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Effects of a 12-week home exercise therapy program on pain and neuromuscular activity in patients with patellofemoral pain syndrome



The aim of this study is to evaluate the effects of a 12-week home exercise therapy program on pain, function and neuromuscular activity of the vastus medialis and vastus lateralis.

Materials and methods

Fifty patients with patellofemoral pain syndrome were treated with a 12-week online home exercise program. The primary outcomes of pain and function were assessed at the 12-week follow-up using the Visual Analog Scale and Kujala Score, respectively. Secondary outcomes were the muscle onset time and the ratio of vastus medialis and vastus lateralis during different daily activities.


After 12 weeks, patients showed significant (p < 0.05) improvements of 27 points on the Visual Analog Scale and 10 points on Kujala Score. Differences in pre-post comparison regarding both temporal and amplitude-related neurophysiological differences between the vastus medialis and lateralis were only found when the subjects were divided into groups of different electromyographic patterns. Then changes in the pre-post comparison were particularly evident in the patient group with a delayed vastus medialis onset and a lower activity of the vastus medialis compared to the VL.


Pain and function improved significantly after a home exercise therapy program in patients with patellofemoral pain syndrome. In addition, patients with a delayed onset or reduced activity of the vastus medialis compared to the vastus lateralis experienced a reduction in this imbalance.

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Patellofemoral pain syndrome


Visual Analog Scale


Vastus medialis


Vastus lateralis


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This study was funded by the “Landesgraduiertenförderung” of the University of Stuttgart (scholarship for the corresponding author).

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Correspondence to Theresa Kölle.

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All authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the institutional review boards of the authors´ affiliated institutions. All measurements within in the study follow the guidelines of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Kölle, T., Alt, W. & Wagner, D. Effects of a 12-week home exercise therapy program on pain and neuromuscular activity in patients with patellofemoral pain syndrome. Arch Orthop Trauma Surg 140, 1985–1992 (2020).

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  • Patellofemoral pain
  • Anterior knee pain
  • Home exercise therapy
  • Electromyography
  • Vastus