Comparative Efficacy of Supervised, Web-Based, and Self-Guided Exercise Interventions in Women with Patellofemoral Pain Syndrome.

Abstract

Background/Objectives: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that causes anterior knee pain, often linked to increased joint stress. Rehabilitation typically includes education, strength training, and functional exercises. Recently, telerehabilitation has become a promising alternative, particularly useful in improving access to care in rural areas. This study compares the effects of supervised (SE), web-based (WBE), and self-guided (SGE) exercise programs on pain, functionality, and fear of movement (kinesiophobia) in individuals with PFPS. Materials and Methods: Sixty female patients with PFPS participated in this randomized controlled trial. They were randomly assigned to one of three groups: SE, WBE, or SGE. Each program lasted six weeks, with exercises adjusted based on individual tolerance. Outcomes were assessed using the Kujala Anterior Knee Pain Scale, the visual analog scale (VAS) for pain, the Timed Up and Go Test (TUG) for mobility, and the Tampa Kinesiophobia Scale. Results: All groups showed significant improvements in pain, functionality, and kinesiophobia (p < 0.05). The SE group achieved the greatest improvements across all measures, reducing pain and kinesiophobia while enhancing functionality (p < 0.017). The WBE group also showed significant improvements, outperforming the SGE group in all outcomes (p < 0.017). The SGE group demonstrated the least improvement but still achieved positive changes. Conclusions: Supervised exercise programs were the most effective in managing PFPS symptoms. However, the web-based programs also provided substantial benefits, making them a viable option when in-person supervision is not feasible. Future research should aim to enhance digital interventions for broader accessibility and engagement. Trial Registration: The study protocol was also registered on ClinicalTrials.gov (NCT06625086).