Author(s): RUXUE, H., HAI FNEG, M., JINGJING, Z., ZESEN, H. , Institution: SHANGHAI UNIVERSITY OF SPORT, Country: CHINA, Abstract-ID: 682

INTRODUCTION:
Patellofemoral Pain Syndrome (PFPS) is a prevalent knee disorder. Abnormal movement patterns, including dynamic knee valgus and femoral internal rotation, are closely associated with PFPS-related pain and dysfunction. While correcting these patterns is a core goal of rehabilitation, the comparative effectiveness of different training modalities (e.g., knee-dominant, hip-dominant, combined hip-knee training) remains controversial. This study aimed to evaluate and compare the effects of various movement pattern trainings on pain relief and functional improvement in PFPS patients.
METHODS:
This PRISMA-guided meta-analysis (PROSPERO: CRD42026127899) involved a systematic search of seven databases up to November 2025. The inclusion criteria were RCTs comparing movement pattern training with control conditions or other training modalities in adults with PFPS.Two reviewers independently performed study selection, data extraction, and risk of bias assessment using the Cochrane tool. Statistical analyses were performed using Stata 18 with random-effects models. Standardized Mean Differences (SMDs) with 95% confidence intervals (CIs) were calculated for pain and function outcomes.
RESULTS:
The systematic review incorporated 15 RCTs encompassing a total of 801 participants. Meta-analysis demonstrated that movement pattern training conferred significant, medium-to-large benefits compared to conventional therapeutic control group for both pain reduction (SMD = -0.83, 95% CI: -1.15 to -0.51) and functional improvement (SMD = 0.72, 95% CI: 0.34 to 1.09). A critical finding was the superior efficacy of combined hip-knee training over knee-dominant training alone for alleviating pain (SMD = -1.20, 95% CI: -1.96 to -0.43). In contrast, no statistically significant difference was observed between hip-dominant and knee-dominant training for either outcome. Subgroup analyses revealed that the intervention effects were more pronounced in female participants and following shorter-term interventions (4 weeks). Furthermore, meta-regression identified baseline pain intensity and Body Mass Index (BMI) as significant moderating factors influencing pain relief and functional recovery, respectively.
CONCLUSION:
Movement pattern training, particularly combined hip-knee training, is an effective intervention for improving pain and function in PFPS patients. The superior efficacy of combined training is likely attributable to optimized lower limb alignment and enhanced dynamic stability through multi-joint neuromuscular coordination. Clinicians should consider implementing a 4-6 week, 3-times-per-week combined hip-knee training regimen, especially for female patients. Integrating weight management strategies is recommended for individuals with higher BMI to optimize functional outcomes.
references：Hosseini,S.H., A., S., &D.,H.(2023).The effect of three types of exercise programs on patella location in athletes with patellofemoral pain.