Limited evidence examining visual feedback in rehabilitation for generalised knee pain: a scoping review and call for further research

Margaret R. Klausing; Jordan Junk; Joshua A. Subialka

doi:10.2478/advrehab-2026-0003

.blurhash-client-img { display: none !important; }

Limited evidence examining visual feedback in rehabilitation for generalised knee pain: a scoping review and call for further research

Advances in Rehabilitation

Volume 40 (2026): Issue 1 (March 2026)

By: Margaret R. Klausing , Jordan Junk and Joshua A. Subialka

Open Access

|Mar 2026

Dey P, Callaghan M, Cook N, Sephton R, Sutton C, Hough E, et al. A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties. BMC Musculoskelet Disord. 2016;17:237. doi: 10.1186/s12891-016-1097-5.
Open DOI Search in Google Scholar Back to article
Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, et al. Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS One. 2018;13(1):e0190892. doi: 10.1371/journal.pone.0190892.
Open DOI Search in Google Scholar Back to article
Farha N, Spencer A, McGervey M. Outpatient evaluation of knee pain. Med Clin North Am. 2021;105(1):117–36. doi: 10.1016/j.mcna.2020.08.017.
Open DOI Search in Google Scholar Back to article
Aldharman SS, Almuhammadi HH, Madkhali AY, Alnami RA, Alkadi MA, Albalawi DM, et al. Prevalence of patellofemoral pain and knee pain in the general population of Saudi Arabia. Cureus. 2022;14:e30355. doi: 10.7759/cureus.30355.
Open DOI Search in Google Scholar Back to article
Farrokhi S, Chen YF, Piva SR, Fitzgerald GK, Jeong JH, Kwoh CK. The influence of knee pain location on symptoms, functional status, and knee-related quality of life in older adults with chronic knee pain: data from the osteoarthritis initiative. Clin J Pain. 2016;32(5):463–70. doi: 10.1097/AJP.0000000000000291.
Open DOI Search in Google Scholar Back to article
Nguyen USD, Zhang Y, Zhu Y, Niu J, Zhang B, Aliabadi P, et al. Increasing prevalence of knee pain and symptomatic knee osteoarthritis. Ann Intern Med. 2011;155(11):725–32. doi: 10.7326/0003-4819-155-11-201112060-00004.
Open DOI Search in Google Scholar Back to article
Young JL, Snodgrass SJ, Cleland JA, Rhon DI. Timing of physical therapy for individuals with patellofemoral pain and the influence on healthcare use, costs and recurrence rates: an observational study. BMC Health Serv Res. 2021;21(1):751. doi: 10.1186/s12913-021-06768-8.
Open DOI Search in Google Scholar Back to article
Willy RW, Hoglund LT, Barton CJ, Bolgla LA, Scalzitti DA, Logerstedt DS, et al. Patellofemoral pain. J Orthop Sports Phys Ther. 2019;49(9):CPG1–CPG95. doi: 10.2519/jospt.2019.0302.
Open DOI Search in Google Scholar Back to article
Kumar D, Neogi T, Peloquin C, Marinko L, Camarinos J, Aoyagi K, et al. Delayed timing of physical therapy initiation increases the risk of future opioid use in individuals with knee osteoarthritis: a real-world cohort study. Br J Sports Med. 2023;57(13):958–64. doi: 10.1136/bjsports-2022-106044.
Open DOI Search in Google Scholar Back to article
Capin JJ, Snyder-Mackler L. The current management of patients with patellofemoral pain from the physical therapist’s perspective. Ann Jt. 2018;3:40. doi: 10.21037/aoj.2018.04.11.
Open DOI Search in Google Scholar Back to article
Hunter CW, Deer TR, Jones MR, Chang Chien GC, D’Souza RS, Davis T, et al. Consensus guidelines on interventional therapies for knee pain (STEP Guidelines) from the American Society of Pain and Neuroscience. J Pain Res. 2022;15:2683–745. doi: 10.2147/JPR.S370469.
Open DOI Search in Google Scholar Back to article
Fukaya T, Mutsuzaki H, Mori K. Influence of pain on knee joint movement and moment during the stance phase in patients with severe bilateral knee osteoarthritis: a pilot study. Medicina (Kaunas). 2019;55(12):756. doi: 10.3390/medicina55120756.
Open DOI Search in Google Scholar Back to article
Farazdaghi M, Sadeghi H, Haghighi MA, Alshammari SM. Comparing the movement system impairment method and routine physical therapy for knee pain: a randomized clinical trial. Life (Basel). 2025;15(2):179. doi: 10.3390/life15020179.
Open DOI Search in Google Scholar Back to article
Alfieri FM, da Silva Dias C, de Oliveira NC, Battistella LR. Gamification in musculoskeletal rehabilitation. Curr Rev Musculoskelet Med. 2022;15(6):629–36. doi: 10.1007/s12178-022-09797-w.
