However, it still has some minor limitations: reliance on documentation of a diagnosis of asthma in medical

records with no confirmatory assessment, and lack of blinding of most of the parties involved. However, the study did blind the data analysts, for whom blinding has only recently been recommended (Kolahi and Abrishami 2009). The benefits of breathing training in asthma appear clinically worthwhile despite the probable absence of an effect on the underlying pathophysiology. Physiotherapists should consider using this intervention in appropriate patients. “
“Summary of: van Linschoten R, van Middelkoop M, Berger MY, Heintjes EM, Verhaar JAN, Willemsen SP, et al (2009) Supervised exercise versus usual care for patellofemoral pain check details syndrome: an open label randomised controlled trial. BMJ 339: b4074. [Prepared by Julia Hush, CAP Editor.] Question: Does supervised

exercise therapy improve pain, function, and recovery more than usual care for patients with patellofemoral pain syndrome? Design: Randomised controlled trial with concealed allocation. Setting: General and sports medicine practices in The Netherlands. Patients: Patients aged 14 to 40 with patellofemoral pain for between 2 months and 2 years were recruited as they consulted a general practitioner or sports physician for the pain. Knee MK0683 osteoarthritis, patellar tendinopathy, and Osgood- Schlatter disease were exclusion criteria. 131 patients were randomised into exercise therapy (n = 65) and control (n = 66) groups with stratification by age and recruiting physician. Interventions: The intervention group received a 6-week progressive exercise program that was individually tailored. This group was instructed to exercise 25 minutes daily for 3 months and was supervised by a physiotherapist for 9 sessions over 6 weeks. The next control group was advised to rest during periods of pain and to refrain from pain-provoking activities. Both groups received written information and advice about their condition, appropriate analgesia, and activity guidelines and daily isometric quadriceps exercises. Outcomes: Primary outcomes measured at 3 and 12 months were

perceived recovery (7-point Likert scale), function (0–100 point Kujala patellofemoral score), and pain at rest and with activity (0–10 point numerical rating scale). Results: After 3 months, the exercise group had less pain at rest (−1.1, 95% CI −1.9 to-0.2), less pain on activity (−1.0, 95% CI −1.9 to −0.1), and improved function (4.9, 95% CI 0.1 to 9.7), compared with usual care. At 12 months the exercise group had less pain at rest (−1.3, 95% CI −2.2 to −0.4), less pain on activity (−1.2, 95% CI −2.2 to −0.2), and improved function (4.5, 95% CI −0.7 to 9.8). A higher proportion of patients in the exercise group than in the control group reported recovery (42% v 35% at 3 months and 62% v 51% at 12 months), although the differences were not statistically significant.