***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: A common rehabilitation strategy for patellofemoral pain syndrome ( PFPS ) , which lacks scientific evidence , includes pulling the patella medially with tape to reduce pain and increase the vastus medialis oblique ( VMO ) muscle activity . The purpose of this study was to examine the effect of various patellar taping procedures on force production , EMG activity of the VMO and vastus lateralis ( VL ) muscles , and perceived pain experienced by 30 women ( 27.3 + /- 1.53 ) , half diagnosed with PFPS . The perceived pain , force , and EMG of the VMO and VL , were recorded while subjects performed maximal isokinetic leg presses at 30 degrees /s for each of the following patellar taping conditions : no tape ( control ) , no glide ( placebo ) , medial and lateral glide ( experimental ) . The medial and placebo procedures significantly ( P < 0.01 ) reduced perceived pain ( 70 - 80 % ) in PFPS subjects . Although patellar taping did not influence leg press force ( P > 0.05 ) , it increased the VMO activity and decreased the VL activity in PFPS subjects but had the opposite effect in healthy subjects . The findings suggest that taping the patella medially can contribute positively to PFPS rehabilitation . Because the medial glide and placebo taping conditions had similar effects , it is proposed that the benefits of patellar taping are not due to a change in patellar position but rather due to enhanced support of the patellofemoral ligaments and /or pain modulation via cutaneous stimulation 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 This study was undertaken to determine if commonly used orthotics ( Palumbo " Dynamic Patellar Brace " [ DynOrthotics , Vienna , Virginia ] and the Cho-Pat Knee Strap [ Cho-Pat Inc , Hainesport , New Jersey ] ) are helpful in the management of  anterior knee pain in an active population who are unable to significantly modify their activity due to basic training requirements . In a prospect i ve , r and omized study , 59 Air Force Academy basic cadets who presented with anterior knee pain during the initial phases of basic cadet training , were placed into one of the three treatment groups . Group A was assigned no brace , group B was issued a Palumbo " Dynamic Patellar Brace , " and group C was issued a Cho-Pat Knee Strap . All patients were started on physical therapy with " closed chain " rehabilitation and given nonsteroidal anti-inflammatory medications . Patients then underwent weekly follow-up with serial examinations and completion of a visual analog pain/motivation question naire . At the completion of training ( 6 to 8 weeks after study initiation ) , all charts were collected and statistically analyzed with analysis of variance ( ANOVA ) . Eight patients were removed from the study group because of insufficient follow-up or failure to complete training ( correlated with low motivation scales ) . There was no significant difference between the groups regarding change in pain throughout the study . The only statistically significant item was the proportion of females presenting with anterior knee pain ( 2.7 % versus 1.4 % incidence ) . Two patients voluntarily separated ( disenrolled ) due to incapacitating anterior knee pain at the completion of the study . Both of these patients were assigned to the Palumbo group . Despite manufacturer cl aims , these two orthotics do not appear to be effective in controlling anterior knee pain in this basic trainee population Abstract Objectives To test the hypotheses that therapeutic taping of the knee improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment . Design R and omised single blind controlled trial with three intervention arms ( therapeutic tape , control tape , and no tape ) of three weeks ' duration and three week follow up . Setting Outcome assessment was performed in a university based laboratory . Taping interventions were applied by eight physiotherapists in metropolitan private practice . Participants 87 patients with symptoms of knee osteoarthritis as defined by the American College of Rheumatology . Main outcome measures Primary outcome measure was pain as measured by visual analogue scale and participant perceived rating of change . Secondary measures of pain and disability included the Western Ontario and MacMaster Universities osteoarthritis index , knee pain scale , and the SF-36 . Results The therapeutic tape group reported a greater reduction in pain on all primary outcomes than either of the other two groups . A significant association was evident between intervention and change in pain at three weeks ( P=0.000 ) , with 73 % ( 21/29 ) of the therapeutic tape group reporting improvement compared with 49 % ( 14/29 ) of the control tape group and 10 % ( 3/29 ) of the no tape group . Significantly greater improvement in pain and disability was observed on most secondary outcomes in the therapeutic tape group compared with the no tape group . Benefits of therapeutic tape were maintained three weeks after stopping treatment . Conclusions Therapeutic knee taping is an efficacious treatment for the management of pain and disability in patients with knee osteoarthritis OBJECTIVES To evaluate the effects of two knee taping techniques , therapeutic tape and neutral tape , on pain and observed disability in symptomatic generalized knee osteoarthritis ( OA ) . METHODS Using a within-subjects study design , 18 participants were tested under three conditions in r and om order : untaped , wearing therapeutic knee tape and wearing neutral knee tape . Outcome measures included assessment of pain during each of four activities ( using a visual analogue scale ) and assessment of observed disability ( walking speed , timed up and go test , and