Open DOI Search in Google Scholar Back to article
Bourdin P, Martini M, Sanchez-Vives MV. Altered visual feedback from an embodied avatar unconsciously influences movement amplitude and muscle activity. Sci Rep. 2019;9:19747. doi: 10.1038/s41598-019-56034-5.
Open DOI Search in Google Scholar Back to article
Gokeler A, Neuhaus D, Benjaminse A, Grooms DR, Baumeister J. Principles of motor learning to support neuroplasticity after ACL injury: implications for optimizing performance and reducing risk of second ACL injury. Sports Med. 2019;49(6):853–65. doi: 10.1007/s40279-019-01058-0.
Open DOI Search in Google Scholar Back to article
Popovic T, Caswell SV, Benjaminse A, Siragy T, Ambegaonkar J, Cortes N. Implicit video feedback produces positive changes in landing mechanics. J Exp Orthop. 2018;5(1):12. doi: 10.1186/s40634-018-0129-5.
Open DOI Search in Google Scholar Back to article
Wulf G, Chiviacowsky S, Schiller E, Avila LTG. Frequent external-focus feedback enhances motor learning. Front Psychol. 2010;1:190. doi: 10.3389/fpsyg.2010.00190.
Open DOI Search in Google Scholar Back to article
Madeleine P, Szeto GPY, Heredia-Rizo AM. Effects of biofeedback and strength training interventions on neck-shoulder sensory-motor responses among visual display unit users: a narrative review. J Electromyogr Kinesiol. 2024;79:102936. doi: 10.1016/j.jelekin.2024.102936.
Open DOI Search in Google Scholar Back to article
Sharma R, Singh G, Kothiyal S, Verma S. Enhancing core stability and strength through abdominal drawing-in maneuver training using a sphygmomanometer: a narrative review. J Bodyw Mov Ther. 2025;43:228–36. doi: 10.1016/j.jbmt.2025.04.035.
Open DOI Search in Google Scholar Back to article
Arcanjo FL, Martins JVP, Moté P, Leporace G, Oliveira DA, Sousa CS, et al. Proprioceptive neuromuscular facilitation training reduces pain and disability in individuals with chronic low back pain: a systematic review and meta-analysis. Complement Ther Clin Pract. 2022;46:101505. doi: 10.1016/j.ctcp.2021.101505.
Open DOI Search in Google Scholar Back to article
Brindle TJ, Mizelle JC, Lebiedowska MK, Miller JL, Stanhope SJ. Visual and proprioceptive feedback improves knee joint position sense. Knee Surg Sports Traumatol Arthrosc. 2009;17(1):40–7. doi: 10.1007/s00167-008-0638-3.
Open DOI Search in Google Scholar Back to article
Oh HT, Hwangbo G. The effects of proprioception exercise with and without visual feedback on pain and balance in patients after total knee arthroplasty. J Phys Ther Sci. 2018;30(1):124–6. doi: 10.1589/jpts.30.124.
Open DOI Search in Google Scholar Back to article
Sielski R, Rief W, Glombiewski JA. Efficacy of biofeedback in chronic back pain: a meta-analysis. Int J Behav Med. 2017;24(1):25–41. doi: 10.1007/s12529-016-9572-9.
Open DOI Search in Google Scholar Back to article
Diller F, Scheuermann G, Wiebel A. Visual cue-based corrective feedback for motor skill training in mixed reality: a survey. IEEE Trans Vis Comput Graph. 2024;30(7):3121–34. doi: 10.1109/TVCG.2022.3227999.
Open DOI Search in Google Scholar Back to article
Salmoni AW, Schmidt RA, Walter CB. Knowledge of results and motor learning: a review and critical reappraisal. Psychol Bull. 1984;95(3):355–86. doi: 10.1037/0033-2909.95.3.355.
Open DOI Search in Google Scholar Back to article
Shadmehr R, Krakauer JW. A computational neuroanatomy for motor control. Exp Brain Res. 2008;185(3):359–81. doi: 10.1007/s00221-008-1280-5.
Open DOI Search in Google Scholar Back to article
Tseng YW, Diedrichsen J, Krakauer JW, Shadmehr R, Bastian AJ. Sensory prediction errors drive cerebellum-dependent adaptation of reaching. J Neurophysiol. 2007;98(1):54–62. doi: 10.1152/jn.00266.2007.
Open DOI Search in Google Scholar Back to article
Byra J, Czernicki K. The effectiveness of virtual reality rehabilitation in patients with knee and hip osteoarthritis. J Clin Med. 2020;9(8):2639. doi: 10.3390/jcm9082639.
Open DOI Search in Google Scholar Back to article
McCabe CS, Haigh RC, Ring EFJ, Halligan PW, Wall PD, Blake DR. A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1). Rheumatology (Oxford). 2003;42(1):97–101. doi: 10.1093/rheumatology/keg041.
Open DOI Search in Google Scholar Back to article
