3, 22 July 2020 | Journal of Medical Internet Research, Vol. Panken AM, Heymans MW, van Oort L, Verhagen AP. Individual clinical research articles were graded according to criteria adapted from the Centre for Evidence-Based Medicine, Oxford, United Kingdom for diagnostic, prospective, and therapeutic studies.229 In 3 teams of 2, each reviewer independently assigned a level of evidence and evaluated the quality of each article using a critical appraisal tool. Cook CE. Concentric and eccentric torque of the hip musculature in individuals with and without patellofemoral pain. ; (5) Is the disease status of the tested population clearly described? An additional measurement method is to use an inclinometer, which is zeroed on a horizontal surface prior to the measurement. Br J Sports Med. There was limited evidence that BMI, anxiety, being an athlete, and movement quality were not predictive of pain or function. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. J Orthop Sports Phys Ther. Patellar mobilization has been combined with other physical therapy interventions with reported effectiveness. Because the retraining interventions that resulted in a reduction in pain were associated with more intensive retraining (ie, more retraining sessions), future research should also assess optimal dosage of retraining sessions. https://doi.org/10.1002/jor.21523, Dye SF. Given the absence of a previously established valid classification system for PFP, the CPG group proposes a classification consisting of 4 subcategories associated with the ICF. 2004;140:121–124. The median classification rates were high in both healthy athletes (86%) and in athletes with PFP (99%). The cited evidence to support high-volume exercise is from a single cohort and lacked a control group of wait and see. All measures demonstrated adequate floor/ceiling effects (less than 15% of participants achieved the lowest or highest scores). 13 Level of Evidence: Level III 14 Methods: PFP patients (n=61, mean age: 27±9 years) were enrolled. However, patients with PFP were no more sensitive to heat or cold compared to healthy controls. mThe individual is in weight bearing and the subtalar joint is positioned in a neutral position, based on the clinician's palpation. Isokinet Exerc Sci. 2016;50:247–250. It should be determined whether gait retraining needs to be targeted to a specific running mechanism thought to contribute to the etiology of PFP, or whether gait retraining can be applied evenly across runners regardless of running mechanics. Similarly, 3 clusters were identified to exclude PFP (−LR = 0.12; 95% CI: 0.06, 0.27) (TABLE 4). Sandow and Goodfellow254 followed 54 adolescent girls for 2 to 8 years after diagnosis of PFP. 2017 Jan 25;10:5. doi: 10.1186/s13047-017-0186-5. https://doi.org/10.2519/jospt.2008.0303, Cibulka MT, Bloom NJ, Enseki KR, MacDonald CW, Woehrle J, McDonough CM. B Clinicians should make the diagnosis of PFP using the fol-lowing criteria: (1) the presence of retropatellar or peri- 2002;37:13–18. ; (12) What is your overall assessment of the methodological quality of this review? A single moderate-quality RCT compared a group that received 8 weeks of non–weight-bearing, hip-targeted exercise therapy utilizing elastic bands to a group that received a control therapy of nutritional supplementation for the treatment of PFP.159 In the short term, large reductions in pain (SMD, 2.80; 95% CI: 1.71, 3.88) and improvements in function on the WOMAC (SMD, 2.88; 95% CI: 1.78, 3.98) were reported for the hip-targeted exercise therapy group when compared with the control. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? In the individuals who received medical advice from a physician, 68% reported no improvement after 3 months, and 54% reported no improvement after 12 months. Hip muscle strength and endurance in females with patellofemoral pain: a systematic review with meta-analysis, Hip abductor, trunk extensor and ankle plantar flexor endurance in females with and without patellofemoral pain, Structural abnormalities on magnetic resonance imaging in patients with patellofemoral pain: a cross-sectional case-control study, Exercise for treating patellofemoral pain syndrome, Exercise for treating patellofemoral pain syndrome: an abridged version of Cochrane systematic review, No difference on quantitative magnetic resonance imaging in patellofemoral cartilage composition between patients with patellofemoral pain and healthy controls, Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial, International patellofemoral osteoarthritis consortium: consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment. 1998;30:556–569. The effects of isolated hip abductor and external rotator muscle strengthening on pain, health status, and hip strength in females with patellofemoral pain: a randomized controlled trial. Clinicians should consider diagnostic classifications associated with serious medical conditions, other musculoskeletal conditions, or psychosocial factors when the patient's reported activity limitations or impairments of body function and structure are not consistent with those presented in the Diagnosis and Classification sections of this guideline, or when the patient's symptoms are not resolving with interventions aimed at normalization of the patient's impairments of body function.

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