Original articleAssociates of Physical Function and Pain in Patients with Patellofemoral Pain Syndrome
Section snippets
Subjects
Subjects were recruited from rehabilitation clinics. Patients diagnosed by a physician with PFPS were invited to participate in this study. Patients were eligible to participate if they were between 12 and 50 years of age, had pain in 1 or both knees, had duration of signs and symptoms greater than 4 weeks, had a history of insidious onset not related to trauma, and had pain in the patellar region with at least 3 of the following: manual compression of the patella against the femur at rest or
Results
Seventy-four patients were recruited from 4 clinical sites. Twenty-five were from Minot Air Force Base, Minot, ND; 23 from Lackland Air Force Base, San Antonio, TX; 17 from Travis Air Force Base, Fairfield, CA; and 9 from University of Pittsburgh's Centers for Rehabilitation Services, Pittsburgh, PA. Participants across the 4 clinical sites were not significantly different on age, sex, height, weight, activity at work, use of pain medication, chronicity of pain, activity level, KOS-ADLS score,
Discussion
Although most physical impairment factors explored during this study have been theoretically or experimentally related to the presence of PFPS, the associates of function and pain in this cohort of patients with PFPS were all psychologic factors. Anxiety was the stronger associate of function, followed by FABQ-W and FABQ-PA. FABQ-W and FABQ-PA were the only associates of pain intensity in this sample. These findings may indicate that psychologic factors are overlooked in patients with PFPS.
Conclusions
Our study indicates that psychologic factors were the only associates of function and pain in this sample of patients with PFPS. Patients with more limitations in physical function reported higher levels of anxiety and fear-avoidance beliefs about work and physical activity. Patients with more pain reported higher levels of fear-avoidance beliefs about work and physical activity. Factors related to physical impairments did not associate with function or pain in this sample. Our preliminary
References (89)
- et al.
What is the maximum number of levels needed in pain intensity measurement?
Pain
(1994) - et al.
Measurement of pain
Surg Clin North Am
(1999) - et al.
Further evidence for the validity of the Beck Anxiety Inventory with psychiatric outpatients
J Anxiety Dis
(1993) - et al.
Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability
Pain
(1993) - et al.
Low back pain: Reliability of a set of pain measurement tools
Arch Phys Med Rehabil
(2001) - et al.
Fear of movement/(re)injury and muscular reactivity in chronic low back pain patients: an experimental investigation
Pain
(1999) - et al.
Outline of a fear avoidance model of exaggerated pain perception—I
J Behav Res Ther
(1983) - et al.
The fear-avoidance model of exaggerated pain perception—II
J Behav Res Ther
(1983) - et al.
Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability
Pain
(1999) - et al.
Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care
Pain
(2004)
Are changes in fear-avoidance beliefs, catastrophizing, and appraisals of control, predictive of changes in chronic low back pain and disability?
Eur J Pain
Fear of injury and physical deconditioning in patients with chronic low back pain
Arch Phys Med Rehabil
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art
Pain
Pain-related fear and daily functioning in patients with osteoarthritis
Pain
The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status
Pain
Strategies for coping with chronic low back pain: relationship to pain and disability
Pain
Changes in weight-bearing following injury or surgical reconstruction of the ACL: relationship to quadriceps strength and function
Gait Posture
Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis
Knee
The relationship between knee strength and functional stability before and after anterior cruciate ligament reconstruction
J Orthop Res
Nonoperative treatment for patellofemoral pain
J Orthop Sports Phys Ther
Current concepts review: patella pain
J Bone Joint Surg Am
A comprehensive treatment approach for patellofemoral pain syndrome in young women
Phys Ther
Patellofemoral pain syndrome: a review of current issues
Sports Med
Neuromechanics of the patellofemoral joint
Med Sci Sports Exerc
Importance of femoral rotation in chondromalacia patellae as shown by serial radiography
J Bone Joint Surg Br
Evaluation of knee ligament injuries with the IKDC form
Knee Surg Sports Traumatol Arthrosc
Development of a patient-reported measure of function of the knee
J Bone Joint Surg Am
Comparison of performance-based and patient-reported measures of function in anterior-cruciate-ligament-deficient individuals
J Orthop Sports Phys Ther
Reliability, validity, and responsiveness of four knee outcome scales for athletic patients
J Bone Joint Surg Am
Reliability of measures of impairments associated with patellofemoral pain syndrome
BMC Musculoskelet Disord
An inventory for measuring clinical anxiety: psychometric properties
J Consult Clin Psychol
The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial
J Rheumatol
Applied regression analysis and other multivariable methods
Personality in patients with long-term patellofemoral pain syndrome
Knee Surg Sports Traumatol Arthrosc
Anterior knee pain syndrome
Int Orthop
Intrinsic risk factors for the development of anterior knee pain in an athletic population: a two-year prospective study
Am J Sports Med
Anxiety and health-related quality of life of patients undergoing total hip arthroplasty for osteoarthritis
Chronic Illn
Anxiety and depression in a community-based rheumatoid arthritis population
Scand J Rheumatol
Anxiety symptoms and decline in physical function over 5 years in the Health, Aging and Body Composition Study
J Am Geriatr
The prediction of chronicity in patients with an acute attack of low-back-pain in a general-practice setting
Spine
Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction
Knee Surg Sports Traumatol Arthrosc
A comparison of fear-avoidance beliefs in patients with lumbar spine pain and cervical spine pain
Spine
Chronic shoulder pain in the community: a syndrome of disability or distress?
Ann Rheum Dis
The role of the fear-avoidance model in female workers with neck-shoulder pain related to computer work
Clin J Pain
Cited by (0)
Supported by the Clinical Research Grant Program of the Orthopaedic Section of the American Physical Therapy Association, and the Pennsylvania Physical Therapy Association Research Fund.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the author.