Biofeedback supplementation to physiotherapy exercise programme for rehabilitation of patellofemoral pain syndrome : a randomized controlled pilot study

Objectives: To examine the efficacy of electromyographic (EMG) biofeedback supplementation to exercise rehabilitation for people with patellofemoral pain syndrome. Design: Double-blinded randomized clinical controlled pilot trial. Setting: Clinical setting with home programme. Participants: Twenty-six subjects diagnosed with patellofemoral pain. Intervention: Subjects were randomly assigned into EMG biofeedback + exercise group or exercise-only group. All subjects participated in an eight-week home exercise programme, while the biofeedback group also received EMG visual feedback of their quadriceps muscle activities during the exercises. Main outcome measures: Isokinetic knee extension strength, patellar alignments and perceived pain severity were assessed in weeks 0, 4 and 8 for all subjects. The data within and between groups were compared by repeated measures ANOVA with α = 0.05. Results: Both groups improved in isokinetic peak torque (P= 0.005), work output (P= 0.037) and patellar alignments (P= 0.001-0.014). Besides, there was a trend of decrease in pain (P = 0.088). The biofeedback group improved faster than the exercise group in lateral patellar rotation and peak torque per body weight, although no statistically significant difference was shown. Conclusion: Biofeedback supplement to the exercise programme might hasten the improvement for subjects with patellofemoral pain in the first few weeks of a physiotherapy exercise programme, but this needs further study before being used.Department of Rehabilitation Science