Musculoskeletal Care最新文献

{"title":"Experiences of the Management of Uncertainty Amongst Musculoskeletal First Contact Practitioners Working in Primary Care.","authors":"Matt Parselle, Sue May","doi":"10.1002/msc.70062","DOIUrl":"10.1002/msc.70062","url":null,"abstract":"<p><strong>Aim: </strong>To develop a deeper understanding of strategies used to manage uncertainty by Musculoskeletal First Contact Practitioners (MSK FCPs), including barriers to and facilitators for these strategies.</p><p><strong>Background: </strong>MSK FCP services provide patients with an alternative to seeing their GP regarding MSK complaints. Research suggests that the role demands different skills and attributes from traditional physiotherapy roles, including the ability to deal with greater clinical uncertainty. There is a lack of research evaluating the strategies FCPs find most helpful for managing uncertainty.</p><p><strong>Method: </strong>A qualitative study using semi-structured online interviews. Participants were recruited using convenience sampling. Data was analysed using Braun & Clarke's reflexive approach to thematic analysis. The research was underpinned by a theoretical framework of hermeneutic phenomenology.</p><p><strong>Findings: </strong>Nine participants were recruited. Three main themes were developed: (1) Being comfortable with being uncomfortable; (2) Teamwork makes the dream work and (3) Navigating uncertainty with patients.</p><p><strong>Conclusion: </strong>This study provides further insight into how FCPs manage uncertainty. Management of uncertainty was influenced by many factors, including: clinician experience, patient complexity and wider medical knowledge, fear of over-medicalising patients, communication and consultation styles and having protected non-clinical time. Recommendations for clinical practice include: consideration of the challenges facing FCPs, and what support is needed to maintain staff retention, health and wellbeing; consideration of how FCPs might best approach meeting the needs of an ageing population and supporting change in health and wellness behaviour. The key to successful management of uncertainty was having a supportive team which encouraged open non-judgemental discussions about uncertainty.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70062"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Therapeutic Education for Patients With Rheumatoid Arthritis Treated With Biologics.","authors":"Selma Bouden, Hiba Ben Ayed, Haifa Khemir, Leila Rouached, Aicha Ben Tekaya, Ines Mahmoud, Raoudha Tekaya, Olfa Saidane, Leila Abdelmoula","doi":"10.1002/msc.70060","DOIUrl":"10.1002/msc.70060","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess the effects of a patient therapeutic education (PTE) programme on the course of the disease and treatment management skills in rheumatoid arthritis (RA) patients treated with biologics.</p><p><strong>Methods: </strong>From January to December 2023, 52 RA patients participated in a face-to-face education session of 1 h, delivered to groups of four to six patients by 2 rheumatologists qualified in PTE. Disease activity, quality of life parameters and patient's skills using the BioSecure score were assessed before the education programme and 3 months later.</p><p><strong>Results: </strong>A statistically significant decrease in mean pain visual Analogue Scale (p = 0.001), mean morning stiffness duration (p = 0.002), mean number of night awakenings (p = 0.01), mean tender joints count (p = 0.001) and mean 28-Disease-activity-score (p = 0.001) were observed 3 months after the PTE. A statistically significant decrease in functional status (HAQ) and fatigue scores (FACIT-F) was observed after PTE (p = 0.03 and p = 0.001, respectively). The mean BioSecure score climbed from 47.9 ± 14.9 at baseline to 74.8 ± 12.9 after PTE (p = 0.001). The variation of BioSecure score was significantly more important in patients with third-level education, patients receiving subcutaneous biotherapy and those on TNF alpha inhibitors therapy.</p><p><strong>Conclusion: </strong>PTE may be effective in improving clinical outcomes and safety skills in RA patients receiving biological treatment.