***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To investigate the efficacy of patellar taping on pain control , patellar alignment , and neuromuscular control ( ie , vastus medialis oblique activation , knee extensor moment , etc ) in subjects with patellofemoral pain syndrome . DATA SOURCES We search ed MEDLINE , SPORT Discus , PEDro , and CINAHL through December 2004 , using the key words patellar taping , therapeutic taping , McConnell taping , taping , chronic injury , patellofemoral pain , and knee . STUDY SELECTION Criteria for inclusion criteria were studies that exclusively recruited patients diagnosed with patellofemoral pain syndrome or anterior knee pain and outcome measures specific to pain reduction , neuromuscular control , and patellar positioning . DATA EXTRACTION We identified and review ed 16 studies with an average PEDro score of 4.25/10 . Articles were divided into 3 categories based on primary outcome measures : 4 r and omized controlled trials on treatment methods and pain , 9 studies on neuromuscular control , and 3 on patellar positioning . DATA SYNTHESIS Although patellar taping seems to reduce pain and improve function in people with patellofemoral pain syndrome during activities of daily living and rehabilitation exercise , strong evidence to identify the underlying mechanisms is still not available BACKGROUND AND PURPOSE Quadriceps strengthening , quadriceps stretching and patellar taping are commonly prescribed together for patellofemoral pain patients . This study aim ed to examine the effectiveness of each of these techniques in isolation for one week and in combination for one week . METHODS A prospect i ve double-blind r and omized control study was design ed involving 41 subjects with 60 knees diagnosed with patellofemoral pain . The knees were r and omized in onto one of four groups ( n = 15 ) : infrapatellar taping , quadriceps strengthening , quadriceps stretching and control . The taping was worn continually for the week ; the strengthening group followed a programme of non-weight-bearing terminal range quadriceps exercises , the stretching group performed rectus femoris stretches . The control group did not receive treatment . All subjects received advice . Seven pre- and post-treatment measures included isokinetic quadriceps strength , quadriceps length , pain measured during four activities and maximum eccentric , posturally controlled , pain-free knee flexion angle during a step-down . Results showed significant changes over time ( p < 0.01 ) in two out of seven measures for the taping group , in five out of seven for the strengthening group and five out of seven for the stretching group and none in the control group . When the three modalities were combined for one week , ( n = 60 ) all seven measures improved significantly ( p < 0.01 ) . CONCLUSION In isolation , quadriceps stretching and quadriceps strengthening result ed in more improvements than taping . Combining these treatments is recommended as the initial approach to treating patellofemoral pain but further individualized more functional , global treatment is essential Abstract Although patellar taping has been shown to reduce pain in participants with patellofemoral pain syndrome , the mechanisms of pain reduction have not completely been established following its application . The purpose of this study was to evaluate EMG activity of vastus medialis and vastus lateralis following the application of patellar taping during a functional single leg squat . Both vastus medialis obliquus – vastus lateralis onset and vastus medialis obliquus/vastus lateralis amplitude of 18 participants with patellofemoral pain syndrome and 18 healthy participants as controls were measured using an EMG unit . This procedure was performed on the affected knee of participants with patellofemoral pain syndrome , before , during , and after patellar taping during unilateral squatting . The same procedure was also performed on the unaffected knees of both groups . The mean values of vastus medialis obliquus – vastus lateralis onset prior to taping ( 2.54 ms , s = 4.35 ) were decreased significantly following an immediate application of tape ( −3.22 ms , s = 3.45 ) and after a prolonged period of taping ( −6.00 ms , s = 3.40 s ) ( P < 0.05 ) . There was also a significant difference between the mean values of vastus medialis obliquus – vastus lateralis onset among controls ( −2.03 ms , s = 6.04 ) and participants with patellofemoral pain syndrome prior to taping ( P < 0.05 ) . However , there were no significant difference between the ranked values of vastus medialis obliquus/vastus lateralis amplitude of the affected and unaffected knees of participants with patellofemoral pain syndrome and controls during different conditions of taping ( P > 0.05 ) . Decreased values of vastus medialis obliquus – vastus lateralis onset may contribute to patellar realignment and explain the mechanism of pain reduction following patellar taping in participants