Dose-response effect of lower limb resistance training volume on pain and function of women with patellofemoral pain: A systematic review and meta-regression

Phys Ther Sport. 2023 Sep:63:95-103. doi: 10.1016/j.ptsp.2023.07.006. Epub 2023 Jul 28.

Abstract

Objective: Analyze whether the effects of lower limb resistance training on pain and self-reported function were associated with the exercise volume prescribed for women with patellofemoral pain (PFP).

Methods: A systematic search was undertaken in four databases from inception to May 2023. Eligible trials examined the effects of resistance training programs on pain (visual analogue scale or numerical pain scale) and function (Anterior Knee Pain Scale) in women with PFP. Meta-analysis was undertaken with a random-effects model. The association of resistance training volume-related variables with mean difference effects on pain and function were tested by exploratory univariable meta-regression models.

Results: From 1,404 estudies retained for screening after duplicate removals, 16 studies (579 patients) were included. Changes in knee pain were inversely associated with weekly training frequency (β = 0.5 ± 0.2, P = 0.012). No associations were found between the amount of resistance exercise prescribed per session or per week and effects on pain. Changes in function were associated with the number of sets per week (β = 0.1 ± 0.1, P = 0.044) and number of sets per session (β = 0.6 ± 0.2, P < 0.001) over the intervention. Most favorable results were achieved with 17 to 27 sets per session and >45 sets per week.

Conclusions: The amount of prescribed resistance exercise does not seem to be critical for pain reduction in women with PFP. However, our findings support a dose-response effect in terms of improving function.

Keywords: Anterior knee pain; Exercise therapy; Female; Knee; Strength training.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Exercise
  • Female
  • Humans
  • Knee
  • Muscle Strength / physiology
  • Pain
  • Patellofemoral Pain Syndrome* / therapy
  • Resistance Training* / methods