The Effect of Psychologically Informed Education in Adolescents With Patellofemoral Pain
Condition: Patellofemoral Pain Syndrome; Anterior Knee Pain Syndrome
MeSH terms: Patellofemoral Pain Syndrome; Syndrome; Somatoform Disorders
Study type: Interventional

Summary: 
      This is a randomized prospective study assessing the impact of psychosocial factors on pain
      and physical performance among adolescents with anterior knee pain. A set of psychosocial
      surveys assessing activity-related fear, stress, anxiety and depression will be completed by
      the participant/parents. Participants will then complete clinical tests of physical
      performance, numeric pain rating scale, and a self-report questionnaire of functional
      ability. Participants will then be randomized into one of two psychosocial intervention
      groups (psychologically informed education group and a control group). After participants
      receive their assigned education intervention, the clinical tests of pain and self-reported
      functional ability will be readministered. Participants with anterior knee pain will then
      complete follow-up surveys of their psychosocial beliefs, pain and self-reported functional
      ability through REDcap at immediately post-intervention, 2 weeks, 6 weeks, and 3 months.
    

Detailed description: 
      This study will be a prospective randomized controlled trial design. Participants will
      complete the randomized intervention immediately after completing baseline testing.
      Post-intervention testing will also be completed immediately after the randomized
      intervention. A follow-up REDcap survey will be sent by email to assess function and pain at
      2 weeks, 6 weeks and 3 months.

      Intervention Psychologically Informed Education Group Psychologically Informed Education
      Medium There are many ways to provide patient education, but the investigators believe that
      adolescents will respond well to video education on a tablet. Adolescents are extremely
      comfortable with this technology, and the video will allow for standardized education among
      all participants.

      Development of Psychologically Informed Education for adolescents with AKP Recommended adult
      pain science education will be modified using published recommendations for the adolescent
      population and tailored to anterior knee pain.(Robins, Perron, Heathcote, & Simons, 2016) The
      education session will teach participants how the body processes nociception and experiences
      pain, and pain does not mean tissues are being damaged. Additionally the psychologically
      informed education video will use the framework called the "Common Sense Model of
      Self-Regulation" which advocates for education to address five cognitive dimensions: (1)
      identity (the effort to evaluate symptoms and label the illness); (2) cause (the subjectively
      formulated belief of what is causing the symptoms); (3) time-line (the patient's perception
      of how long the problem will last); (4) consequences (the patient's predictions of how the
      illness will affect them in different areas of their life); and (5) controllability (the
      patient's belief regarding their outcome and personal ability to change it).(Leventhal,
      Phillips, & Burns, 2016) Control Group Participants in the control education group will watch
      a video on the iPad equal in length to the psychologically informed education video. The
      control video will discuss basic anatomy of the knee and provide no psychosocial education or
      positive reinforcement about their condition.
    

Intervention name(s): Psychologically Informed Education Video; Anatomy Education Video
Intervention type(s): Other; Other
Intervention description(s): The education session will teach participants how the body processes nociception and experiences pain, and pain does not mean tissues are being damaged. Additionally we will use the framework called the "Common Sense Model of Self-Regulation" which advocates for education to address five cognitive dimensions: (1) identity (the effort to evaluate symptoms and label the illness); (2) cause (the subjectively formulated belief of what is causing the symptoms); (3) time-line (the patient's perception of how long the problem will last); (4) consequences (the patient's predictions of how the illness will affect them in different areas of their life); and (5) controllability (the patient's belief regarding their outcome and personal ability to change it); Participants in the control group will watch three videos equal in length to the psychologically-informed videos. The control videos will discuss anatomy of the lower extremity, basic instruction in proper lower extremity biomechanics, and simple lower extremity exercises. The control videos will provide no psychologically-informed education or positive reinforcement about the condition.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment