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Modulating Patellofemoral Joint Stress Through Targeted Neuromuscular Training in Runners: A Systematic Review and Meta-Analysis I Gusti Made Baskara Teragnya Mahaputra; Bagus Bayu Pradnyana; Made Dwi Puja Setiawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1589

Background: Patellofemoral pain syndrome remains a highly prevalent running-related injury, characterized by retropatellar pain exacerbated by knee flexion. While multifactorial, biomechanical imbalances and proximal neuromuscular deficits are primary contributors. This systematic review and meta-analysis evaluated the efficacy of targeted neuromuscular training and gait retraining on pain, functional capacity, and biomechanical parameters in runners with patellofemoral pain syndrome. Methods: A systematic search and analysis were conducted, incorporating nine randomized controlled trials. Inclusion criteria focused on adult runners diagnosed with patellofemoral pain syndrome undergoing neuromuscular exercise or gait retraining compared to control or standard care. Primary outcomes included self-reported pain and functional status. Standardized Mean Differences with 95 percent confidence intervals were calculated using an inverse-variance random-effects model. Results: Nine randomized controlled trials involving robust sample sizes were analyzed. The pooled meta-analysis for pain reduction demonstrated a statistically significant large effect size favoring targeted neuromuscular and gait retraining interventions (Standardized Mean Difference = -1.38, 95 percent confidence interval [-1.85, -0.91], p less than 0.001). Functional outcomes also showed significant improvement in the intervention groups (Standardized Mean Difference = 1.51, 95 percent confidence interval [1.02, 2.00], p less than 0.001). Biomechanical analyses indicated significant modulations in hip kinematics, notably reduced peak hip adduction. Conclusion: Targeted neuromuscular training and gait retraining significantly reduced pain and improved lower extremity function in runners. These interventions successfully modulated patellofemoral joint stress through enhanced proximal control and altered strike mechanics.

Comparative Efficacy of Intra-articular Platelet-Rich Plasma Versus Dextrose Prolotherapy for Pain Reduction and Functional Recovery in Knee Osteoarthritis: A Meta-Analysis of Randomised Controlled Trials Bagus Bayu Pradnyana; Bagus Diva Indra Dharma
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1623

Background: Knee osteoarthritis (OA) is a primary cause of chronic pain and disability. Intra-articular platelet-rich plasma (PRP) and hypertonic dextrose prolotherapy are emerging regenerative therapies, yet their comparative and long-term effectiveness remain incompletely characterized. This meta-analysis quantifies their pooled effect on pain and function, prioritizing the head-to-head comparison of PRP versus prolotherapy. Methods: A systematic search of PubMed, Scopus, and Google Scholar (to July 2025) identified randomized and prospective comparative trials evaluating intra-articular PRP and/or prolotherapy in adults with Kellgren–Lawrence grade I–III knee OA. Pain and functional outcomes were extracted, and risk of bias was assessed using the Cochrane RoB 2 framework. Standardized mean differences (Hedges' g) were pooled using a restricted maximum likelihood random-effects model, alongside subgroup and small-study effect analyses. Results: Ten studies (n=855) were included. The mixed-comparator pooled estimate significantly favored the active therapies (Hedges' g = −0.948, 95% CI −1.725 to −0.171; p=0.022; I²=94.9%). Subgroup analyses revealed an effect size of g = −1.302 for PRP versus prolotherapy, g = −1.049 for prolotherapy versus inactive comparators, and g = −0.412 for PRP versus saline placebo. Differences between subgroups were not statistically significant (p=0.627). Egger regression indicated small-study effects (p=0.016). Conclusion: Both PRP and prolotherapy yield clinically meaningful improvements in knee OA pain and function. PRP demonstrates larger, more durable effects in direct comparisons, positioning it as the preferred regenerative option for sustained benefit beyond six months. Prolotherapy remains a practical alternative for shorter-term relief. However, substantial heterogeneity, small-study effects, and modest advantages over blinded saline necessitate cautious translational interpretation.

