title: Management of patients with patellofemoral pain syndrome using a multimodal approach: a case series.
abstract: METHODS
  A case series of consecutive patients referred to physical therapy with patellofemoral pain syndrome (PFPS).
  
  
  BACKGROUND
  Physical therapists often treat patients with PFPS, yet there is currently no consensus as to the most effective management strategies. The purpose of this case series is to describe the outcomes of patients referred to physical therapy with PFPS who were treated with a multimodal approach.
  
  
  METHODS
  Five patients were treated with a combination of thrust and nonthrust manipulation directed at the joints of the lower quarter, trunk and hip stabilization exercises, patellar taping, and foot orthotics. Outcome measures used to capture change in patient status included the Numeric Pain Rating Scale, the Kujala Anterior Knee Pain Scale, the Lower Extremity Functional Scale, and the Global Rating of Change.
  
  
  RESULTS
  Five patients (median age, 15 years; range, 14-50 years) with a median duration of knee pain for 8 months (range, 3-24 months) were included in this prospective case series. Four (80%) of the 5 patients demonstrated decreased pain and a clinically significant improvement in function. These gains in function were maintained at a 6-month follow-up.
  
  
  CONCLUSIONS
  Although a cause-and-effect relationship cannot be inferred from a case series, the outcomes achieved by the patients are consistent with studies incorporating manual physical therapy, exercise, patellar taping, and orthotic prescription to the management of conditions of the lower extremity. Further randomized controlled trials should be performed to determine the effectiveness of this multimodal approach for the management of individuals with PFPS.
authors.affiliation: Saint Joseph Hospital, Nashua, NH 03061, USA. carina.lowry@hotmail.com
authors.forename: Carina D
authors.initials: CD
authors.lastname: Lowry
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Cleland
authors.forename: Kelly
authors.initials: K
authors.lastname: Dyke
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D046788:Patellofemoral Pain Syndrome / Q000145:classification / Q000534:rehabilitation*; D026761:Physical Therapy Specialty / Q000379:methods*; D055815:Young Adult