Distal Approaches in Patellofemoral Pain: A Systematic Review, Part I

Purpose: Increased patellofemoral joint reaction force (PFJRF) is the main cause of patellofemoral pain syndrome (PFP). Foot pronation causes faulty joint coupling of the lower limb and increases the PFJRF. Therefore, the aim of systematic review is effect of the distal interventions on the clinical symptoms and kinematic of PFP patients.   Methods: The search strategy was carried out from Google Scholar, PubMed, Science Direct, Medline, Web of science, Scopus databases limited to English language. The studies were limited to the period of 2000 to 2022. In four stages, the selected articles were screened for systematic review. The quality of study was evaluated by Down and Black scale and they were classified into three categories of high, medium and low quality. Results: Twelve articles were screened for systematic review. In general, the quality of study was medium. Five articles had medium quality and seven articles had high quality. The results of the systematic review showed that distal interventions are effective in improving clinical symptoms and correcting the faulty kinematics of the lower limb. Conclusion: Distal interventions with correct the faulty joint coupling reduce the PFJRF and pain reduce. As a result, distal interventions in combination with proximal exercise have a better effect on clinical symptoms.