Efectividad de los ejercicios excéntricos y la terapia con ondas de choque en el manejo del dolor patelofemoral: revisión sistemática

Abstract

Background: Patellofemoral pain syndrome (PFPS) is one of the main causes of anterior knee pain in young and physically active individuals, leading to functional limitations and affecting quality of life. Among the most commonly used conservative interventions are eccentric exercises (EE) and extracorporeal shock wave therapy (ESWT), both of which have shown evidence of benefits in pain reduction and functional improvement. Objective: To evaluate, based on scientific evidence, the effectiveness of EE compared with ESWT in reducing pain and improving function in young adults aged 18 to 40 years with patellofemoral pain syndrome. Methods: A systematic literature review was conducted following the PRISMA 2020 guidelines. Cohort studies published between 2015 and 2025 were included from the PubMed, Scopus, Web of Science, and ScienceDirect databases. Results: Ten studies that met the inclusion criteria were selected. The results show that EE produces a reduction in pain between 1.5 and 3 points on the visual analog scale, as well as functional improvements of up to 20 points on scales such as Kujala and Lower Extremity Functional Scale (LEFS). On the other hand, ESWT showed pain reductions of 1.5 to 2.5 points, being more effective when used as a complement to conservative treatment. Conclusion: EE constitutes the basis of the treatment of PFPS due to its consistent effectiveness, while ESWT may be used as a complementary strategy, especially in early stages or persistent cases. Keywords: patellofemoral pain, eccentric exercises, shock wave therapy, conservative treatment