Foot-Targeted Rehabilitation for Pronation-Related Anterior Knee Pain: A Two-Phase Case-Control Study and…

Randomized trialPhysiotherapy research international : the journal for researchers and clinicians in physical therapy· Oct 2026

Foot-Targeted Rehabilitation for Pronation-Related Anterior Knee Pain: A Two-Phase Case-Control Study and Single-Blind Randomized Controlled Trial of Manual Therapy Versus Neuromuscular Training Each With Augmented Low-Dye Taping.

Albert Anand Udhaya Kumar, Vinodhkumar Ramalingam, Venkadesan Rajendran

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Musculoskeletal RehabilitationRandomized trialTreatmentQ2IF 1.9

Foot pronation linked to markedly worse knee function scores in anterior knee pain patients

Foot-Targeted Rehabilitation for Pronation-Related Anterior Knee Pain: A Two-Phase Case-Control Study and Single-Blind Randomized Controlled Trial of Manual Therapy Versus Neuromuscular Training Each With Augmented Low-Dye Taping.

Albert Anand Udhaya Kumar … Venkadesan Rajendran

Physiotherapy research international · Oct 2026 · Q2 in Rehabilitation

Background

The mechanistic rationale for treating the foot in anterior knee pain (anterior knee pain) is well established in the biomechanics literature; however, translating it into a clinically actionable evidence-supported rehabilitation protocol has proven difficult.

Purpose

To characterize the functional and biomechanical differences between patients with anterior knee pain with and without pronated foot posture, and to compare the short-term effectiveness of two foot-targeted physiotherapy regimens, manual therapy with augmented low-dye taping (MT + ALDT) and neuromuscular training with ALDT (NMT + ALDT), against routine physiotherapy care.

Methods

Phase 2 was a single-blind parallel-group RCT that randomized 31 participants with confirmed pronation 1:1:1 to MT + ALDT (n = 11), NMT + ALDT (n = 10), or routine physiotherapy (n = 10) across 12 sessions in 4 weeks.

n = 31 participants

Results

pronated feet score far worse on knee function than neutral or supinated feet

50.2AKPS s

Pronated

83.9AKPS s

Neutral/supinated

More results

In Phase 2, ANCOVA confirmed that both foot-targeted regimens significantly outperformed routine care on all four outcomes (all p < 0.001), with MT + ALDT demonstrating the greatest improvements.

More results

Effect sizes were large (η 2 = 0.646-0.958; 95% CIs reported in Results) and are treated as preliminary estimates warranting cautious interpretation given the small sample and single-center setting.

“

Conclusion

These preliminary single-center findings support further investigation of foot posture assessment and distal intervention in anterior knee pain pending confirmation in adequately powered multicenter trials.

Foot-Targeted Rehabilitation for Pronation-Related Anterior Knee Pain: A Two-Phase Case-Control Study and Single-Blind Randomized Controlled Trial of Manual Therapy Versus Neuromuscular Training Each With Augmented Low-Dye Taping.

Foot-Targeted Rehabilitation for Pronation-Related Anterior Knee Pain: A Two-Phase Case-Control Study and Single-Blind Randomized Controlled Trial of Manual Therapy Versus Neuromuscular Training Each With Augmented Low-Dye Taping.

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