Comparative Effectiveness of Proprioceptive Neuromuscular Facilitation Stretching and Core Training for Patellofemoral Pain Syndrome in Adolescents: A Systematic Review

Abstract

Background: Patellofemoral pain syndrome (PFPS) is a common knee issue in teenagers, causing pain in the front of the knee that can make everyday activities and sports difficult. To manage PFPS, two popular exercise-based approaches are proprioceptive neuromuscular facilitation (PNF) stretching and core training exercises. However, it's still unclear which method works best. Objective: This review looks at the effectiveness of PNF stretching versus core training exercises in helping adolescents manage PFPS. Methods: We searched multiple medical databases—PubMed, Scopus, Web of Science, and PEDro—up to March 2025 for studies on this topic. We included randomized controlled trials (RCTs) and quasi-experimental studies that compared PNF stretching and core training, either against each other or a control group, in adolescents aged 10–19 with PFPS. The main factors we examined were pain levels, functional performance, and quality of life. To ensure the reliability of our findings, we assessed the quality of the studies using the PEDro scale. Results: Out of the studies reviewed, 25 met the criteria for inclusion. Both PNF stretching and core training helped reduce pain and improve function compared to no treatment. However, core training was better at improving posture and overall quality of life. Conclusion: Both methods are beneficial, but core training has a stronger effect on movement and daily comfort for teens with PFPS. More research is needed to determine the best long-term approach and exercise routine.