Introduction

Patellofemoral pain syndrome (PFPS) is a common condition characterized by pain around or behind the patella (kneecap), often associated with activities like climbing stairs, squatting, or prolonged sitting. It is prevalent among both athletes and non-athletes, particularly those who engage in sports or exercises that involve repetitive knee movements. While various treatment approaches have been proposed, exercise therapy remains a cornerstone of managing PFPS. A recent study compared two exercise programs—Functional Strength Training (FST) and Standard Strength Training (SST)—to determine their effectiveness in alleviating pain, improving knee function, and modifying kinematics in patients with PFPS.

This article provides an engaging summary of the research findings, highlighting the key differences between FST and SST, the benefits of each approach, and the implications for future exercise interventions. Additionally, we explore how health tracking apps like Health Genius could play a role in supporting individuals with chronic conditions like PFPS by providing tools to monitor their general health and view insights.

Methods and Study Design

The study involved 40 participants diagnosed with PFPS, randomly assigned to either the FST or SST group. Participants were non-athletic adults aged 18–30 years with a BMI between 18.5 and 24.9. The intervention lasted six weeks, during which participants performed their respective training programs three times per week.

Functional Strength Training (FST)

FST emphasizes multi-joint exercises that mimic real-life movements, focusing on hip-knee coordination, core stability, and functional mobility. Examples of FST exercises include forward lunges, Romanian deadlifts, and step-down tests with an emphasis on proper form and engagement of the gluteus maximus.

Standard Strength Training (SST)

SST focuses on isolated muscle groups, targeting quadriceps, hamstrings, and hip muscles through exercises like leg presses, leg extensions, and knee flexions. This approach prioritizes muscle strength over functional movement patterns.

Outcomes were measured using:

  1. Visual Analog Scale (VAS) for pain intensity.
  2. Kujala Patellofemoral Scale (KPS) for knee function.
  3. Kinematic assessments to evaluate hip and knee angles during movement.
  4. Muscle activation measurements using surface electromyography (sEMG).

Key Findings

Pain Reduction

Both FST and SST reduced pain in participants, but FST demonstrated superior results:

  • FST: 66.98% reduction in pain intensity.
  • SST: 39.71% reduction in pain intensity.

The greater emphasis on hip-knee coordination in FST likely contributed to better outcomes by reducing stress on the patellofemoral joint.

Knee Function

Improvements in knee function were also more pronounced in the FST group:

  • Participants in the FST group showed significant improvements in functional tasks like squatting and stair climbing.
  • SST participants experienced moderate improvements but struggled with activities requiring multi-joint coordination.

Kinematic and Muscle Activation Changes

FST led to favorable changes in movement patterns, including increased hip flexion and external rotation during squats and lunges. This suggests that FST helps restore normal movement mechanics, which may reduce the risk of further injury or pain recurrence. In contrast, SST did not significantly alter movement patterns but improved isolated muscle strength.

Discussion: Why FST May Be More Effective for PFPS

The study highlights several reasons why FST might be more beneficial than SST for managing PFPS:

  1. Improved Movement Patterns: By focusing on functional exercises that mimic real-life movements, FST helps restore normal kinematics and reduces abnormal stress on the knee joint.
  2. Enhanced Hip-Knee Coordination: Strengthening the gluteal muscles and improving hip mobility are critical for reducing patellofemoral pain, as dysfunction in these areas is often linked to PFPS.
  3. Long-Term Benefits: While both interventions reduced pain and improved function, FST’s focus on functional movements may lead to better long-term outcomes by addressing the root causes of PFPS.

Limitations of the Study

While the study provides valuable insights into the management of PFPS, it has some limitations:

  1. Small Sample Size: The study involved only 40 participants, and future research with larger, more diverse populations (e.g., athletes or individuals with higher BMIs) is needed to confirm these findings.
  2. Short Intervention Duration: The six-week intervention period may not capture the full potential of either training program. Longer-term follow-ups would provide insights into the sustainability of outcomes.
  3. Lack of Control Group: The study did not include a control group, making it difficult to determine whether the observed improvements were solely due to the interventions or other factors.

Implications for Future Exercise Interventions

The findings suggest that FST should be prioritized over SST for individuals with PFPS, particularly those whose symptoms are linked to poor movement patterns or hip-knee dysfunction. However, SST may still have a role in certain cases, such as when isolated quadriceps weakness is identified.

Future research could explore the following:

  • The effects of combining FST and SST into a hybrid program.
  • The role of core stability exercises in enhancing outcomes for PFPS.
  • The impact of exercise adherence and progression on long-term results.

The Role of Health Tracking Apps in Managing Chronic Conditions

For individuals with chronic conditions like PFPS, consistent monitoring of symptoms and adherence to treatment plans are crucial. Health tracking apps like Health Genius can play a valuable role by providing tools to:

  1. Track Pain Levels: Users can log their pain intensity using a VAS-like scale.
  2. Monitor Progress: The app could include features to track improvements in functional tasks, such as stair climbing or squatting.
  3. Set Reminders for Exercises: Consistency is key in exercise therapy, and the app could remind users to perform their daily exercises.
  4. Provide Insights: By analyzing data over time, the app could offer personalized insights into what works best for each individual.

While Health Genius does not specifically target PFPS, its general health tracking features make it a useful tool for anyone managing chronic pain or undergoing rehabilitation.

Conclusion

This study underscores the importance of exercise choice in managing PFPS and highlights the superiority of Functional Strength Training over Standard Strength Training in reducing pain and improving knee function. By addressing movement patterns and hip-knee coordination, FST offers a more comprehensive approach to alleviating symptoms and restoring normal function.

For individuals with PFPS, incorporating FST into their rehabilitation program is likely to yield better outcomes. Additionally, leveraging health tracking apps like Health Genius can support long-term management by providing tools for monitoring progress and maintaining adherence to exercise routines. As research continues to evolve, we may uncover even more effective strategies for managing this challenging condition.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-025-05482-z