Physiotherapy for anterior knee pain: a randomised controlled trial

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.