400 Section - Effects of Combination of Monopolar Radiofrequency and Exercise Therapy versus Exercise Therapy alone in Individuals With Patellofemoral Pain: A Randomized Controlled Study

Objectives : Patellofemoral pain (PFP) is a common musculoskeletal condition characterized by anterior knee pain and functional limitations.  Monopolar radiofrequency (MRF) has emerged as a promising non-invasive modality that may enhance pain modulation and tissue healing. Whether combining MRF with exercise produces superior clinical benefits remains unclear.

Design: Participants with patellofemoral pain (n = 30) were randomly allocated to an exercise therapy (EX) group or a combined monopolar radiofrequency plus exercise group (MRF+EX). All interventions were delivered twice weekly for six weeks. The EX group performed a supervised program including hip and knee strengthening and neuromuscular training. The MRF+EX group received the same supervised exercise program, supplemented with standardized monopolar radiofrequency treatment (448 kHz, INDIBA) applied to the patellofemoral region within the same treatment session. Outcome measures included pain intensity using the visual analogue scale (VAS), function assessed by the Anterior Knee Pain Scale (AKPS), health-related quality of life measured by the EQ-5D-5L, and quadriceps strength assessed through isometric 90° knee extension.

Results: Both groups demonstrated significant improvements from baseline across all outcome measures following the 6-week intervention. Participants in the MRF+EX and EX groups showed reductions in VAS (p < 0.01) and increases in AKPS  (p < 0.05), EQ-5D-5L  (p < 0.05), and quadriceps isometric strength at 90° knee extension  (p < 0.05). Between-group comparisons indicated that the MRF+EX group achieved a greater reduction in VAS scores than the EX group  (p < 0.05). However, improvements in AKPS, EQ-5D-5L, and quadriceps strength were comparable between groups, with no meaningful additional benefit observed for the combined intervention beyond that of exercise alone.

Conclusion:

Although the combined monopolar radiofrequency plus exercise intervention produced a greater reduction in pain intensity compared with exercise alone, no additional benefits were observed in functional outcomes, health-related quality of life, or quadriceps strength.