PT  - JOURNAL ARTICLE
AU  - Jean-Francois Esculier
AU  - Laurent Julien Bouyer
AU  - Blaise Dubois
AU  - Pierre Fremont
AU  - Lynne Moore
AU  - Bradford McFadyen
AU  - Jean-Sébastien Roy
TI  - Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain?A randomised clinical trial
AID  - 10.1136/bjsports-2016-096988
DP  - 2018 May 01
TA  - British Journal of Sports Medicine
PG  - 659--666
VI  - 52
IP  - 10
4099  - http://bjsm.bmj.com/content/52/10/659.short
4100  - http://bjsm.bmj.com/content/52/10/659.full
SO  - Br J Sports Med2018 May 01; 52
AB  - Design Single-blind randomised clinical trial.Objective To compare the effects of three 8-week rehabilitation programmes on symptoms and functional limitations of runners with patellofemoral pain (PFP).Methods Sixty-nine runners with PFP were randomly assigned to one of three intervention groups: (1) education on symptoms management and training modifications (education); (2) exercise programme in addition to education (exercises); (3) gait retraining in addition to education (gait retraining). Symptoms and functional limitations were assessed at baseline (T0), and after 4, 8 and 20 weeks (T4, T8 and T20) using the Knee Outcome Survey of the Activities of Daily Living Scale (KOS-ADLS) and visual analogue scales (VASs) for usual pain, worst pain and pain during running. Lower limb kinematics and kinetics during running, and isometric strength were also evaluated at T0 and T8. The effects of rehabilitation programmes were assessed using two-way analysis of variance.Results No significant group × time interactions (p<0.447) were found for KOS-ADLS and VASs. All three groups showed similar improvements at T4, T8 and T20 compared with T0 (p<0.05). Only the exercises group increased knee extension strength following rehabilitation (group × time: p<0.001) and only the gait retraining group (group × time: p<0.001) increased step rate (+7.0%) and decreased average vertical loading rate (−25.4%).Conclusion Even though gait retraining and exercises improved their targeted mechanisms, their addition to education did not provide additional benefits on symptoms and functional limitations. Appropriate education on symptoms and management of training loads should be included as a primary component of treatment in runners with PFP.Trial registration number ClinicalTrials.gov (NCT02352909).