Background: Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders, especially in active individuals and athletes. Although the etiology of this syndrome is multifactorial, weakness and dysfunction of the lower limb muscles, especially in the motor chain, play a key role in its pathomechanics. Open kinetic chain (OKC) and closed kinetic chain (CKC) exercises are considered two important approaches in PFPS rehabilitation. This systematic review aimed to evaluate the available evidence on the effect of OKC and CKC exercises on pain reduction and function improvement in patients with PFPS.

Methods: This study was conducted as a systematic review. A search for English articles between 2010 and 2026 was conducted in the external databases Scopus, WOS, PubMed, and Google Scholar. Finally, 15 relevant articles were selected based on the inclusion and exclusion criteria. The effectiveness of open- and closed-chain exercises in pain management and improving motor function in patients with PFPS was compared and investigated.

Findings: The findings of this review study showed that functional exercises based on trunk control, closed-chain exercises, and combined approaches are more effective than traditional exercises in reducing pain and improving function in patients with PFPS. Overall, multidimensional and person-centered interventions are considered the most effective approach to managing this syndrome.

Conclusion: Effective management of PFPS requires a multifaceted, individualized approach that combines strengthening key muscles, improving motor control, increasing flexibility, and using a variety of functional exercises. This combination can lead to reduced pain, improved function, and lasting modification of movement patterns.