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Selhorst M, Rice W, Degenhart T, et al. Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. Int J Sports Phys Ther. 2015;10(2):178-88
Selhorst, M., Rice, W., Degenhart, T., Jackowski, M., & Tatman, M. (2015). Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. International journal of sports physical therapy, 10(2), 178-88.
Selhorst, Mitchell, et al. "Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study." International journal of sports physical therapy vol. 10,2 (2015): 178-88.
Selhorst M, Rice W, Degenhart T, Jackowski M, Tatman M. Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. Int J Sports Phys Ther. 2015 Apr;10(2):178-88. PMID: 25883866; PMCID: PMC4387725.
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Int J Sports Phys Ther. 2015 Apr;10(2):178-88.

Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study.

International journal of sports physical therapy

Mitchell Selhorst, William Rice, Todd Degenhart, Michael Jackowski, Melissa Tatman

Affiliations

  1. Sports and Orthopedic Physical Therapy, Nationwide Children's Hospital, Columbus, Ohio, USA.

PMID: 25883866 PMCID: PMC4387725

Abstract

BACKGROUND: Treatment of patellofemoral pain syndrome (PFPS) has been extensively studied in physical therapy literature. Patients with PFPS demonstrate quadriceps and hip musculature weakness, altered lower extremity (LE) kinematics, and decreased LE flexibility. Psychosocial factors have also been identified as an important factor in patients with PFPS. The authors hypothesize that an ordered approach addressing each of these impairments sequentially will result in greater improvement in PFPS symptoms. The purpose of this pilot study was to assess the feasibility of performing a randomized trial and to determine the sample size necessary to examine the validity of this hypothesis.

METHODS: Patients received a sequential treatment approach using a PFPS treatment algorithm (PFPS Algorithm) designed by the authors. Patients were evaluated assessing psychosocial factors, flexibility, LE kinematics, and LE strength. Impairments that were found in the evaluation were addressed sequentially over the episode of care. Patients were prescribed therapy two times per week for six weeks. Pain, Anterior Knee Pain Scale (AKPS), and Global Rating of Change (GROC) were measured at evaluation and discharge.

RESULTS: Thirty consecutive patients with PFPS who were referred to physical therapy were enrolled in the pilot study. All phases of the feasibility study including recruitment, treatment protocols and data collection were effectively carried out. One hundred percent of patients treated with the PFPS algorithm who completed the prescribed treatment had a clinically significant improvement in the AKPS and GROC. A floor effect was noted with NPRS with 38% of patients unable to achieve clinically significant improvement.

CONCLUSIONS: With minor changes to the protocol and outcome measures used, a full randomized trial is feasible and merited. Steps must be taken to reduce the high drop-out rate among both groups.

LEVEL OF EVIDENCE: 1b.

Keywords: Patellofemoral pain; knee pain; physical therapy

References

  1. Pain Res Manag. 2011 May-Jun;16(3):178-82 - PubMed
  2. Am J Sports Med. 2000 Jul-Aug;28(4):480-9 - PubMed
  3. Phys Ther. 2011 May;91(5):675-88 - PubMed
  4. Spine (Phila Pa 1976). 2005 Jun 1;30(11):1331-4 - PubMed
  5. Br J Sports Med. 2013 Mar;47(4):227-33 - PubMed
  6. Am J Sports Med. 2002 May-Jun;30(3):447-56 - PubMed
  7. J Orthop Sports Phys Ther. 1989;10(8):302-8 - PubMed
  8. Arch Phys Med Rehabil. 2004 May;85(5):815-22 - PubMed
  9. Nephrol Dial Transplant. 2010 May;25(5):1388-93 - PubMed
  10. J Rehabil Med. 2009 Jul;41(8):604-12 - PubMed
  11. J Athl Train. 2002 Sep;37(3):256-261 - PubMed
  12. J Orthop Sports Phys Ther. 1998 Nov;28(5):299-306 - PubMed
  13. J Orthop Sports Phys Ther. 1998 Nov;28(5):307-22 - PubMed
  14. J Orthop Sports Phys Ther. 2011 Jun;41(6):377-87 - PubMed
  15. Knee Surg Sports Traumatol Arthrosc. 2005 Mar;13(2):122-30 - PubMed
  16. Physiother Theory Pract. 2006 Jun;22(3):105-18 - PubMed
  17. PM R. 2013 Jul;5(7):568-72 - PubMed
  18. BMJ Open. 2013 Sep 23;3(9):e003795 - PubMed
  19. J Orthop Sports Phys Ther. 2003 Nov;33(11):639-46 - PubMed
  20. Orthop Clin North Am. 1986 Apr;17 (2):235-48 - PubMed
  21. Br J Sports Med. 2009 Mar;43(3):169-71 - PubMed
  22. Pain. 1994 Sep;58(3):387-92 - PubMed
  23. J Orthop Sports Phys Ther. 2005 Mar;35(3):136-46 - PubMed
  24. J Orthop Sports Phys Ther. 2010 Nov;40(11):736-42 - PubMed
  25. Am J Sports Med. 2002 Nov-Dec;30(6):857-65 - PubMed
  26. Injury. 2000 Jun;31(5):373-8 - PubMed
  27. J Bone Joint Surg Am. 1982 Jan;64(1):147-52 - PubMed
  28. J Orthop Sports Phys Ther. 2010 Mar;40(3):A1-16 - PubMed
  29. Pain. 1993 Feb;52(2):157-68 - PubMed
  30. J Orthop Sports Phys Ther. 2010 Dec;40(12):792-800 - PubMed
  31. Am J Sports Med. 1992 Jul-Aug;20(4):434-40 - PubMed

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