Early Intervention for Adolescents With Patellofemoral Pain Syndrome
Condition: Patellofemoral Pain Syndrome
MeSH terms: Patellofemoral Pain Syndrome; Syndrome; Somatoform Disorders
Study type: Interventional

Summary: 
      Self-reported, unspecific knee pain is highly prevalent among adolescents. A large proportion
      of the unspecific knee pain can be attributed to Patellofemoral Pain Syndrome (PFPS). There
      are a number of treatment options for PFPS. Physical therapy has been advocated as one of the
      cornerstones in rehabilitation of patients with PFPS. Twenty-five years ago, McConnell
      proposed a multimodal approach that combined several treatment options. The regimen included
      retraining of the vastus medialis oblique muscle through functional weight bearing
      activities. This exercise is combined with patellar taping, patellar mobilization, and
      stretching to improve patellar tracking, reduce pain, and enhance vastus medialis oblique
      muscle activation. Short term results (<12 months) indicates that multimodal physiotherapy is
      more effective than placebo treatment.

      While treatment for PFPS may be successful for the short-term, long-term results are less
      promising. A recent review covering the long term prognosis for patients diagnosed with PFPS,
      reported that only 1/3 of those diagnosed with PFPS and treated conservatively were pain free
      12 months after diagnosis. Further ¼ stopped participating in sports because of knee pain.

      Predictors of long term outcome (>52weeks) indicate that a long symptom duration, higher age
      and greater severity at baseline are associated to poorer outcome after treatment. These
      prognostic factors suggest that an early initiation of treatment might lead to a better
      long-term prognosis. The purpose of this study is to examine the short and long-term
      effectiveness of multi-modal physiotherapy compared to standard wait-and-see treatment
      applied at a very early state of disease among adolescents. The investigators hypothesized a
      significantly larger proportion of completely recovered patients at three-month follow-up in
      the interventions group compared to the control group.
    


Intervention name(s): Patient information and education; Information, education and physiotherapy
Intervention type(s): Behavioral; Other
Intervention description(s): All subjects will receive one-to-one patient education delivered by a physiotherapist. The information will be standardized and cover the topics of: why does it hurt: pain management; information of how to reduce physical activity if necessary; how to return slowly to sports; how to cope with knee pain and information of how to increase knee alignment during walking and stair walking. The patients will also receive this information in written form. This information is expected to take approximately 45minutes per patient.; Patients will receive one-to-one patient education delivered by a physiotherapist. The information will be standardized and cover the topics of: why does it hurt: pain management; information of how to reduce physical activity if necessary; how to return slowly to sports; how to cope with knee pain and information of how to increase knee alignment during walking and stair walking. The patients will also receive this information in written form.
In addition the patients will receive supervised multimodal physiotherapy carried out by a physiotherapist with previous experience in treating adolescents and PFPS and has more than two years of practical experience in these areas. The multimodal physiotherapy intervention will be carried out at school premises right after the end of class.
Other intervention name(s): Standard care; Physiotherapy; Multimodal intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Anterior Knee Pain