Running Retraining Technique and Neuromuscular Exercises in Runners with Patellofemoral Pain: A Scoping Review.

Background: When treating runners with patellofemoral pain (PFP), clinicians aim to reduce patients' symptoms, such as pain and discomfort. Running retraining techniques (RRT) and neuromuscular exercises (NME) are key interventions to achieve these goals.

Purpose: This scoping review examined the use of RRT and NME, either combined or standalone, in runners with PFP.

Study design: Scoping review.

Methods: Databases searched included MEDLINE, ScienceDirect, and Google Scholar. Two researchers independently identified eligible studies and extracted data. The scoping review followed the PRISMA-SCR framework, using population, concept, and context criteria. The population included recreational to professional runners over 18 years with PFP, excluding those involved in any sport other than running., as well as those with prior knee surgeries, the history or presence of other knee pathologies, or pediatric populations. The review focused on studies utilizing NME or RRT for PFP treatment, adhering to ACSM guidelines and excluding studies only providing study protocols. Exercise reporting was assessed using the Consensus on Exercise Reporting Template. NME protocols were analyzed using the FITT framework (Frequency, Intensity, Time, Type). RRT protocols were evaluated by session frequency, start timing, clinician input, cadence, feedback, footwear use, speed changes, self-rehabilitation, and progression.

Results: Fifteen studies were reviewed. The timing and complementarity of RRT with NME were often absent or poorly defined. NME mainly focused on single-leg squats in seven protocols, with forward lunges, step-downs, and trunk-rotating squats in three studies each. These exercises emphasized trunk inclination and gluteal activation, with variations in feedback, sets, reps, and progression. RRT treatment ranged from a single 10-minute retraining session to 12 weekly sessions. Cadence increase was addressed in six studies, dynamic valgus in four, with most feedback being auditory/visual. Minimalist shoes were used in two studies, and three standardized running speed.

Conclusion: A notable variability exists in interventions for PFP in runners, especially in the timing and complementarity of RRT and NME. A standardized reporting system is needed to better analyze study protocol implementation.

Level of evidence: N/A.