Effects of telerehabilitation on pain and physical function in patients with patellofemoral pain syndrome: Systematic review and meta-analysis

BACKGROUND: Patellofemoral pain syndrome (PFPS) is a prevalent knee injury impairing daily life, yet conventional rehabilitation suffers from poor long-term adherence due to time and space constraints. Telerehabilitation has exhibited benefits in other disorders, but its efficacy for PFPS lacks systematic evaluation. OBJECTIVE: To assess the impacts of telerehabilitation on pain, physical function and psychological status in PFPS patients. METHODS: Randomised controlled trials (RCTs) published up to 17 September 2025 were retrieved from SinoMed, CNKI, WanFang, VIP, PubMed, Embase, Web of Science and The Cochrane Library. Two researchers independently screened studies, extracted data and evaluated bias risk. Meta-analyses were conducted via RevMan 5.3 and StataMP 16, with continuous outcomes presented as Mean Difference (MD), Standard Mean Difference (SMD) and 95% Confidence Intervals (CI). RESULTS: Seven RCTs involving 531 patients were included. Meta-analysis indicated that, versus conventional therapy, telerehabilitation more effectively relieved PFPS-related pain (SMD = -0.85, 95% CI = -1.21 ∼ -0.5, P < 0.01), improved KUJALA/AKPS functional scores (MD = 13.11, 95% CI = 7.09-19.13, P < 0.01) and increased knee flexion angle (MD = 5.68, 95% CI = 1.47-9.89, P < 0.01). No significant between-group differences were observed in UCLA activity scores, Tampa Scale for Kinesiophobia (TSK) scores or Pain Catastrophizing Scale (PCS) scores (all P > 0.05). CONCLUSION: Telerehabilitation can alleviate pain and improve physical function in patients with PFPS, which confers certain clinical value, particularly in improving access to rehabilitation services. Its impact on psychological status remains inconclusive. Future research should conduct more high-quality, large-sample studies with long-term follow-up and explore their potential in psychological and behavioural interventions.