Evaluation of the scope and quality of systematic reviews on nonpharmacological conservative treatment for patellofemoral pain syndrome

Abstract

STUDY DESIGN: Systematic literature review. OBJECTIVE: To evaluate the quality and scope of recently published systematic reviews on the topic of patellofemoral pain syndrome (PFPS) and to provide an overview of their findings. BACKGROUND: PFPS is a commonly treated condition. There is a large body of literature on conservative nonpharmacological interventions for PFPS, including multiple systematic reviews, which require critiquing and summarizing. METHODS AND MEASURES: A systematic review of systematic reviews on conservative nonpharmacological treatment strategies for PFPS was performed. Published systematic reviews were identified by searching MEDLINE, EMBASE, CINAHL, SPORTDISCUS, Current Contents, The Cochrane Library, and PEDro electronic databases from the year 2000 until May 2007. Cited reference searches of each author in the Web of Science complemented this search. Review quality was evaluated by a specifically designed scale and only high-quality reviews were retained to validate and summarize reported findings. RESULTS: Ten reviews met the inclusion criteria. Among them, only 3 were considered to be high quality, covering exercise, foot and knee orthoses, and ultrasound intervention for PFPS. None of the 3 reviews included literature published after the year 2001. Some limited evidence for the use of exercise, exercise combined with taping, and exercise combined with the use of a Protonics brace was found for treatment of individuals with PFPS. CONCLUSION: Published systematic reviews and clinical trials need to be conducted with more rigorous methodological design. There are no up-to-date, high-quality systematic reviews covering conservative nonpharmacological treatments for individuals with PFPS, which indicates that updates in all areas are needed.