-term for decreasing pain
in patients with PFP.
To assess the effectiveness of manual therapy (MT) alone
or as an adjunct therapy as compared to the sham or standard treatment to
improve self-report function and reduce pain among the persons with
patellofemoral pain (PFP).
CENTRAL,
PubMed, CINAHL, and OVID databases were searched electronically
to collect the studies which involved the comparison of MT provision either in combination or alone with
sham or control therapies through August 2017. Data associated with patient
self-reported outcomes and pain were gathered and synthesized. Cochrane
risk-of-bias tool was applied to evaluate the trials, and then a meta-analysis
of the evidence conducted.
A total of nine studies were selected out of which five
found with the low risk of bias. As compared to control or sham, the MT
implemented to the local knee structure was related to desirable short-term
changes in self-reported pain and function among PFP individuals. However, the
changes related to pain were found to be clinically significant. On the basis
of three studies, the evidence was inconclusive for lumbopelvic manipulation
regarding reduction in pain among the PFP patients.
The MT is helpful in reducing short-term pain among the
PFP patients. Various studies incorporated MT into a comprehensive treatment
program. Significant changes in self-reported function with the inclusion of
manual therapy were noticed. However, it is not clinically significant. More
studies are demanded to estimate the suitable approaches and doses of MT and
direct longer follow-up to observe long-term effects.
J Orthop Sports Phys Ther. 2018 Jan 6:1-48
Effectiveness of Manual Therapy on Pain and Self-Reported Function in Individuals With Patellofemoral Pain: Systematic Review and Meta-Analysis
Brian J. Eckenrode et al.
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