Prospective Randomized Treatment of Patellofemoral Pain:
Bracing, Home Exercise Program and Physical Therapy
M.J. Wetzler MD, R. Schrepfer MSPT, and M.J. Gillespie MD
 INTRODUCTION
The Patellofemoral Joint is complex, lacking in inherent stability, with six
different structures pulling on the patella in four different directions.
Treatment usually consists of muscle stretching and strengthening, patella
mobilization, and bracing.
A prospective randomized study on the treatment of patellofemoral pain (AKP)
was undertaken to determing the effectiveness of a home exercise program (HEP),
physical therapy (PT) and
patellofemoral (PF) bracing.
DISCUSSION
Formal physical therapy and bracing
had the largest improvement of PF symptoms than any other group.
If the patient obtains symptomatic relief with squatting after the initial
fitting of the brace, then this study supports the use of a patella tracking
brace to improve the outcome of either HEP or formal PT.
The Bio Skin® Q Brace™, like
McConnel taping, can be individualized
depending on the direction and degree of patella misalignment.
The cost of treatment was significantly different between the patients
randomized into the HEP with a patellofemoral brace and those placed in physical
therapy also with a patellofemoral brace.
Therefore, a monitored home exercise program with patellofemoral bracing can
be a cost effective treatment for appropriately selected and motivated patients.
RESULTS
There were no significant differences in the demographics of each group.
For patients randomized into the brace groups, symptoms improved with
squatting after fitting of the Bio Skin® Q Brace™.
The average PF index score improved 7% for HEP, 21% for PT, 30% for HEPB and
46% for PTB.
The improvement between each group was significantly different (P<0.05).
Furthermore, the cost of treatment was significantly higher for any patient
that had physical therapy versus groups having home exercise programs.
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