title: Evaluating the potential synergistic benefit of a realignment brace on patients receiving exercise therapy for patellofemoral pain syndrome: a randomized clinical trial.
abstract: BACKGROUND
  It has been previously shown that exercise programs for patellofemoral pain syndrome (PFPS) can be supported by medially directed taping. Evidence supporting the use of patellar braces is limited because previous studies have been low quality. The aim of this study is to compare the outcomes of patients with PFPS after treatment with a medially directed patellar realignment brace and supervised exercise.
  
  
  METHODS
  In a prospective randomized multicenter trial, 156 patients with PFPS were included and randomly assigned to 6 weeks of supervised physiotherapy in combination with the patellar realignment brace, or supervised physiotherapy alone. Outcome measures were the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, numeric analog pain scores, and the Kujala score at baseline, 6 weeks, 3 months, and 1 year after the start of therapy. The patient's self-reported perception of recovery was also assessed at these points.
  
  
  RESULTS
  Both treatment groups showed a significant improvement in all outcome measures over the study period. After 6 and 12 weeks of therapy, patients in the brace group had significantly higher KOOS sub-scale scores, a higher mean Kujala score, and less pain while climbing stairs or playing sports. After 54 weeks a group difference could be only detected for the KOOS ADL sub-scale.
  
  
  CONCLUSIONS
  The use of a medially directed realignment brace leads to better outcomes in patients with PFPS than exercise alone after 6 and 12 weeks of treatment. After 1 year of follow-up this positive effect diminished.
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus Berlin, Grunewald, Caspar Theyß Strasse 27-31, 14193, Berlin, Germany. w.petersen@mlk-berlin.de.
authors.forename: Wolf
authors.initials: W
authors.lastname: Petersen
authors.affiliation: Arcus Sportklinik, Pforzheim, Germany.
authors.forename: Andree
authors.initials: A
authors.lastname: Ellermann
authors.affiliation: Otto Bock, Duderstadt, Germany.|Asklepios, Harzkliniken GmbH, Fritz-König-Stift, Bad Harzburg, Germany.
authors.forename: Ingo Volker
authors.initials: IV
authors.lastname: Rembitzki
authors.affiliation: Sporthopaedicum Berlin, Berlin, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Scheffler
authors.affiliation: Klinik für Unfall-, Hand-, und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Germany.
authors.forename: Mirco
authors.initials: M
authors.lastname: Herbort
authors.affiliation: Deutsche Sporthochschule Köln, Institut für Biomechanik, Cologne, Germany.
authors.forename: Gert Peter
authors.initials: GP
authors.lastname: Brüggemann
authors.affiliation: Sportklinik Stuttgart, Stuttgart, Germany.
authors.forename: Raymond
authors.initials: R
authors.lastname: Best
authors.affiliation: Sporthopaedicum, Straubing, Germany.
authors.forename: Thore
authors.initials: T
authors.lastname: Zantop
authors.affiliation: Asklepios, Harzkliniken GmbH, Fritz-König-Stift, Bad Harzburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Liebau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001915:Braces; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010329:Patella; D046788:Patellofemoral Pain Syndrome / Q000628:therapy*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anterior knee pain; Chondromalacia patellae; Dynamic valgus; Functional malalignment; Patellar maltracking; Patellar orthosis; Patellar tape