Effectiveness of Adding Neuromuscular Training to Conventional Physiotherapy in Adults with Patellofemoral Pain Syndrome: A Randomized Controlled Trial
- 1Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Üsküdar University, 34662 Istanbul, Türkiye
- 2Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Gelişim University, 34310 Istanbul, Türkiye
- 3Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Üsküdar University, 34662 Istanbul, Türkiye
Abstract
Background/Objectives: Patellofemoral pain syndrome (PFPS) is associated with pain, functional limitation and impaired balance. This study investigated whether adding neuromuscular training to conventional physiotherapy provides additional benefit over conventional physiotherapy alone in adults with PFPS. Methods: In this single-blind randomized controlled trial (NCT06407414), 56 adults aged 30–60 years with PFPS were randomized to conventional physiotherapy alone (control) or conventional physiotherapy plus neuromuscular training, each performed three times per week for 12 weeks as a home-based program with physiotherapist follow-up every three weeks. The analysis was per protocol and included the 50 of 56 randomized participants (25 per group) who completed the trial. The primary outcome was the Kujala Patellofemoral Score. Secondary outcomes were pain (Visual Analog Scale, VAS), the 30-Second Chair Stand Test, the Y Balance Test, the International Physical Activity Questionnaire–Short Form (IPAQ) and, as an exploratory outcome, the Pittsburgh Sleep Quality Index (PSQI). Results: After treatment, the neuromuscular training group had higher Kujala scores (median 77 vs. 65; r = 0.81, 95% CI 0.69–0.89) and lower VAS scores (r = 0.72, 95% CI 0.55–0.83), and performed better on the chair stand test (mean difference 2.60 repetitions, 95% CI 0.88–4.32) and IPAQ-walking; these differences remained significant after Bonferroni correction for 12 comparisons, although for the chair stand test this was not consistent in a supplementary change-score analysis. Y Balance Test values are reported descriptively only, because the groups differed at baseline and the analytical definition of the reported values (stance limb) could not be verified against the original records. Between-group differences in the other IPAQ domains and the PSQI were not significant and were inconclusive. Conclusions: Under the conditions of this trial, adding neuromuscular training to conventional physiotherapy produced greater short-term improvements in pain and function than conventional physiotherapy alone. No conclusion is drawn regarding dynamic balance, and the effect on sleep quality remains uncertain.
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BibTeX
@article{arısut2026effectiveness,
title = {{Effectiveness of Adding Neuromuscular Training to Conventional Physiotherapy in Adults with Patellofemoral Pain Syndrome: A Randomized Controlled Trial}},
author = {Büşra Arısüt and Suzan Aydın and Beyzanur Dikmen Hoşbaş and Ömer Şevgin},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218668},
url = {https://www.mdpi.com/2077-0383/15/21/8668},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effectiveness of Adding Neuromuscular Training to Conventional Physiotherapy in Adults with Patellofemoral Pain Syndrome: A Randomized Controlled Trial
AU - Büşra Arısüt
AU - Suzan Aydın
AU - Beyzanur Dikmen Hoşbaş
AU - Ömer Şevgin
PY - 2026
DA - 2026/11/06
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218668
UR - https://www.mdpi.com/2077-0383/15/21/8668
AB - Background/Objectives: Patellofemoral pain syndrome (PFPS) is associated with pain, functional limitation and impaired balance. This study investigated whether adding neuromuscular training to conventional physiotherapy provides additional benefit over conventional physiotherapy alone in adults with PFPS. Methods: In this single-blind randomized controlled trial (NCT06407414), 56 adults aged 30–60 years with PFPS were randomized to conventional physiotherapy alone (control) or conventional physiotherapy plus neuromuscular training, each performed three times per week for 12 weeks as a home-based program with physiotherapist follow-up every three weeks. The analysis was per protocol and included the 50 of 56 randomized participants (25 per group) who completed the trial. The primary outcome was the Kujala Patellofemoral Score. Secondary outcomes were pain (Visual Analog Scale, VAS), the 30-Second Chair Stand Test, the Y Balance Test, the International Physical Activity Questionnaire–Short Form (IPAQ) and, as an exploratory outcome, the Pittsburgh Sleep Quality Index (PSQI). Results: After treatment, the neuromuscular training group had higher Kujala scores (median 77 vs. 65; r = 0.81, 95% CI 0.69–0.89) and lower VAS scores (r = 0.72, 95% CI 0.55–0.83), and performed better on the chair stand test (mean difference 2.60 repetitions, 95% CI 0.88–4.32) and IPAQ-walking; these differences remained significant after Bonferroni correction for 12 comparisons, although for the chair stand test this was not consistent in a supplementary change-score analysis. Y Balance Test values are reported descriptively only, because the groups differed at baseline and the analytical definition of the reported values (stance limb) could not be verified against the original records. Between-group differences in the other IPAQ domains and the PSQI were not significant and were inconclusive. Conclusions: Under the conditions of this trial, adding neuromuscular training to conventional physiotherapy produced greater short-term improvements in pain and function than conventional physiotherapy alone. No conclusion is drawn regarding dynamic balance, and the effect on sleep quality remains uncertain.
SN - 2077-0383
ER -