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Towards a meaningful self-management intervention to improve long-term prognosis for adolescents with patellofemoral pain (PhD Academy Award)
  1. Michael Skovdal Rathleff1,2,3
  1. 1Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
  2. 2Center for General Practice at Aalborg University, Aalborg University, Aalborg, Denmark
  3. 3Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
  1. Correspondence to Dr Michael Skovdal Rathleff, Department of Health Science and Technology, Aalborg Universitet, Aalborg, Denmark; misr{at}

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What did I do?

This doctoral thesis (higher doctorate) consists of nine papers that were written during a period of 10 years. The aim of this thesis was to apply the biopsychosocial model to understand and improve management of adolescent patellofemoral pain, one of the most common overused, sports-related complaints in adolescents.

Why did I do it?

Prior to this thesis, there was a dearth of evidence surrounding adolescent patellofemoral pain. This knowledge gap impeded evidence-based treatment of this common condition that affects 6%–7% of adolescents in schools and up twice as many sports-active adolescents.

How did I do it?

The thesis started by evaluating current evidence and knowledge gaps, followed by innovative pain assessments to better understand ‘pain’ in patellofemoral pain.1 ,2 This was complemented with self-report questionnaires, objective measures of physical activity, and knee and hip strength to gain a deeper insight into other aspects of the biopsychosocial model.3 I formed a large cohort of adolescents with patellofemoral pain to study the prognosis and prognostic factors.4 ,5 The identification of prognostic factors was subsequently expanded through an individual participant meta-analysis (pooling, harmonising and analysing data from >1200 adolescents).6 Based on the identified needs, we developed a novel management strategy.7

What did I find?

This series of studies improved our understanding of adolescent patellofemoral pain by demonstrating

  1. Rather than being a localised pain complaint, my research highlighted that patellofemoral pain in adolescents resulted in increased pain sensitivity and altered indices of pain modulation, as well as significant impairments …

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  • Contributors MSR wrote the doctoral thesis. The individual papers contain detailed information about contributorship.

  • Funding The work forming this doctoral thesis was done during a period of over 10 years while employed at Aarhus University, Aalborg University, Aalborg University Hospital, and the Center for General Practice at Aalborg University. The work is funded by Independent Research Foundation Denmark (DFF-4004-00247B), Aarhus University (full PhD scholarship, TRYG Foundation (grant ID 118547), Danish Physio Association, the Danish Rheumatism Association (grant number R175-A6057) and the Foundation for General Practice (grant number A2596). Funders had no influence on the individual studies or the interpretation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.