Objective To compare the effectiveness of adjunct treatments combined with exercise to exercise alone in people with patellofemoral pain (PFP) and explore the quality of intervention descriptions in randomised controlled trials (RCTs). Design Systematic review. Data sources Seven databases were searched in November 2023. Eligibility RCTs that evaluated the effectiveness of any adjunct treatment combined with exercise to exercise alone on self-reported pain and function in people with PFP. Results We included 45 RCTs (2023 participants), with 25 RCTs (1050 participants) contributing to meta-analyses. Pooled analysis indicated very low-certainty evidence that neuromuscular electrical stimulation or monopolar dielectric diathermy combined with exercise leads to small and large improvements in self-reported pain when compared with exercise alone (standardised mean difference (95% CI)=−0.27 (−0.53 to −0.02) and −2.58 (−4.59 to −0.57), respectively) in the short-term. For self-reported pain and function, very low-certainty evidence indicates that knee taping, whole-body vibration, electromyographic biofeedback and knee brace combined with exercise do not differ from exercise alone. Interventions are poorly described in most RCTs, adjunct treatments scored on average 14/24 and exercise therapy 12/24 in the Template for Intervention Description and Replication checklist. Conclusion Neuromuscular electrical stimulation and monopolar dielectric diathermy combined with exercise seem to improve self-reported pain in people with PFP compared with exercise alone. Knee taping, whole-body vibration, electromyographic biofeedback and knee brace do not offer additional benefits to exercise alone. Most interventions are poorly described, which is detrimental to translating research knowledge into clinical practice. PROSPERO registration number CRD42020197081. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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对于髌股疼痛患者，在运动疗法的基础上添加辅助治疗是否能有效改善疼痛和功能？对干预措施质量进行荟萃分析和评估的系统回顾


目的 比较辅助治疗联合运动与单独运动对髌股疼痛 (PFP​​) 患者的疗效，并探讨随机对照试验 (RCT) 中干预描述的质量。设计系统审查。数据来源 2023 年 11 月检索了 7 个数据库。随机对照试验评估了任何辅助治疗与运动相结合对单独运动对 PFP 患者自我报告的疼痛和功能的有效性。结果 我们纳入了 45 项随机对照试验（2023 名受试者），其中 25 项随机对照试验（1050 名受试者）参与了荟萃分析。汇总分析表明，非常低确定性的证据表明，与单独运动相比，神经肌肉电刺激或单极介电透热疗法与运动相结合，可以使自我报告的疼痛有小有大的改善（标准化平均差（95% CI）=−0.27（−0.53短期内分别为-0.02）和-2.58（-4.59至-0.57））。对于自我报告的疼痛和功能，极低质量的证据表明，膝盖贴扎、全身振动、肌电图生物反馈和护膝与运动相结合与单独运动没有区别。大多数随机对照试验中对干预措施的描述很差，干预描述和重复检查表模板中辅助治疗的平均得分为 14/24，运动疗法的平均得分为 12/24。结论 与单独运动相比，神经肌肉电刺激和单极介电透热疗法与运动相结合似乎可以改善 PFP 患者的自我报告疼痛。膝部贴带、全身振动、肌电生物反馈和护膝并不能为单独锻炼带来额外的好处。 大多数干预措施的描述很差，这不利于将研究知识转化为临床实践。 PROSPERO 注册号 CRD42020197081。与研究相关的所有数据都包含在文章中或作为补充信息上传。