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Pilot Feasibility Stud. 2018 Apr 13;4:73. doi: 10.1186/s40814-017-0227-7. eCollection 2018.

Exercise therapy, patient education, and patellar taping in the treatment of adolescents with patellofemoral pain: a prospective pilot study with 6 months follow-up.

Author information

1Research Unit for General Practice, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
2Department of Occupational Therapy and Physiotherapy, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
3Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.
4Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg, Denmark.



Patellofemoral pain (PFP) is the most common knee condition among adolescents, with a prevalence of 6-7% resulting in reduced function and quality of life. Exercise therapy is recommended for treating PFP, but has only been tested in older adolescents (15-19 years). This pilot study aimed to investigate the adherence to, and clinical effects of, exercise and patient education in young adolescents (12-16 years), with PFP.


Twenty adolescents (16 females) with PFP were recruited from a population-based cohort to undergo a 3-month multimodal intervention. This comprised of a 30-min patient education and group-based exercise therapy. Exercises included supervised lower extremity strength exercises three times per week, in addition to similar home-based strength exercises. Outcomes included a 7-point global rating of change scale (ranging from "completely recovered" to "worse than ever"), the Knee injury and Osteoarthritis Outcome Score (KOOS), physical activity scale (PAS), weekly sports participation and health-related quality of life measured by European Quality of Life 5 dimensions Youth (EQ-5DY) and isometric knee and hip muscle strength. Pain was measured on a visual analogue scale (VAS), and satisfaction treatment was measured on a five-point Likert scale ranging from "highly satisfied" to "not satisfied at all". These were collected at 3- and 6-month follow-ups. Adherence to supervised exercise was measured as session attendance, and adolescent self-reported adherence to home-based exercises.


Adherence to the exercise therapy was poor, with adolescents participating in a median of 16 (IQR 5.5-25) out of 39 possible supervised training session. Five out of 18 adolescents had a successful outcome after both 3 and 6 months. There were no relevant changes in isometric muscle strength.


This was the first study to investigate adherence to, and clinical effects of, exercise therapy and patient education in young adolescents with patellofemoral pain. Adherence to the exercise therapy was low with little to no clinical effects making a full clinical trial impractical. Future studies need to explore how an intervention can be successfully tailored to young adolescents with patellofemoral pain to obtain good adherence while improving pain and function.

Conflict of interest statement

The local ethics committee of North Denmark Region approved the study (2011–0200). All participants were required to give written informed consent accompanied by their parents’ consent. The study was conducted according to the Declaration of Helsinki.The manuscript does not contain data from any individual person in a form that could be offensive to anyone but written informed consent for all patients was collected.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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