with patellofemoral pain syndrome Background Since knee complaints are common among athletes and are frequently presented in general practice , it is of interest to investigate the type of knee complaints represented in general practice of athletes in comparison with those of non-athletes . Therefore , the aim of this study is to investigate the differences in type of knee complaints between sport participants , in this study defined as athletes , and non-sport participants , defined as non-athletes , presenting in general practice . Further , differences in the initial policy of the GP , medical consumption , and outcome at one-year follow-up were also investigated . Methods Patients consulting their GP for a new episode of knee complaints were invited to participate in this prospect i ve cohort study . From the total HONEUR knee cohort population ( n = 1068 ) we extracted patients who were athletes ( n = 421 ) or non-athletes ( n = 388 ) . Results The results showed that acute distortions of the knee were significantly more diagnosed in athletes than in non-athletes ( p = 0.04 ) . Further , more athletes were advised by their GP to ' go easy on the knee ' than the non-athletes ( p < 0.01 ) , but no differences were found in number of referrals and medication prescribed by the GP . The medical consumption was significantly higher among athletes ; however , no significant differences were found between the two groups for recovery at one-year follow-up . Conclusion There are no major differences in the diagnosis and prognosis of knee complaints between athletes and non-athletes presented to the GP . This implies that there are no indications for different treatment strategies applied in both groups . However , athletes are more often advised to ' go easy on the knee ' and to rest than non-athletes . Further , there is a trend towards increased medical consumption among athletes while functional disability and pain are lower than among the non-athletes OBJECTIVE The purpose of this prospect i ve , r and omized , controlled study was to determine the effects of kinesio taping in the treatment of patients with patellofemoral pain syndrome ( PFPS ) . METHODS Thirty-one women with PFPS ( mean age : 44.88 years ; range : 17 to 50 years ) were r and omly assigned to either a kinesio taping ( KT ) ( n=15 ) or control ( n=16 ) group . Both groups received the same muscle strengthening and soft tissue stretching exercises for six weeks and the KT group additionally received kinesio taping at four day intervals for six weeks . Visual analog scale was used to measure pain intensity . Tension of the iliotibial b and /tensor fascia lata and hamstring muscles and the mediolateral location of the patella were measured before the treatment and at the end of the third and sixth week . The Anterior Knee Pain Scale / Kujala Scale was used for the analysis of functional performance . RESULTS Comparing pretreatment and 6th week values , significant improvements were found in pain , soft tissue flexibility and functional performance of both groups ( p<0.05 ) . However , patellar shift was unchanged ( p>0.05 ) . The KT group had significantly better hamstring flexibility than the control group at the end of three weeks ( p<0.05 ) . CONCLUSION The addition of kinesio taping to the conventional exercise program does not improve the results in patients with PFPS , other than a faster improvement in hamstring muscle flexibility The aim of this study was to assess the effect of patellar taping of the proprioceptive status of patients with patellofemoral pain syndrome ( PFPS ) . A total of 32 subjects ( 18 males , 14 females of age 31.9 + /- 11.2 , body mass index 25.8 + /- 5.3 ) with PFPS were tested for  Joint Position Sense ( JPS ) using a Biodex dynamometer . Outcomes of interest were the absolute error ( AE ) , the variable error ( VE ) and the relative error ( RE ) of the JPS values for both active ( AAR ) and passive ( PAR ) angle reproduction at an angular velocity of 2 degrees /s with a start angle at 90 degrees and target angles of 60 degrees and 20 degrees . Taping was applied in r and om order across the patella of each subject with each of the subjects acting as their own internal control . Results indicated initially that application of patellar tape did not enhance and in some cases worsened the JPS of the subjects ( P > 0.05 ) . However , when the subjects ' proprioceptive status was grade d according to their closeness to the target angles into ' good ' ( 5 degrees , N = 10 ) and ' poor ' ( > 5 degrees , N = 22 ) taping enhanced nearly all values of those with ' poor ' proprioception , with AE at 20 degrees to statistical significance ( P = 0.021 ) . In conclusion , this study has shown that patellar taping did not improve the AAR and PAR JPS tests of a whole sample of 32 PFPS patients . It also has shown that a subgroup of PFPS patients with poor proprioception may exist and be helped by patellar taping STUDY DESIGN A r and omized