the step test ) . RESULTS Therapeutic tape significantly reduced pain on three of the four activities assessed , when compared with the neutral and untaped conditions ( P<0.017 ) . The only statistically significant change in observed disability was detected in the step test ( P<0.001 ) , in favour of the therapeutic tape . CONCLUSIONS Therapeutic knee tape is a simple , inexpensive strategy that increases the treatment options for therapists and patients in the conservative management of knee OA . Whilst effective in immediately reducing pain , it does not appear to have a significant immediate impact on observed disability associated with the disease . Therapeutic tape may be used as an adjunct to drug and exercise therapies , potentially augmenting the individual benefits of each The efficacy of treatment of overuse patellofemoral pain with an elastic knee sleeve with a silicone patellar ring was compared with a simple elastic sleeve and with no treatment in a prospect i ve study of 395 army recruits . During 14 weeks of basic training , 84 knees were diagnosed as having overuse patellofemoral pain . Recruits treated with a simple elastic knee sleeve had a statistically significant better comfort score and more had their pain resolved by the end of training than those treated with elastic knee sleeves with a silicone patellar ring . The mean pain score at the end of training decreased more among recruits who were treated with a simple elastic knee sleeve than among recruits who received no treatment , but this difference was not significant . Among the treatment options tried , the simple elastic knee sleeve was no more effective than no treatment at all , but it was more effective than the more elaborate patellar brace Objectives : To identify the sites and intensity of pain in patients with patellofemoral pain syndrome . Method : A prospect i ve cohort study was conducted at an academic sports medicine practice in Boston , Massachusetts . All patients met inclusion criteria and were enrolled and evaluated during the study time frame . A single sports medicine orthopaedic surgeon examined a consecutive sample of patients with patellofemoral pain not explained by one of several well-defined anterior knee pain diagnoses . The study group consisted of 100 patients ( 75 females , 25 males ) with median age of 14 years . Eleven discrete locations were palpated for tenderness .  Hamstring tightness  was evaluated by measuring the popliteal angle . Patients reported intensity of pain using a 0- to 9-point ordinal scale . Regression and nonparametric statistical methods were used . Results : The most common site of pain was the patella during anterior-posterior compression ( 90 patients ) , followed by the distal pole of the patella , the medial plica , and the nonarticular medial femoral condyle . Median “ worst pain ” intensity was 6 out of a possible 9 . The most common site of “ worst pain ” was also the patella in compression ( 63 patients ) . Median duration of symptoms was 10 months , with an interquartile range of 3 to 20 months . Pain intensity was inversely correlated with duration of symptoms ( P < 0.01 ) . Conclusions : In these patients with patellofemoral pain syndrome , the major source of pain was the patella subchondral bone OBJECTIVE To examine the test-retest reliability , validity , and responsiveness of several outcome measures in the treatment of patellofemoral pain . DESIGN Evaluation of the clinimetric properties of individual outcome measures for patellofemoral pain treatment , using data collected from a previously published r and omized controlled trial ( RCT ) . SETTING General community and private practice . PARTICIPANTS The data from 71 persons enrolled in an RCT of a conservative intervention for patellofemoral pain were used to evaluate the measures ' validity and responsiveness . A subset of this cohort ( n=20 ) was used to assess reliability . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Three  10-cm visual analog scales ( VASs ) for usual pain ( VAS-U ) , worst pain ( VAS-W ) , and pain on 6 aggravating activities ( walking , running , squatting , sitting , ascending and descending stairs ) ( VAS-activity ) ; the Functional Index Question naire ( FIQ ) ; the Anterior Knee Pain Scale ( AKPS ) ; and the global rating of change . RESULTS The test-retest reliability ranged from poor ( intraclass correlation coefficient [ICC]=.49 ) to good ( ICC=.83 ) , and the measures correlated moderately with each other ( r range,.56-.72 ) . Median change scores differed significantly between improved and unimproved persons for all measures . The effect sizes for VAS-U ( .79 ) , VAS-W ( .88 ) , and the AKPS ( .98 ) were large , indicating greater responsiveness than the FIQ ( .37 ) and VAS-activity ( .66 ) . Similarly , the AKPS and VAS-W were the most efficient measures for detecting a treatment effect when compared with a reference measure ( VAS-U , which was assigned a value of 1 ) . The minimal difference that patients or clinicians consider clinical ly important for the AKPS is 10 ( out of 100 ) points and for the VAS it is 2 cm ( out of 10 cm ) . CONCLUSIONS The AKPS and VAS for usual or worst pain are reliable , valid , and responsive and are therefore recommended for future clinical trials or clinical practice in assessing treatment outcome in persons with patellofemoral pain 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 patello 
    Output:
    
There was disputable evidence from low- quality studies for patellar bracing benefits .
There was evidence that tape applied to exert a medially-directed force on the patella produces a clinical ly meaningful change in chronic knee pain .
There was limited evidence to demonstrate the efficacy of patellar bracing .