.: ORİJİNAL ARAŞTIRMA
Effectiveness of Patient Education on Patellofemoral Pain Syndrome: A Randomized Controlled Study
Patellofemoral Ağrı Sendromunda Hasta Eğitiminin Etkinliği: Randomize Kontrollü Çalışma
Turkiye Klinikleri J Health Sci. 2022;7(1):148-57
doi: 10.5336/healthsci.2021-81790
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The aim of this study was to evaluate the effectiveness of the routine physiotherapy program and the education program given to individuals diagnosed with patellofemoral pain syndrome (PFPS) on pain, daily life activities, kinesiophobia, quality of life and functional status. Material and Methods: The study included 68 patients who were diagnosed with PFPS. The participants included in the study were randomly divided into 2 groups as control (routine physiotherapy and rehabilitation) and study (routine physiotherapy and rehabilitation+ patient education). Visual analogue scale, Knee Outcome Survey Activities of Daily Living, Tampa, EQ-5D-5L, Kujala scales were filled by the participants before and after treatment and at the 6th
week. Results: Comparing preand post treatment values, significant improvements were found in pain, functionality, activities of daily living and quality of life of both groups (p<0.05). However, at the end of the 6th week, it was determined that the study group had significantly better values than the control group in all parameters (p<0.05). Conclusion: In addition to other routine physiotherapy program in PFPS, patient education was found to be more effective in reducing the pain and kinesiophobia of the patient, increasing daily life activities, functional status and quality of life at 6 weeks follow-up than the routine physiotherapy program. Therefore, it should be remembered that physical activity regulation, life style changes, in short, patient education is the main component of rehabilitation in PFPS. However, with the patient education, we think that the patient will be able to manage himself and hence health expenses can be reduced.
Keywords: Patellofemoral pain syndrome; patient education handout; functional status
Objective: The aim of this study was to evaluate the effectiveness of the routine physiotherapy program and the education program given to individuals diagnosed with patellofemoral pain syndrome (PFPS) on pain, daily life activities, kinesiophobia, quality of life and functional status. Material and Methods: The study included 68 patients who were diagnosed with PFPS. The participants included in the study were randomly divided into 2 groups as control (routine physiotherapy and rehabilitation) and study (routine physiotherapy and rehabilitation+ patient education). Visual analogue scale, Knee Outcome Survey Activities of Daily Living, Tampa, EQ-5D-5L, Kujala scales were filled by the participants before and after treatment and at the 6th
week. Results: Comparing preand post treatment values, significant improvements were found in pain, functionality, activities of daily living and quality of life of both groups (p<0.05). However, at the end of the 6th week, it was determined that the study group had significantly better values than the control group in all parameters (p<0.05). Conclusion: In addition to other routine physiotherapy program in PFPS, patient education was found to be more effective in reducing the pain and kinesiophobia of the patient, increasing daily life activities, functional status and quality of life at 6 weeks follow-up than the routine physiotherapy program. Therefore, it should be remembered that physical activity regulation, life style changes, in short, patient education is the main component of rehabilitation in PFPS. However, with the patient education, we think that the patient will be able to manage himself and hence health expenses can be reduced.
Keywords: Patellofemoral pain syndrome; patient education handout; functional status
ÖZET
Amaç: Bu çalışmada amacımız, patellofemoral ağrı sendromu (PFAS) tanılı bireylere, rutin fizyoterapi ve ek olarak verilen eğitim programlarının ağrı, günlük yaşam aktiviteleri, kinezyofobi, yaşam kalitesi ve fonksiyonel durum üzerine olan etkilerini incelemekti. Gereç ve Yöntemler: Bu çalışmaya 68 PFAS tanısı alan hasta dâhil edildi. Hastalar rastgele olarak kontrol (rutin fizyoterapi ve rehabilitasyon) ve çalışma (rutin fizyoterapi ve rehabilitasyon+hasta eğitimi) grubu olarak ikiye ayrıldı. Tedavi öncesi, sonrası ve 6. haftada vizüel analog skala, Diz Sonlanım Anketi-Günlük Yaşam Aktiviteleri, Tampa, EQ-5D-5L, Kujala ölçekleri katılımcılar tarafından dolduruldu. Bulgular: Tedavi öncesi ve sonrası değerler karşılaştırıldığında, her 2 grupta da ağrı, fonksiyonellik, günlük yaşam aktiviteleri ve yaşam kalitesi açısından anlamlı gelişmeler görüldü (p<0,05). Bununla birlikte, çalışma grubunun 6. hafta sonunda tüm parametrelerde kontrol grubuna göre daha iyi verilere sahip olduğu tespit edildi (p<0,05). Sonuç: PFAS'de rutin fizyoterapi programına ek olarak verilen hasta eğitiminin, hastanın ağrı ve kinezyofobisini azaltmada, günlük yaşam aktiviteleri, fonksiyonel durum ve yaşam kalitesini artırmada rutin fizyoterapi programına göre 6 haftalık takipte daha etkili olduğu bulundu. Bu nedenle PFAS'de fiziksel aktivite düzenlemesi, yaşam tarzı değişiklikleri kısacası hasta eğitiminin rehabilitasyonun temel bileşeni olduğu unutulmamalıdır. Hastaya verilecek hasta eğitimi ile hastanın, kendi kendini yönetmeyi başarabileceğini ve dolayısıyla sağlık harcamalarının azaltılabileceğini düşünmekteyiz.