controlled trial . OBJECTIVES To investigate the effectiveness of daily patella taping and exercise on pain and function in individuals with patellofemoral pain syndrome . BACKGROUND Patella taping and muscle-strengthening programs are commonly used to treat patellofemoral pain syndrome . There is , however , little evidence for the effectiveness of these approaches . METHODS AND MEASURES Twenty-four men and 6 women aged 17 to 25 years ( mean + /- SD , 18.7 + /- 1.2 years ) participated in the study . Subjects were r and omly and exclusively assigned to 1 of 3 treatment groups : patella taping combined with a st and ardized exercise program , placebo patella taping and exercise program , or exercise program alone ( n = 10 in each group ) . Taping was applied and exercises performed on a daily basis for 4 weeks . Outcome measures were visual analog scales for pain and the functional index question naire , recorded at weekly intervals by a therapist who was blinded to group allocation . RESULTS Separate mixed-model ANOVAs , with repeated measures on time , indicated statistically significant improvements in pain and function over time for all groups ( P<.01 ) and also significant differences between groups for all measures ( P<.01 ) . Separate independent sample s t tests showed that the group receiving taping and exercises had better pain and function scores following treatment than the placebo taping- and -exercise group and the exercise-alone group . There were no significant differences between the placebo taping- and -exercise group and exercise-alone group at any time point . CONCLUSIONS These findings indicate that over a period of 4 weeks a combination of daily patella taping and exercises was successful in improving pain and function in individuals with patellofemoral pain syndrome . The combination of patella taping and exercise was superior to the use of exercise alone Objective : To examine the immediate effects of experimentally induced anterior knee pain ( AKP ) on involuntary and voluntary quadriceps strength and activation . Design : Crossover 3 × 3 r and omized controlled laboratory study with repeated measures . Setting : Human Performance Research Center , Brigham Young University . Participants : Thirteen neurologically sound volunteers ( age , 21.9 ± 3.2 years ) . Interventions : Subjects underwent 3 different conditions ( pain , sham , and control ) . To induce AKP and sham condition , 5 % sodium chloride and 0.9 % sodium chloride ( total volume of 1.0 mL for each condition ) , respectively , were injected into the infrapatellar fat pad on the dominant leg . No injection was performed for the control condition . Main Outcome Measures : The vastus medialis peak Hoffmann reflex normalized by the peak motor response ( H : M ratio ) was used to measure involuntary quadriceps activation . Quadriceps central activation ratio ( CAR ) using maximal isometric knee extension torque ( N·m ) was calculated to assess voluntary quadriceps activation . The visual analog scale was used to measure pain perception . Results : Our pain model increased perceived pain immediately after the 5 % hypertonic saline injection and pain lasted for 12 minutes on average ( F40,743 = 16.85 , P < 0.001 ) . During the pain condition , subjects showed a 12 % decrease in H : M ratio ( F2,59 = 8.64 , P < 0.001 ) , a 34 % decrease in maximal isometric knee extension torque ( F2,59 = 5.89 , P < 0.01 ) , and a 5 % decrease in CAR ( F2,59 = 3.83 , P = 0.03 ) . Conclusions : Our data showed that joint pain may be an independent factor to alter function of the muscles surrounding the painful joint . Both involuntary and voluntary inhibitory pathways may play a role in an immediate reduction of muscle activation STUDY DESIGN A multicenter , single-masked study of patients with patellofemoral pain syndrome ( PFPS ) using a repeated- measures design . OBJECTIVE To compare 3 different methods of patellar taping for 
    Output:
    
There is moderate evidence that ( 1 ) tailored ( customised to the patient to control lateral tilt , glide and spin ) and untailored patellar taping provides immediate pain reduction of large and small effect , respectively and ( 2 ) tailored patellar taping promotes earlier onset of vastus medialis oblique ( VMO ) contraction ( relative to vastus lateralis contraction ) .
There is limited evidence that ( 1 ) tailored patellar taping combined with exercise provides superior pain reduction compared to exercise alone at 4 weeks , ( 2 ) untailored patellar taping added to exercise at 3 - 12 months has no benefit and ( 3 ) tailored patellar taping promotes increased internal knee extension moments .
CONCLUSIONS Tailoring patellar taping application ( ie , to control lateral tilt , glide and spin ) to optimise pain reduction is important for efficacy .
Possible mechanisms behind patellar taping efficacy include earlier VMO onset and improved knee function capacity ( ie , ability to tolerate greater internal knee extension moments )