Louw Q, Gillion N, van Niekerk SM, Morris L, Baumeister J. The effect of vision on knee biomechanics during functional activities: a systematic review. J Sci Med Sport. 2015;18(4):469–74. doi: 10.1016/j.jsams.2014.06.009.
Open DOI Search in Google Scholar Back to article
Riel H, Matthews M, Vicenzino B, Bandholm T, Thorborg K, Rathleff MS. Efficacy of live feedback to improve objectively monitored compliance to prescribed, home-based exercise therapy-dosage in 15 to 19 year old adolescents with patellofemoral pain: a study protocol of a randomized controlled superiority trial (The XRCISE-AS-INSTRUcted-1 trial). BMC Musculoskelet Disord. 2016;17:242. doi: 10.1186/s12891-016-1103-y.
Open DOI Search in Google Scholar Back to article
Hasan S, Alonazi A, Anwer S, Jamal A, Parvez S, Alfaiz FAS, et al. Efficacy of patellar taping and electromyographic biofeedback training at various knee angles on quadriceps strength and functional performance in young adult male athletes with patellofemoral pain syndrome: a randomized controlled trial. Pain Res Manag. 2022;2022:8717932. doi: 10.1155/2022/8717932.
Open DOI Search in Google Scholar Back to article
Alonazi A, Hasan S, Anwer S, Jamal A, Parvez S, Alfaiz FAS, et al. Efficacy of electromyographic-biofeedback supplementation training with patellar taping on quadriceps strengthening in patellofemoral pain syndrome among young adult male athletes. Int J Environ Res Public Health. 2021;18(9):4514. doi: 10.3390/ijerph18094514.
Open DOI Search in Google Scholar Back to article
Fyock M, Cortes N, Hulse A, Martin J. Gait retraining with real-time visual feedback to treat patellofemoral pain in adult recreational runners: a critically appraised topic. J Sport Rehabil. 2020;29(5):675–9. doi: 10.1123/jsr.2019-0094.
Open DOI Search in Google Scholar Back to article
Agresta C, Brown A. Gait retraining for injured and healthy runners using augmented feedback: a systematic literature review. J Orthop Sports Phys Ther. 2015;45(7):576–84. doi: 10.2519/jospt.2015.5823.
Open DOI Search in Google Scholar Back to article
Gazendam A, Zhu M, Chang Y, Phillips S, Bhandari M. Virtual reality rehabilitation following total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc. 2022;30(8):2548–55. doi: 10.1007/s00167-022-06910-x.
Open DOI Search in Google Scholar Back to article
Chan ZYS, Zhang JH, Au IPH, An WW, Shum GLK, Ng GYF, et al. Gait retraining for the reduction of injury occurrence in novice distance runners: 1-year follow-up of a randomized controlled trial. Am J Sports Med. 2018;46(2):388–95. doi: 10.1177/0363546517736277.
Open DOI Search in Google Scholar Back to article
Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011;45(9):691–6. doi: 10.1136/bjsm.2009.069112.
Open DOI Search in Google Scholar Back to article
Willy RW, Scholz JP, Davis IS. Mirror gait retraining for the treatment of patellofemoral pain in female runners. Clin Biomech (Bristol). 2012;27(10):1045–51. doi: 10.1016/j.clinbiomech.2012.07.011.
Open DOI Search in Google Scholar Back to article
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
Open DOI Search in Google Scholar Back to article
Macri EM, Neogi T, Jarraya M, Guermazi A, Roemer FW, Lewis CE, et al. MRI-defined osteoarthritis features and anterior knee pain in individuals with or at risk for knee osteoarthritis: a multicenter study. Arthritis Care Res (Hoboken). 2022;74(9):1533–40. doi: 10.1002/acr.24604.
Open DOI Search in Google Scholar Back to article
Bedson J, Jordan KP, Croft PR. A cross-sectional study of requests for knee radiographs from primary care. BMC Musculoskelet Disord. 2007;8:77. doi: 10.1186/1471-2474-8-77.
Open DOI Search in Google Scholar Back to article
Yusuf E, Kortekaas MC, Watt I, Huizinga TWJ, Kloppenburg M. Do knee abnormalities visualised on MRI explain knee pain in osteoarthritis? a systematic review. Ann Rheum Dis. 2011;70(1):60–7. doi: 10.1136/ard.2010.131904.
Open DOI Search in Google Scholar Back to article
Shamir L, Ling SM, Scott WW Jr, Bos A, Orlov N, Macura TJ, et al. Knee X-ray image analysis method for automated detection of osteoarthritis. IEEE Trans Biomed Eng. 2009;56(2):407–15. doi: 10.1109/TBME.2008.2006025.
Open DOI Search in Google Scholar Back to article
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomized trials. BMJ. 2019;366:l4898. doi: 10.1136/bmj.l4898.
Open DOI Search in Google Scholar Back to article
