Pain and disability in women with patellofemoral pain relate to kinesiophobia, but not to patellofemoral joint loading variables

Silva, Danilo de Oliveira; Willy, Richard W.; Barton, Christian J; Christensen, Kelly; Pazzinatto, Marcella Ferraz; Azevedo, Fernando Mendes de

doi:10.1111/sms.13767

Cited by 31 publications

(16 citation statements)

References 34 publications

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Section: Resultsmentioning

confidence: 99%

“…Nine studies reported PFJRF during stair ambulation 28 38 39 41 42 48 65 84 85. During stair ascent, pooled peak PFJRF in healthy individuals was 3.2±0.7 BW28 38 39 41 48 84 based on six studies and 2.5±0.5 BW in those with patellofemoral pain based on three studies,38 42 65 and peak PFJRF in individuals with patellofemoral OA was 1.6±0.4 BW48 based on a single study (figure 3). During stair descent, pooled peak PFJRF in healthy individuals was 2.8±0.5 BW38 39 48 84 based on four studies and 2.6±0.8 BW in those with patellofemoral pain38 65 based on two studies, and peak PFJRF was 1.0±0.5 BW in individuals with patellofemoral OA48 based on one study (figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…The full text of 227 studies was retrieved and screened (figure 2). In total, 71 articles were included in the systematic review 25–95. There were 63 within-subject studies (56 healthy individuals, 7 patellofemoral pain), 1 randomised controlled trial in healthy individuals (online supplemental table 2) and…”

Section: Resultsmentioning

confidence: 99%

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May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis

et al. 2022

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ObjectiveTo systematically review and synthesise patellofemoral joint reaction force (PFJRF) in healthy individuals and those with patellofemoral pain and osteoarthritis (OA), during everyday activities, therapeutic exercises and with physical interventions (eg, foot orthotics, footwear, taping, bracing).DesignA systematic review with meta-analysis.Data sourcesMedline, Embase, Scopus, CINAHL, SportDiscus and Cochrane Library databases were searched.Eligibility criteriaObservational and interventional studies reporting PFJRF during everyday activities, therapeutic exercises, and physical interventions.ResultsIn healthy individuals, the weighted average of mean (±SD) peak PFJRF for everyday activities were: walking 0.9±0.4 body weight (BW), stair ascent 3.2±0.7 BW, stair descent 2.8±0.5 BW and running 5.2±1.2 BW. In those with patellofemoral pain, peak PFJRF were: walking 0.8±0.2 BW, stair ascent 2.5±0.5 BW, stair descent 2.6±0.5 BW, running 4.1±0.9 BW. Only single studies reported peak PFJRF during everyday activities in individuals with patellofemoral OA/articular cartilage defects (walking 1.3±0.5 BW, stair ascent 1.6±0.4 BW, stair descent 1.0±0.5 BW). The PFJRF was reported for many different exercises and physical interventions; however, considerable variability precluded any pooled estimates.SummaryEveryday activities and exercises involving larger knee flexion (eg, squatting) expose the patellofemoral joint to higher PFJRF than those involving smaller knee flexion (eg, walking). There were no discernable differences in peak PFJRF during everyday activities between healthy individuals and those with patellofemoral pain/OA. The information on PFJRF may be used to select appropriate variations of exercises and physical interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis

et al. 2022

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“…However, other non-mechanical factors such altered pain processing, kinesiophobia and catastrophism may also affect neural control and should be addressed in future studies. 4,38,39…”

Section: Clinical Interpretation Of Altered Neural Control Of Gait In...mentioning

confidence: 99%

Altered neural control of gait and its association with pain and joint impairment in adults with haemophilic arthropathy: Clinical and methodological implications

