To determine the effectiveness of adding BFR to the resistance exercise in patients with PFPS. In addition, the study aimed to find its effect on improving pain, mobility, and strength.
This systematic review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A computer-assisted database search was conducted for articles in Medline, Central, Embase, PEDro, CINAHL, SPORTDiscus, and Web of Science databases searched from August 2000 to March 2024. Randomized clinical trials that compared BFR with resistance exercise with or without BFR to treat knee pain and function in individuals older than 18 years of age with anterior knee pain due to PFPS were included.
Six randomized clinical trials met the eligibility criteria. Critical Appraisal Skills Programme (CASP) was used to check the quality of the study. Out of 6, 4 studies were good and the remaining 2 were of moderate quality.
One of the studies showed a significant reduction of pain whereas the others proved to be not significant. 50% of the studies showed significant improvement in mobility the others failed to measure it. One of them added the maximum pain-free flexion angle (MPFA) has improved clinically. The isometric quadriceps strength was measured using dynamometers (handheld / isokinetic) and 4 studies showed significant improvement among the BFR group.
In the short term, there is a piece of evidence that BFR has statistically significant improvement in increasing the mobility and strength among PFPS whereas the evidence is not in favour of reducing the pain. The study also found that BFR with low-load resistance exercise is better than the high-load. Further research is needed to further clarify the clinical effectiveness of BFR exercise in these patients. We recommend that there is a need for the development of an individualised approach to training prescriptions to minimise patient risk and increase effectiveness.
PFPS rehabilitation aims to reduce pain, improve function, and strengthen quadriceps. In Physiotherapy practice, quadriceps strengthening is widely used. Unfortunately, many patients with PFPS feel that this is painful to perform. This may lead to avoiding the quadriceps strengthening exercise, which can lead to muscle weakness and thus end in worsening the condition. Thus, this study shows that BFR training can be an alternative to conventional quadriceps strengthening exercises in PFPS patients with less tolerance to high-load resistance training.
Patello Femoral Pain Syndrome
Anterior Knee Pain