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. doi: 10.1136/bmj.i4919.
Open DOI Search in Google Scholar Back to article
Hwangbo PN. The effects of squatting with visual feedback on muscle activation of the vastus medialis oblique and vastus lateralis in young adults with an increased quadriceps angle. J Phys Ther Sci. 2015;27(5):1507–10. doi: 10.1589/jpts.27.1507.
Open DOI Search in Google Scholar Back to article
Rabelo NDDA, Costa LOP, de Lima BM, dos Reis AC, Bley AS, Fukuda TY, et al. Adding motor control training to muscle strengthening did not substantially improve the effects on clinical or kinematic outcomes in women with patellofemoral pain: a randomized controlled trial. Gait Posture. 2017;5(8):280–6. doi: 10.1016/j.gaitpost.2017.08.018.
Open DOI Search in Google Scholar Back to article
Kernozek TW, Schiller M, Rutherford D, Smith A, Durall C, Almonroeder TG. Real-time visual feedback reduces patellofemoral joint forces during squatting in individuals with patellofemoral pain. Clin Biomech (Bristol, Avon). 2020;77:105050. doi: 10.1016/j.clinbiomech.2020.105050.
Open DOI Search in Google Scholar Back to article
Grooms D, Appelbaum G, Onate J. Neuroplasticity following anterior cruciate ligament injury: a framework for visual-motor training approaches in rehabilitation. J Orthop Sports Phys Ther. 2015;45(5):381–93. doi: 10.2519/jospt.2015.5549.
Open DOI Search in Google Scholar Back to article
Wulf G. Attentional focus and motor learning: a review of 15 years. Int Rev Sport Exerc Psychol. 2013;6(1):77–104. doi: 10.1080/1750984X.2012.723728.
Open DOI Search in Google Scholar Back to article
Deconinck FJ, Smorenburg AR, Benham A, Ledebt A, Feltham MG, Savelsbergh GJ. Reflections on mirror therapy: a systematic review of the effect of mirror visual feedback on the brain. Neurorehabil Neural Repair. 2015;29(4):349–61. doi: 10.1177/1545968314546134.
Open DOI Search in Google Scholar Back to article
Neblett R. Surface electromyographic (SEMG) biofeedback for chronic low back pain. Healthcare (Basel). 2016;4(2):27. doi: 10.3390/healthcare4020027.
Open DOI Search in Google Scholar Back to article
Feng S, Tang M, Huang G, Wang J, He S, Liu D, et al. EMG biofeedback combined with rehabilitation training may be the best physical therapy for improving upper limb motor function and relieving pain in patients with post-stroke shoulder-hand syndrome: a Bayesian network meta-analysis. Front Neurol. 2023;13:1056156. doi: 10.3389/fneur.2022.1056156.
Open DOI Search in Google Scholar Back to article
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(Suppl 2):ii7–ii11. doi: 10.1093/ageing/afl077.
Open DOI Search in Google Scholar Back to article
Sigrist R, Rauter G, Riener R, Wolf P. Augmented visual, auditory, haptic, and multimodal feedback in motor learning: a review. Psychon Bull Rev. 2013;20(1):21–53. doi: 10.3758/s13423-012-0333-8.
Open DOI Search in Google Scholar Back to article
Bent LR, McFadyen BJ, Inglis JT. Visual-vestibular interactions in postural control during the execution of a dynamic task. Exp Brain Res. 2002;146(4):490–500. doi: 10.1007/s00221-002-1204-8.
Open DOI Search in Google Scholar Back to article
Dwan K, Gamble C, Williamson PR, Kirkham JJ. Reporting Bias Group. Systematic review of the empirical evidence of study publication bias and outcome reporting bias—an updated review. PLoS One. 2013;8(7):e66844. doi: 10.1371/journal.pone.0066844.
Open DOI Search in Google Scholar Back to article

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.2478/advrehab-2026-0003 | Journal eISSN: 1734-4948

Journal RSS Feed

Language: English

Page range: 36 - 53

Submitted on: May 30, 2025

Accepted on: Nov 4, 2025

Published on: Mar 31, 2026

Published by: University of Physical Education in Warsaw

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

closed kinetic chain,

exercise therapy,

motor activity,

patellofemoral pain syndrome,

visual feedback

Related subjects:

Medicine,

Clinical medicine,

Physical and rehabilitation medicine,

Rheumatology,

Cardiology,

Sports and recreation,

Sports and recreation, other

© 2026 Margaret R. Klausing et al., published by Józef Piłsudski University of Physical Education in Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Volume 40 (2026): Issue 1 (March 2026)