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70060"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Despite the Pain, I Keep Moving Forward': A Qualitative Study on Brazilian Older Adults' Experiences With Chronic Low Back Pain.","authors":"Marina Jacobucci Pellegrini, Ney Meziat-Filho, Jessica Fernandez, Nathalia Costa","doi":"10.1002/msc.70050","DOIUrl":"10.1002/msc.70050","url":null,"abstract":"<p><strong>Objective: </strong>The burden of chronic low back pain (CLBP) is increasing rapidly along with the global population ageing. Such an increase will occur more rapidly in low- and middle-income countries (LMICs). Yet, few studies have explored the experiences of older adults with CLBP, and these are primarily conducted in high-income countries. To address this concern, we explored the experiences of older Brazilian adults with CLBP.</p><p><strong>Methods: </strong>We used a descriptive qualitative study and gathered data through interviews and drawings from participants representing their experiences. Data were analysed using reflexive thematic analysis principles.</p><p><strong>Results: </strong>We interviewed 22 participants and identified the following themes: (1) Low back pain: an intense sensory and emotional experience; (2) causes of pain: wear and tear due to ageing, physical overload and emotional overload; (3) seeking treatment and not improving; (4) health professionals with a biomedical and pessimistic view; (5) the impact of pain on life: functional limitations and social repercussions; and (6) dealing with pain through movement, resilience and passive strategies.</p><p><strong>Conclusions: </strong>Participants described CLBP as a sensory and emotional experience that impacts various aspects of their lives. Wear and tear due to ageing, physical and emotional overload were highlighted as causes of pain, and health professionals as a source of pessimism. Despite this, many participants discussed coping through movement, resilience, and passive strategies. Health professionals should address the emotional aspects associated with CLBP, explore its impact on their patients' lives and provide information that aligns with current evidence, promoting reassurance and a multidimensional understanding of CLBP.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70050"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Predictors Associated With Postoperative Chronic Knee Pain Following Total Knee Arthroplasty and the Effect on Patient Reported Outcomes at 6-Months.","authors":"Nick D Clement, Gillian Leitch, Chloe E H Scott","doi":"10.1002/msc.70064","DOIUrl":"10.1002/msc.70064","url":null,"abstract":"<p><strong>Aim: </strong>The aim was to identify independent variables associated with chronic knee pain (CKP) 6 months after knee arthroplasty (KA) and to determine whether CKP influenced improvement in patient reported outcomes measures (PROMs).</p><p><strong>Methods: </strong>A retrospective study was conducted over an 8-year period and included 3310 patients with completed PROMs at 6 months postoperatively; with a mean age of 69.9 (standard deviation 9.3) and 1823 (55.1%) were females. The Oxford knee score (OKS) pain component score was used to define patients with CKP (≤ 14 points) at 6 months.</p><p><strong>Results: </strong>There were 551 (16.6%) patients with CKP. Gender (p < 0.001), BMI (p = 0.025), preoperative EQ-5D (p = 0.010) and pain VAS (p < 0.001) as well as questions 2: washing (p = 0.006), 8: night pain (p = 0.001), 10: stability (p = 0.008) and 11: shopping (p = 0.047) of the OKS were independently associated CKP. The pre-operative OKS total score (p = 0.542) was not independently associated with CKP. The risk of CKP was shown to vary from 3.0% to 30.5% when discriminatory threshold values were used in the pre-operative responses to questions 2, 8, 10 and 11 of the OKS. Patients with CKP had significantly (p < 0.001) worse 6-month OKS, EQ-5D, EQ-VAS, and pain VAS scores and improvements in scores relative to preoperative baseline that were potentially not clinically meaningful (OKS mean difference 2.6, 95% CI 2.1-3.2). Those with CKP were significantly less likely to be satisfied with their KA (odds ratio 0.076, p < 0.001): only 231 (42.9%) patients with CKP were satisfied.</p><p><strong>Conclusions: </strong>Approximately one-in-six (16.6%) patients had CKP at 6 months following KA, which was associated with significantly worse PROMs and lower satisfaction. Preoperative responses to four (2, 8, 10 and 11) of the pre-operative OKS questions were independently associated with CKP. These questions could be used to inform patients of their risk of CKP (3.0%-30.5%) following KA and potentially with expectation modification this may improve their PROMs.