Objective-To determine the efficacy of the individual components of physiot
herapy in subjects with anterior knee pain.
Methods-An observer blind, prospective, factorial design randomised control
led trial. 81 young adults with anterior knee pain were randomly allocated
to one of four treatment groups: (1) exercise, taping, and education; (2) e
xercise and education; (3) taping and education; and (4) education alone. E
ach group received six physiotherapist-led treatments over three months. Fo
llow up took place at three months using the following outcome measures: pa
tient satisfaction (discharge/refer for further treatment); a visual analog
ue pain score; the WOMAC lower limb function score; the Hospital Anxiety an
d Depression scale (HAD); and quadriceps strength. At 12 months the WOIMAC
and HAD were assessed by postal questionnaire.
Results-All groups showed significant improvements in WOMAC, visual analogu
e, and HAD scores; these improvements did not vary significantly between th
e four groups or between exercising/non-exercising and taped/non-taped pati
ents at three and 12 months. However, patients who exercised were significa
ntly more likely to be discharged at three months than non-exercising patie
nts (chi(2), p<0.001). Taping was not significantly associated with dischar
ge. Significantly greater improvements in WOMAC, visual analogue, and the a
nxiety score (but not the depression score) were seen in patients who were
discharged than in those who were referred.
Conclusions-The proprioceptive muscle stretching and strengthening aspects
of physiotherapy have a beneficial effect at three months sufficient to per
mit discharge from physiotherapy. These benefits are maintained at one year
. Taping does not influence the outcome.