Task-specific plantar pressure adaptations in individuals with patellofemoral pain syndrome during dynamic activities: a systematic review

Altered plantar pressure distribution may be associated with patellofemoral pain syndrome (PFP), particularly during dynamic activities; however, findings on task-specific adaptations remain inconsistent. A systematic search was conducted in major databases for articles published up to January 2025 using key terms on patellar/knee pain, plantar pressure, and foot loading. Studies were included if they compared plantar pressure variables between individuals with PFP and controls during walking, running, stair descent, squatting, or jumping. Eleven studies met the eligibility criteria. Across studies, findings varied in definition and magnitude. Six walking studies reported reduced medial forefoot pressure and increased medial heel contact in individuals with PFP. One prospective running study reported increased lateral heel and forefoot loading in those who developed PFP. A stair descent study reported greater midfoot and medial heel contact during step down, while squatting and jumping tasks reported asymmetrical loading patterns and shifts in centre of pressure. Overall, this review suggests task-specific plantar pressure alterations in individuals with PFP. However, the evidence remains limited, and heterogeneity in activity types, pressure systems, analysis methods, and study designs contributed to inconsistent findings. While some patterns may reflect changes in loading, causal relationships cannot be established, underscoring the need for prospective research.