Comparative Effects of Core Neuromuscular Training versus Conservative Physical Therapy to Reduce Pain and Improve Functional Performance in Patients with Patellofemoral Pain Syndrome

Effects of Core Neuromuscular Training versus Conservative Physical Therapy


  • Amna Khalid Department of Physical Therapy, King Edward Medical University, Lahore, Pakistan
  • Nidia Javed Faculty of Medical Sciences, Government College University, Faisalabad, Pakistan
  • Noor Fatima Faculty of Medical Sciences, Government College University, Faisalabad, Pakistan



Conservative Therapy, Neuromuscular Training, Patellofemoral Pain Syndrome, Visual Analogue Scale, Kujala Questionnaire


Running, stair climbing, jumping and squatting represent a few of the activities that can cause patellofemoral pain syndrome. Patellofemoral pain syndrome (PFPS) is one of the most typical causes of anterior knee discomfort in teenagers and persons below Sixty. Objective: To contrast the results of conservative physical treatment plus core neuromuscular training and conservative physical therapy alone. Methods: It was a quasi-experimental study in which patients suffering from patellofemoral pain syndrome were selected on the basis of convenience sampling from Government hospitals of Faisalabad after meeting the inclusion and exclusion criteria. Twenty patients with patellofemoral pain syndrome were divided into Group A and Group B at random. Participants of Group A performed neuromuscular core training plus conservative physical therapy exercise program for 4 weeks while participants of group B performed conservative physical therapy exercise alone for 4 weeks. Data were analyzed by SPSS version 27.0. Results: Following therapy, the pain level was substantially reduced in both of the groups (P < 0.05) with Intervention group showing better results. Similarly, there was improvement in scores of Kujala questionnaire in both groups after treatment (P< 0.05) but the results of Intervention group were comparatively better. Conclusions:  There is significant effect of core neuromuscular training plus conservative physical therapy as compared to conservative physical therapy alone.  


Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral pain syndrome. American Family Physician. 2019 Jan; 99(2): 88-94.

Tramontano M, Pagnotta S, Lunghi C, Manzo C, Manzo F, Consolo S et al. Assessment and management of somatic dysfunctions in patients with patellofemoral pain syndrome. Journal of Osteopathic Medicine. 2020 Mar; 120(3): 165-73. doi: 10.7556/jaoa.2020.029.

Azab AR, Abdelbasset WK, Basha MA, Mahmoud WS, Elsayed AE, Saleh AK et al. Incorporation of Pilates-based core strengthening exercises into the rehabilitation protocol for adolescents with patellofemoral pain syndrome: a randomized clinical trial. European Review for Medical & Pharmacological Sciences. 2022 Feb; 26(4).

Yañez-Álvarez A, Bermúdez-Pulgarín B, Hernández-Sánchez S, Albornoz-Cabello M. Effects of exercise combined with whole body vibration in patients with patellofemoral pain syndrome: a randomised-controlled clinical trial. BMC Musculoskeletal Disorders. 2020 Dec; 21(1): 1-1. doi: 10.1186/s12891-020-03599-2.

Kesary Y, Singh V, Frenkel-Rutenberg T, Greenberg A, Dekel S, Schwarzkopf R et al. Botulinum toxin injections as salvage therapy is beneficial for management of patellofemoral pain syndrome. Knee Surgery & Related Research. 2021 Dec; 33(1): 1-8. doi: 10.1186/s43019-021-00121-3.

Xie P, István B, Liang M. The Relationship between Patellofemoral Pain Syndrome and Hip Biomechanics: A Systematic Review with Meta-Analysis. Healthcare. 2022 Dec; 11(1): 99. doi: doi: 10.3390/healthcare11010099.

Clifford AM, Dillon S, Hartigan K, O’Leary H, Constantinou M. The effects of McConnell patellofemoral joint and tibial internal rotation limitation taping techniques in people with Patellofemoral pain syndrome. Gait & Posture. 2020 Oct; 82: 266-72. doi: 10.1016/j.gaitpost.2020.09.010.

Alsulaimani BH. Effectiveness of patellar mobilization in patellofemoral pain syndrome. MOJ Orthopedics & Rheumatology. 2019; 11(1): 31-3. doi: 10.15406/mojor.2019.11.00465.

Pereira PM, Baptista JS, Conceição F, Duarte J, Ferraz J, Costa JT. Patellofemoral pain syndrome risk associated with squats: A systematic review. International Journal of Environmental Research and Public Health. 2022 Jul; 19(15): 9241. doi: 10.3390/ijerph19159241.

