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

Articles in Press

Document Type : RESEARCH PAPER

Authors

1 Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

10.22038/abjs.2025.89727.4066

Abstract

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 owing to a lack of understanding regarding which patient characteristics predict treatment success. This study aimed to identify clinical predictors of successful outcomes following a six-week combined intervention of exercise therapy, patellar taping, and prefabricated orthoses in individuals with PFPS.

Methods: Fifty patients (30 females, 20 males; mean age, 29.4 years) diagnosed with PFPS were assessed for demographic, pain-related, biomechanical, and functional variables. Treatment success was defined as a ≥2-point reduction in the visual analog scale (VAS) score of pain during daily activities and a ≥8-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 = 0.427, p = 0.043; OR = 0.317, p = 0.027, respectively). Conversely, higher baseline AKPS scores (indicating better function), greater isometric hip internal rotation strength, hip extensor strength, hip abductor strength, and hip external rotation strength were positively associated with treatment success (ORs ranging from 2.583 to 3.858, all p < 0.05). Furthermore, hamstring shortness negatively impacted treatment outcomes (OR = 0.497, p = 0.034).

Conclusions: 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. The identified predictors may aid clinicians in tailoring treatment strategies and improving long-term outcomes for this challenging patient population.

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The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 16 December 2025

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History

  • Receive Date: 20 July 2025
  • Revise Date: 18 November 2025
  • Accept Date: 12 August 2025

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