</p><p><strong>Level of evidence: </strong>Retrospective study, Level III.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70064"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Disease Duration and Onset Pattern on Treatment Delays and Progression of Rheumatoid Arthritis: Insights From a Pakistani Cohort.","authors":"Asadullah Khan, Junaid Ahmed, Sakina Kazmi, Rabbey Raza Khan, Naseer Ahmed, Ilsa Khan","doi":"10.1002/msc.70068","DOIUrl":"10.1002/msc.70068","url":null,"abstract":"<p><strong>Introduction: </strong>Early diagnosis of rheumatoid arthritis (RA) is crucial to prevent joint damage and improve treatment outcomes. RA cases that are not polyarticular at onset, and/or are not beginning in the hand joints may face diagnostic delays, because of more convincing alternate diagnoses. This study examines the prevalence of onset pattern and location and its impact on diagnostic timing and disease progression in RA.</p><p><strong>Methods: </strong>This prospective cross-sectional study was conducted at Sandeman Provincial Hospital Quetta, Pakistan (January-December 2022). Adults aged 17 years & above with RA meeting ACR criteria 2010 were included using a consecutive sampling technique. The associations were measured by Chi-squared and Cramer's V test. Bivariate and multinominal Regression models were used to analyse the duration and pattern of disease, delay in diagnosis and location of onset.</p><p><strong>Results: </strong>Twelve hundred RA patients (966, 82.8% female) with a median age of 42 (IQR: 33-55), and a median disease duration of 5 years (IQR: 2-8), both positively skewed, were included in the study. At-least 408 (34%) patients had non-polyarticular onset at initial presentation, and around 458 (38%) patients had the onset on illness not beginning in the small joints of hands. Non-hand onset was significantly associated with age of onset, being 2.5 times higher in juvenile onset than in adult onset (OR = 2.515, p = 0.035). A diagnostic delay of 17.8 ± 27.9 months was found in the cohort, correlating significantly with total duration of disease (p < 0.01), pattern of disease (polyarticular vs. non polyarticular, p < 0.050) and with female gender (p = 0.014) but not with area of onset.</p><p><strong>Conclusions: </strong>RA onset outside the hands with non-polyarticular patterns accounts for nearly one-third of cases, emphasising the need for a more easily accessible rheumatology care to reduce delays and mitigate prolonged disease impact.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70068"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Movement, Mindfulness, and Pain Science (MMaPS) Class Improves Well-Being and Physical Function in Patients With Chronic Pain.","authors":"Sharna Prasad, Olivia Coskey, Micah Wong, Jonathan D Jones","doi":"10.1002/msc.70076","DOIUrl":"10.1002/msc.70076","url":null,"abstract":"<p><strong>Objectives: </strong>This study sought to quantify the impact of participation in an interactive class for patients with chronic pain called Movement, Mindfulness, and Pain Science (MMaPS), on physical function, pain catastrophizing, and quality of life.</p><p><strong>Methods: </strong>Patients with chronic pain of any type were enroled in an 8-week course that implemented principles of safe movement, mindfulness, and meditation practice, and also incorporated education related to the biopsychosocial model of pain science. Questionnaires were collected from participants who attended the MMAPS programme in the 2018 through 2020 sessions prior to and after the class to measure participant outcomes, which included the pain catastrophizing scale (PCS), Adverse Childhood Events score (ACE), Quality of Life scale (QOL), Patient Specific Functional Score (PSFS), 30 s sit to stand (30 STS), and 4-stage balance (4SBT).</p><p><strong>Results: </strong>One hundred fifty-five people completed the class. The median Pain Catastrophizing Scale score dropped from 19 to 11 (p < 0.001). Median Quality of Life scores increased from 5 to 6 (p < 0.001) on a 10-point scale. Patient Specific Functional Scale scores improved from an average score of 2.5 to 5.1 (p < 0.001). Median 30 Second Sit-to-Stand scores improved from 8 to 11 (p < 0.001). The 4-stage balance test improved with 39% of patients having completed all four stages at intake and 56% completing all four stages by the end of class (p = 0.001).