The Role of Biofeedback in Patellofemoral Pain Conservative Treatment: A Systematic Review

This paper aims to investigate the effectiveness and the outcomes of the association between different types of biofeedback techniques and therapeutic exercises in the conservative treatment of patellar femoral pain (PFP). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines have been used and followed the Cochrane Handbook for Systematic Reviews of Interventions. Between April and June 2023, the following electronic databases were searched: PubMed, ScienceDirect, BIOMED Central, Cochrane Library, and PEDro. Only randomized controlled trials (RCTs) were selected. Following the search, 414 records were found, and after using strict inclusion and exclusion criteria, 12 RCTs were retrieved to include in this systematic review, assessing 513 patients. The association between biofeedback and therapeutic exercise may be beneficial for pain, function (AKPS), extensor muscle strength, reduction of the dynamic knee valgus and vastus medialis (VM) and vastus lateralis (VL) (EMG) optimization. All these results were valued in the short term. Regarding the intervention type, it was possible to correlate the EMG biofeedback with the benefits of the knee extensor strength and the EMG activity of VM and VL. Conversely, using mirror, verbal, and somesthetic (hands and band) feedback seems to be linked to the reduction of the knee dynamic valgus.