Modulating Patellofemoral Joint Stress Through Targeted Neuromuscular Training in Runners: A Systematic Review and Meta-Analysis I Gusti Made Baskara Teragnya Mahaputra; Bagus Bayu Pradnyana; Made Dwi Puja Setiawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1589

Background: Patellofemoral pain syndrome remains a highly prevalent running-related injury, characterized by retropatellar pain exacerbated by knee flexion. While multifactorial, biomechanical imbalances and proximal neuromuscular deficits are primary contributors. This systematic review and meta-analysis evaluated the efficacy of targeted neuromuscular training and gait retraining on pain, functional capacity, and biomechanical parameters in runners with patellofemoral pain syndrome. Methods: A systematic search and analysis were conducted, incorporating nine randomized controlled trials. Inclusion criteria focused on adult runners diagnosed with patellofemoral pain syndrome undergoing neuromuscular exercise or gait retraining compared to control or standard care. Primary outcomes included self-reported pain and functional status. Standardized Mean Differences with 95 percent confidence intervals were calculated using an inverse-variance random-effects model. Results: Nine randomized controlled trials involving robust sample sizes were analyzed. The pooled meta-analysis for pain reduction demonstrated a statistically significant large effect size favoring targeted neuromuscular and gait retraining interventions (Standardized Mean Difference = -1.38, 95 percent confidence interval [-1.85, -0.91], p less than 0.001). Functional outcomes also showed significant improvement in the intervention groups (Standardized Mean Difference = 1.51, 95 percent confidence interval [1.02, 2.00], p less than 0.001). Biomechanical analyses indicated significant modulations in hip kinematics, notably reduced peak hip adduction. Conclusion: Targeted neuromuscular training and gait retraining significantly reduced pain and improved lower extremity function in runners. These interventions successfully modulated patellofemoral joint stress through enhanced proximal control and altered strike mechanics.

Comparative Efficacy of Intra-articular Platelet-Rich Plasma Versus Dextrose Prolotherapy for Pain Reduction and Functional Recovery in Knee Osteoarthritis: A Meta-Analysis of Randomised Controlled Trials Bagus Bayu Pradnyana; Bagus Diva Indra Dharma
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1623

Background: Knee osteoarthritis (OA) is a primary cause of chronic pain and disability. Intra-articular platelet-rich plasma (PRP) and hypertonic dextrose prolotherapy are emerging regenerative therapies, yet their comparative and long-term effectiveness remain incompletely characterized. This meta-analysis quantifies their pooled effect on pain and function, prioritizing the head-to-head comparison of PRP versus prolotherapy. Methods: A systematic search of PubMed, Scopus, and Google Scholar (to July 2025) identified randomized and prospective comparative trials evaluating intra-articular PRP and/or prolotherapy in adults with Kellgren–Lawrence grade I–III knee OA. Pain and functional outcomes were extracted, and risk of bias was assessed using the Cochrane RoB 2 framework. Standardized mean differences (Hedges' g) were pooled using a restricted maximum likelihood random-effects model, alongside subgroup and small-study effect analyses. Results: Ten studies (n=855) were included. The mixed-comparator pooled estimate significantly favored the active therapies (Hedges' g = −0.948, 95% CI −1.725 to −0.171; p=0.022; I²=94.9%). Subgroup analyses revealed an effect size of g = −1.302 for PRP versus prolotherapy, g = −1.049 for prolotherapy versus inactive comparators, and g = −0.412 for PRP versus saline placebo. Differences between subgroups were not statistically significant (p=0.627). Egger regression indicated small-study effects (p=0.016). Conclusion: Both PRP and prolotherapy yield clinically meaningful improvements in knee OA pain and function. PRP demonstrates larger, more durable effects in direct comparisons, positioning it as the preferred regenerative option for sustained benefit beyond six months. Prolotherapy remains a practical alternative for shorter-term relief. However, substantial heterogeneity, small-study effects, and modest advantages over blinded saline necessitate cautious translational interpretation.

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