Exercise that relieves knee pain

Patients with severe knee pain may benefit from supervised exercise therapy, researchers report today.

So-called patellofemoral pain syndrome is a common problem that usually develops during adolescence. It causes pain at the front of the knee during or after exercise. However, Dr Robbart van Linschoten of Erasmus University Medical Centre, Rotterdam, the Netherlands, believed that supervised exercise may help.

His team assessed the benefits of supervised exercise therapy compared with usual care – a "wait and see" approach – among 131 participants recruited through GPs or sport physicians.

Half received a six week exercise programme "tailored to individual performance" and supervised by a physical therapist. They were then told to continue the exercises at home for three months. The remaining half were encouraged to rest during periods of pain and refrain from pain provoking activities.

Results appear on the website of the British Medical Journal. The authors write: "After three months, the intervention group showed better outcomes than the control group with regard to pain at rest, pain on activity, and function."

They add that, after a year, those who exercised "continued to show better outcomes with regard to pain but not function". Although more patients in that group recovered (62 per cent versus 51 per cent), the difference was not significant.

"Supervised exercise therapy resulted in less pain and better function at short term and long term follow-up compared with usual care in patients with patellofemoral pain syndrome in general practice," the researchers conclude.

They recommend that further research "should aim to elucidate the mechanisms whereby exercise therapy results in better outcome".

van Linschoten, R. et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. The British Medical Journal, 2009;339:b4074.