</p><p><strong>Conclusion: </strong>Patients with chronic pain had significant improvements in several measures of wellness and physical function after participating in the MMaPS class.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70076"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibromyalgia and Rehabilitation. Not as You Thought. Changing the Stigma.","authors":"Amit Kosto, Julia Getmansky, Michael Glukhoded, Judith Nosgorodsky, Alan Friedman, Lena Lutsky, Iuly Treger","doi":"10.1002/msc.70080","DOIUrl":"10.1002/msc.70080","url":null,"abstract":"<p><strong>Background: </strong>A cohort of patients in the rehabilitation wards also suffer from Fibromyalgia, which is considered the most prevalent cause of chronic pain. Poor function, subjective cognitive impairment, instability and imbalance are all common features of Fibromyalgia, among other more prominent features such as the use of chronic pain medication. The main purpose of this study was to examine the differences in Length of Stay (LOS) and functional outcome parameters.</p><p><strong>Methods: </strong>A retrospective cohort trial was conducted at the Soroka University Medical Centre. The time of data collection was conducted from January 2015 to December 2021. Patients were divided into two groups based on their exposure status: With Fibromyalgia (n = 43) and Control group Without Fibromyalgia (n = 1119). A 1:10 matching process and regression analysis were performed to avoid confounding factors. Matching was based on age, gender, and ethnicity. Various rehabilitation outcomes were collected along with pain assessment and pain medication use during the hospitalisation. Statistical analysis was performed using R software. A p value of < 0.05 will be considered statistically significant.</p><p><strong>Results: </strong>No statistically significant difference was found in the duration of hospitalisation, the FIM index at admission and discharge, or the change in the FIM index (ΔFIM) during hospitalisation between the two groups. No statistically significant differences were demonstrated in stability and balance indices (DGI, BBS) or cognitive assessment tests (MoCA).</p><p><strong>Conclusions: </strong>The stigma is incorrect, as patients with fibromyalgia can improve their functional parameters during an inpatient rehabilitation programme to the same degree as those without fibromyalgia.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70080"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plantar Pressure Distribution Patterns During Gait and Functional Mobility in Early-Stage Knee Osteoarthritis: A Comparative Study.","authors":"Fereshteh Sabet, Ehsan Ebrahimipour, Mehrdad Anbarian","doi":"10.1002/msc.70049","DOIUrl":"10.1002/msc.70049","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is characterised by altered gait mechanics, which can lead to significant functional impairments. This study aims to investigate plantar pressure distribution during walking and assess functional mobility in patients with early-stage KOA, providing insights for targeted therapeutic interventions.</p><p><strong>Methods: </strong>Eighteen women with KOA were matched with 18 healthy controls for this study. We assessed plantar pressure distribution, relative phase durations during the stance phase, and performance on the Timed Up and Go (TUG) test. Independent sample t-tests were employed to identify group differences, with significance set at p < 0.05.</p><p><strong>Results: </strong>Patients with KOA exhibited significantly lower maximum plantar pressure in the Toe 1 (p < 0.01), medial heel (p < 0.01), and lateral heel (p < 0.01) regions, while demonstrating higher pressure in the Metatarsal 4 (p < 0.01) and midfoot (p < 0.01) areas. Furthermore, KOA patients spent less time in the initial contact (p = 0.01), foot-flat (p < 0.01), and forefoot push-off (p = 0.03) phases but more time in the forefoot plantarflexion phase (p < 0.01). Additionally, KOA patients demonstrated longer TUG times (p < 0.01), indicating reduced functional mobility.</p><p><strong>Conclusions: </strong>Early-stage KOA patients display distinct patterns of plantar pressure distribution and impaired functional mobility compared with healthy controls. These findings highlight the necessity for interventions aimed at addressing altered gait mechanics in KOA, which could help mitigate mobility limitations and enhance patient outcomes.