The treatment of patellofemoral pain (PFP) is predominantly conservative, with an emphasis on exercises for quadriceps strengthening. However, one of the challenges in rehabilitation is the pain experienced during the execution of these exercises, as well as the difficulty in progressing with load. In this context, Partial Vascular Occlusion (PVO) emerges as a promising strategy, as it enables improvements in strength and hypertrophy with less overload.

To evaluate the effect of PVO or resisted exercises for quadriceps strengthening on pain, functional capacity, postural control, activation, and quadriceps strength in women with patellofemoral pain.

A randomized clinical trial, with a blinded evaluator, approved by the ethics committee (Opinion 4.062.833) and registered at Clinical Trials. The sample consisted of 24 women, aged 18 to 45 years, diagnosed with patellofemoral pain. Participants were randomized into two groups: Group 1 (G1; N = 12), who performed resisted exercises with an external load of 20% of their body weight, and Group 2 (G2; N = 12), who performed exercises without additional load, with PVO applied to the proximal region of the thigh, at a pressure of 200 mmHg. All participants were evaluated before the intervention, immediately post-intervention, and at a four-week follow-up. The outcomes analyzed were pain (visual analogue pain scale), functional capacity (Anterior Knee Pain Scale and Lysholm Knee Scoring Scale), postural control during stair ascent and descent (force platform), quadriceps muscle activation (electromyography), and quadriceps strength (isometric dynamometer). Both groups performed the same exercises: bilateral squats, lunges, single-leg squats, and at the fourth week, single-leg squats on an inclined platform (25°), executed at the participant’s most comfortable angle. Three sets of each exercise were performed, with up to 15 repetitions per set, over 12 sessions, twice a week, for a total treatment duration of six weeks. Statistical analysis was conducted using intention-to-treat analysis, effect size calculation, and generalized estimating equations (GEE) model. A generalized estimating equation (GEE) model, using specific syntax, was employed to compare the variables of anxiety and sleep. Multiple comparisons were conducted using the Bonferroni post hoc test. All analyses were performed using IBM-SPSS software, with a significance level set at 5%.

Initially, the groups did not show differences in age, body mass index, physical activity level, or pain level (P > 0.05). Pain, functional capacity, postural control, and muscle strength were similar between the groups at all three assessment points (P > 0.05), with improvements in pain and functional capacity after treatment (P < 0.05; d > 1). Muscle activation results were inconclusive, G1 showed less activation of the rectus femoris and greater activation of the vastus medialis at follow-up. No differences in pain during exercise execution were found (P = 0.79).

The results indicate that treatment protocols for PFP using PVO or resisted exercises with an external load of 20% of body weight similarly improved pain and functional capacity.

The use of PVO and resisted exercises proved to be effective therapeutic options for improving pain and functional capacity in women with patellofemoral pain.