Comparisons of Strengthening, Taping, and Stretching on Clinical Outcomes in Patients with Patellofemoral Pain Syndrome

Introduction: Patellofemoral pain syndrome ( PFPS ) is a common knee disorder. Factors that cause patellofemoral pain include: over use, soft tissue imbalance, and malalignment of lower extremity. Patients with patellofemoral pain, caused by soft tissue imbalance were thought to be favorite to receive physical therapies. Clinically, physical therapies for patients with PFPS are including: strength training, taping, and stretching exercise. The aforementioned treatment tools showed different effect mechanism. However, there were few clinical studies to compare the clinical effects among the aforementioned three treatment tools. The purpose of this study was to investigate the different effects among the strength training, taping, and stretching exercise in patients with patellofemoral pain syndrome by randomized control trial study. Method: 80 young adults with patellofemoral pain syndrome were randomly allocated into one of three treatment groups: (1) strength training, (2) taping, and (3) stretching exercise. Each group received treatment for 8 weeks. Outcome measures were including visual analog scales for worst pain, active-active joint reposition error test, physical function subscale of the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, times of walking on different surfaces recorded, and one repetition maximum at baseline and after the interventions for 8 weeks. Result: After intervention for 8 weeks, patients in all groups showed significant improvement in visual analog scales for worst pain, active-active joint reposition error test, physical function subscale of the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, and times of walking on different surfaces recorded but no difference between groups. The one repetition maximum of patients are showed improvements, too. The improvements in strength training group are more than in taping group or stretching group. However, the three groups showed distinctively different effects on clinical effects in patients with PFPS. Conclusions: This study shows that each physical therapeutic tool used in patients with patellofemoral pain syndrome has its unique effect. Though there were no significant difference between groups, strength training group got most improvements in pain reduction, physical function subscale, one repetition maximum, fast walking on ground level, and obstacle crossing. Taping groups got most improvements in all groups in active-active joint reposition error test and walking on sponge. Patients in strength training group, their functional improvements were probably caused by increasing muscle strength and circulation. As regards, patients in taping group, got functional improvements may resulted in increasing proprioceptive accuracy. Additionally, the stretching exercise group, got improvements may caused by loosening the tightness structures around the knee joints. The short term results are similar between groups, continuous follow up should be taken to test how long the outcomes can maintain. This result also showed patients with patellofemoral pain syndrome may have problems like poor flexibility, insufficient muscle strength, and proprioception deficit at the same time. Therefore, these three methods can improve the performance of patients with patellofemoral pain syndrome. The future study could focus on if there were additional treatment effects of combination of two or more treatment methods.