Foroughi F, Sobhani S, Yoosefinejad AK, et al. Added Value of Isolated Core Postural Control Training on Knee Pain and Function in Women With Patellofemoral Pain Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2019 Feb;100(2):220-229. doi: 10.1016/j.apmr.2018.08.180. Epub 2018 Sep 26. (Original study)

OBJECTIVES: To evaluate the added value of isolated core postural control training on knee pain and function in women with patellofemoral pain syndrome (PFPS).

DESIGN: Randomized controlled trial.

SETTING: Rehabilitation sciences research center.

PARTICIPANTS: Women (N=33) between 18 and 30 years of age with PFPS were randomly assigned to a control group (n=16) or the experimental group (n=17).

INTERVENTIONS: Participants in both groups received the same stretching and strengthening exercises during 4 weeks (12 sessions 3 days per week). The experimental group also received isolated core postural training with an unstable seat apparatus.

MAIN OUTCOME MEASURES: Center of pressure (CoP) trajectories in sitting postural control, pain intensity, and function were recorded before and after the 4-week intervention period. Functional capacity and pain intensity were reassessed 3 months after the intervention.

RESULTS: After treatment, both groups had significant improvements in pain, function (P<.001), and CoP trajectories in sitting postural control (control group P<.05, experimental group P<.001). Between-group comparisons demonstrated greater improvements in pain, function, and CoP trajectories in the experimental group (P<.001). This group also had significantly greater improvements in pain and Kujala Anterior Knee Pain Scale score at 3-month follow-up compared to the control group (P<.001).

CONCLUSIONS: Adding isolated core postural control training to physiotherapy exercises was associated with significantly greater improvements in pain, function, and CoP trajectories than physiotherapy exercises alone. Therefore, unstable sitting postural control training is potentially useful to enhance rehabilitation management in patients with PFPS.

Discipline Area Score
Rehab Clinician (OT/PT) 6 / 7
Physician 5 / 7
Comments from MORE raters

Rehab Clinician (OT/PT) rater

This is an interesting study. It is unfortunate that the exercise (it would be debatable whether postural is an accurate description of this exercise) was not done in a way that would be more easily translatable into clinical practice.

Rehab Clinician (OT/PT) rater

The authors should be commended for the clarity and transparency of their intervention for both groups. This article can serve as a model for authors of other interventional studies.
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