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70049"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE Key Elements of the Exercise Prescription Process in Musculoskeletal Rehabilitation in a One-On-One Setting. A Delphi Study of Australian Physiotherapy Specialists.","authors":"Samantha S Smith, Suzanne J Snodgrass, Peter G Osmotherly","doi":"10.1002/msc.70042","DOIUrl":"10.1002/msc.70042","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision making to develop an exercise program and then prescribe that program should be based on the best evidence available. However, little evidence exists to guide the development of an exercise program, determining optimal dosage parameters or for effective prescription techniques to achieve best patient outcomes possible.</p><p><strong>Objective: </strong>To gain consensus from expert clinical physiotherapists in the field of musculoskeletal rehabilitation on key recommendations for developing and prescribing effective exercise programs in musculoskeletal rehabilitation in a one-on-one setting.</p><p><strong>Methods: </strong>Delphi study method involving three rounds of questionnaires with subsequent rounds developed based upon results of the previous round, aiming to achieve consensus in the final round. The consensus threshold was set at 80% agreement. Participants were physiotherapists considered experts in the field of musculoskeletal rehabilitation as acknowledged by the Australian College of Physiotherapists, being Clinical Fellows of the College in musculoskeletal or sports and exercise physiotherapy.</p><p><strong>Results: </strong>Thirteen experts completed the three rounds of questionnaires. Most experts reported 'always' prescribing exercises to their patients. The expert clinicians agreed that a clinician should blend evidence-based protocols, clinical experience, and empirical knowledge to develop the exercise program, and then tailor the program further based on individual patient factors. Most experts agreed that it was essential to collaborate with the patient when designing the exercise program.</p><p><strong>Conclusion: </strong>Future research is needed to determine the effectiveness and necessity of each element of the exercise program in musculoskeletal rehabilitation in a one-on-one setting to achieve best patient outcomes possible.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70042"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Hip and Knee Muscles Strengthening Versus Knee Muscle Strengthening Alone in Managing Patellofemoral Pain Syndrome: A Systematic Review and Meta-Analysis.","authors":"Mumen H Halabi, Belal A Alturkistani, Rayan H Abuhadi, Amr N Garout, Faisal B Almuqbil, Mohammed S Alshehri","doi":"10.1002/msc.70059","DOIUrl":"10.1002/msc.70059","url":null,"abstract":"<p><strong>Background: </strong>Patellofemoral pain syndrome (PFPS) is a common knee issue in young adults characterised by anterior knee pain during knee flexion with weight-bearing or prolonged sitting. Physical therapy is the primary treatment. This systematic review and meta-analysis compares the efficacy of hip and knee muscle strengthening (HKS) versus knee muscle strengthening alone (KS) in managing PFPS.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic search of Elsevier, PubMed, Cochrane, and Web of Science identified randomized controlled trials (RCTs) comparing HKS and KS in PFPS patients. A risk of bias tool assessed study quality. Outcomes, including pain, functional activity, and muscle strength, were analysed using a random-effects model with standardized mean difference (SMD) and 95% confidence intervals.</p><p><strong>Results: </strong>Six RCTs involving 241 patients (96.3% females) were included. HKS significantly improved pain (SMD = -1.29, 95% CI [-1.98, -0.59], p = 0.0003, I² = 87%) and functional activity (SMD = 0.99, 95% CI [0.22, 1.76], p = 0.01, I² = 88%) compared to KS. No significant difference was observed in muscle strength (SMD = 0.20, 95% CI [-0.31, 0.71], p = 0.44, I² = 63%).</p><p><strong>Conclusion: </strong>HKS effectively reduces pain and improves functional activity in patients with PFPS. Further research is needed to confirm these findings and address study limitations.</p><p><strong>Study registration: </strong>This systematic review was registered in PROSPERO (CRD42023451065) and reported by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70059"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}