et al. 2022

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Introduction:It is unknown whether altered neural control is associated with clinical outcomes in people with haemophilic arthropathy (PWHA). The dynamic motor control index during walking (Walk-DMC) is a summary metric of neural control. Aims:The primary aim of this study was to apply the Walk-DMC to assess if people diagnosed with haemophilic arthropathy have impaired neural control of gait and investigate the association of Walk-DMC with pain and joint impairment. Method:The Walk-DMC was assessed using surface electromyography in 11 leg muscles. Twenty-two PWHA and 15 healthy subjects walked on a 30-m walkway at 1 m/s.In addition, pain (visual analogue scale), knee flexion contracture (degrees) and joint impairment (Haemophilia Joint Health Score, HJHS) were assessed. The clinical outcomes were correlated with the Walk-DMC. Multiple regression analysis was performed to predict the Walk-DMC using the clinical outcomes. Results:In 13 PWHA the Walk-DMC was beyond the normal range (80-120 pts).PWHA with an altered Walk-DMC showed more years with arthropathy, more pain, higher knee flexion contracture and a higher HJHS score (P < .05, effect size > .8).Significant negative moderate associations between Walk-DMC and pain, knee flexion contracture and HJHS were found (P < .05). The model that best predicted the Walk-DMC was the pain with knee flexion contracture (R 2 = .44; P = .004).Conclusions: PWHA with abnormal neural control of gait also has more years with arthropathy, more pain, and more impaired joints. Our results indicate an association between the Walk-DMC index and joint damage, specifically with pain in combination with knee flexion contracture.

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“… 38 In addition, several studies focusing on kinesiophobia have shown this to be associated more strongly with function in PFP compared with physical factors such as patellofemoral joint loading variables, muscle strength, and flexibility. 14 , 16 , 17 , 43 – 45 Another recent study found that comorbid anxiety and depression may be increased in patients with PFP. 66 More detailed knowledge about the importance of such factors within PFP would not only improve our understanding of etiological mechanisms but might also inform development of psychologically targeted interventions.…”

mentioning

confidence: 99%

Self-efficacy and Emotional Distress in a Cohort With Patellofemoral Pain

Hott

Pripp

Juel

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Patellofemoral pain (PFP) is commonly described and approached in biomechanical terms despite strong evidence that psychosocial factors such as kinesiophobia, emotional distress, and self-efficacy are important in long-standing musculoskeletal pain. Purpose: To describe levels of self-efficacy, emotional distress, kinesiophobia, and widespread pain in a cohort with long-standing PFP and determine their association with measures of pain, function, and health-related quality of life. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were 112 patients with PFP (age range, 16-40 years) who had been recruited to a randomized controlled trial. Seven baseline factors (patient sex, pain duration, number of pain sites throughout the body, kinesiophobia [Tampa Scale of Kinesiophobia], emotional distress [Hopkins Symptom Checklist], self-efficacy, and knee extension strength) were investigated for associations with the following outcomes: symptoms of PFP (Anterior Knee Pain Scale), pain (worst and usual), and health-related quality of life (5-level EuroQol-5 Dimensions [EQ-5D-5L]). We used bivariate models and multivariable linear regression models with a stepwise backward removal method to find associations with the outcomes. Internal validation was conducted, and adjusted coefficients after shrinkage are presented. Results: Of the study patients, 28% reported emotional distress (Hopkins Symptom Checklist ≥1.75), 69% reported multiple pain sites, and 33% had widespread pain. The kinesiophobia score was elevated, with a mean score of 35.4 ± 8.2. Self-efficacy was strongly associated with better function (Anterior Knee Pain Scale) and health-related quality of life (EQ-5D-5L) as well as lower pain scores in bivariate and multivariable models. Self-efficacy and emotional distress explained 50% of the variance in health-related quality of life (EQ-5D-5L). Conclusion: Our findings support other studies of PFP suggesting elevated levels of kinesiophobia and emotional distress and higher rates of widespread pain compared with the general population or pain-free controls. Higher self-efficacy was associated with better function and health-related quality of life. Together with emotional distress, it explained half the variance of health-related life quality. The results underline the importance of approaching these patients in a biopsychosocial model. Registration: NCT02114294 ( ClinicalTrials.gov identifier).

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Pain and disability in women with patellofemoral pain relate to kinesiophobia, but not to patellofemoral joint loading variables

Cited by 31 publications

References 34 publications

May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis

May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis

Altered neural control of gait and its association with pain and joint impairment in adults with haemophilic arthropathy: Clinical and methodological implications

Self-efficacy and Emotional Distress in a Cohort With Patellofemoral Pain

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