Emamvirdi M, Hosseinzadeh M, Letafatkar A, Thomas AC, Dos’ Santos T, Smania N et al.Comparing kinematic asymmetry and lateral step-down test scores in healthy, chronic ankle instability, and patellofemoral pain syndrome female basketball players: A cross-sectional study. Scientific Reports. 2023 Jul; 13(1): 12412. doi: 10.1038/s41598-023-39625-1.

Singer MS and Halawa AM. Outcome of arthroscopic radiofrequency denervation of the patella in the management of resistant patellofemoral pain syndrome. The Egyptian Orthopaedic Journal. 2020 Jul; 55(3): 127-30. doi: 10.4103/1110-1148.319293.

Pereira PM, Duarte J, Santos Baptista J, Torres Costa J. Patellofemoral pain syndrome risk factors analysis in selective garbage truck drivers. Occupational and Environmental Safety and Health III. Springer; 2021. 357-68. doi: 10.1007/978-3-030-89617-1_32.

Alshaharani MS, Lohman EB, Bahjri K, Harp T, Alameri M, Jaber H et al. Comparison of Protonics™ Knee Brace with Sport Cord on Knee Pain and Function in Patients with Patellofemoral Pain Syndrome: A Randomized Controlled Trial. Journal of sport rehabilitation. 2019 Oct; 29(5): 547-54. doi: 10.1123/jsr.2018-0171.

Atzmon R, Steen A, Vel MS, Pierre K, Murray IR, Sherman SL. Tibial tubercle osteotomy to unload the patellofemoral joint. Journal of Cartilage & Joint Preservation. 2023 Mar; 3(1): 100112. doi: 10.1016/j.jcjp.2023.100112.

Valera-Calero JA, Sánchez-Mayoral-Martín A, Varol U. Short-term effectiveness of high-and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study. World Journal of Orthopedics. 2021 Oct; 12(10): 781. doi: 10.5312/wjo.v12.i10.781.

Motealleh A, Mohamadi M, Moghadam MB, Nejati N, Arjang N, Ebrahimi N. Effects of core neuromuscular training on pain, balance, and functional performance in women with patellofemoral pain syndrome: a clinical trial. Journal of Chiropractic Medicine. 2019 Mar; 18(1): 9-18. doi: 10.1016/j.jcm.2018.07.006.

Prieto-García LF, Cortés-Reyes E, Lara-Cotacio G, Rodríguez-Corredor LC. Therapeutic effect of two muscle strengthening programs in patients with patellofemoral pain syndrome. A randomized controlled clinical trial. Revista de la Facultad de Medicina. 2021 Jun; 69(2). doi: 10.15446/revfacmed.v69n2.85599.

Clara SM, Arulmozhe A, Kanna BS. A Study to Compare Effectiveness of Hip Core Strengthening and Knee Strengthening Exercises in the Treatment of Patellofemoral Pain Syndrome: A Prospective Study.

Chevidikunnan MF, Al Saif A, Gaowgzeh RA, Mamdouh KA. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome. Journal of Physical Therapy Science. 2016; 28(5): 1518-23. doi: 10.1589/jpts.28.1518.

Foroughi F, Sobhani S, Yoosefinejad AK, Motealleh A. Added value of isolated core postural control training on knee pain and function in women with patellofemoral pain syndrome: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2019 Feb; 100(2): 220-9. doi: 10.1016/j.apmr.2018.08.180.

Tazesh B, Mansournia MA, Halabchi F. Additional effects of core stability exercises on pain and function of patients with patellofemoral pain: A randomized controlled trial. Journal of Orthopaedics, Trauma and Rehabilitation. 2021: 2210491721989075. doi: 10.1177/2210491721989075.



DOI: 10.54393/tt.v5i01.190
Published: 2024-03-31

How to Cite

Khalid, A., Javed, N., & Fatima, N. (2024). Comparative Effects of Core Neuromuscular Training versus Conservative Physical Therapy to Reduce Pain and Improve Functional Performance in Patients with Patellofemoral Pain Syndrome : Effects of Core Neuromuscular Training versus Conservative Physical Therapy . THE THERAPIST (Journal of Therapies &Amp; Rehabilitation Sciences), 5(01), 41–45.


Most read articles by the same author(s)

1 2 > >>