Anahtar Kelimeler: Patellofemoral ağrı sendromu; hasta eğitim broşürü; fonksiyonel durum
Amaç: Bu çalışmada amacımız, patellofemoral ağrı sendromu (PFAS) tanılı bireylere, rutin fizyoterapi ve ek olarak verilen eğitim programlarının ağrı, günlük yaşam aktiviteleri, kinezyofobi, yaşam kalitesi ve fonksiyonel durum üzerine olan etkilerini incelemekti. Gereç ve Yöntemler: Bu çalışmaya 68 PFAS tanısı alan hasta dâhil edildi. Hastalar rastgele olarak kontrol (rutin fizyoterapi ve rehabilitasyon) ve çalışma (rutin fizyoterapi ve rehabilitasyon+hasta eğitimi) grubu olarak ikiye ayrıldı. Tedavi öncesi, sonrası ve 6. haftada vizüel analog skala, Diz Sonlanım Anketi-Günlük Yaşam Aktiviteleri, Tampa, EQ-5D-5L, Kujala ölçekleri katılımcılar tarafından dolduruldu. Bulgular: Tedavi öncesi ve sonrası değerler karşılaştırıldığında, her 2 grupta da ağrı, fonksiyonellik, günlük yaşam aktiviteleri ve yaşam kalitesi açısından anlamlı gelişmeler görüldü (p<0,05). Bununla birlikte, çalışma grubunun 6. hafta sonunda tüm parametrelerde kontrol grubuna göre daha iyi verilere sahip olduğu tespit edildi (p<0,05). Sonuç: PFAS'de rutin fizyoterapi programına ek olarak verilen hasta eğitiminin, hastanın ağrı ve kinezyofobisini azaltmada, günlük yaşam aktiviteleri, fonksiyonel durum ve yaşam kalitesini artırmada rutin fizyoterapi programına göre 6 haftalık takipte daha etkili olduğu bulundu. Bu nedenle PFAS'de fiziksel aktivite düzenlemesi, yaşam tarzı değişiklikleri kısacası hasta eğitiminin rehabilitasyonun temel bileşeni olduğu unutulmamalıdır. Hastaya verilecek hasta eğitimi ile hastanın, kendi kendini yönetmeyi başarabileceğini ve dolayısıyla sağlık harcamalarının azaltılabileceğini düşünmekteyiz.
Anahtar Kelimeler: Patellofemoral ağrı sendromu; hasta eğitim broşürü; fonksiyonel durum
REFERANSLAR:
- Mølgaard C, Rathleff MS, Simonsen O. Patellofemoral pain syndrome and its association with hip, ankle, and foot function in 16- to 18-year-old high school students: a single-blind case-control study. J Am Podiatr Med Assoc. 2011;101(3):215-22. [Crossref] [PubMed]
- Collins NJ, Bierma-Zeinstra SM, Crossley KM, van Linschoten RL, Vicenzino B, van Middelkoop M. Prognostic factors for patellofemoral pain: a multicentre observational analysis. Br J Sports Med. 2013;47(4):227-33. [Crossref] [PubMed]
- Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Risk factors for patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther. 2012;42(2):81-94. [Crossref] [PubMed]
- Powers CM, Witvrouw E, Davis IS, Crossley KM. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. Br J Sports Med. 2017;51(24):1713-23. [Crossref] [PubMed]
- Barton CJ, Lack S, Hemmings S, Tufail S, Morrissey D. The 'Best Practice Guide to Conservative Management of Patellofemoral Pain': incorporating level 1 evidence with expert clinical reasoning. Br J Sports Med. 2015;49(14):923-34. [Crossref] [PubMed]
- Lankhorst NE, van Middelkoop M, Crossley KM, Bierma-Zeinstra SM, Oei EH, Vicenzino B, et al. Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. Br J Sports Med. 2016;50(14):881-6. [Crossref] [PubMed]
- Barton CJ, Rathleff MS. 'Managing My Patellofemoral Pain': the creation of an education leaflet for patients. BMJ Open Sport Exerc Med. 2016;2(1):e000086. [Crossref] [PubMed] [PMC]
- Randhawa K, Côté P, Gross DP, Wong JJ, Yu H, Sutton D, et al. The effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. J Can Chiropr Assoc. 2015;59(4):349-62. [PubMed] [PMC]
- Hott A, Brox JI, Pripp AH, Juel NG, Paulsen G, Liavaag S. Effectiveness of isolated hip exercise, knee exercise, or free physical activity for patellofemoral pain: a randomized controlled trial. Am J Sports Med. 2019;47(6):1312-22. [Crossref] [PubMed]
- Chesworth BM, Culham E, Tata GE, Peat M. Validation of outcome measures in patients with patellofemoral syndrome. J Orthop Sports Phys Ther. 1989;10(8):302-8. [Crossref] [PubMed]
- Irrgang JJ, Snyder-Mackler L, Wainner RS, Fu FH, Harner CD. Development of a patient-reported measure of function of the knee. J Bone Joint Surg Am. 1998;80(8):1132-45. [Crossref] [PubMed]
- Evcik D, Ay S, Ege A, Turel A, Kavuncu V. Adaptation and validation of Turkish version of the Knee Outcome Survey-Activities for Daily Living Scale. Clin Orthop Relat Res. 2009;467(8):2077-82. [Crossref] [PubMed] [PMC]
- Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363-72. [Crossref] [PubMed]
- Yilmaz ÖT, Yakut Y, Uygur F, Uluğ N. [Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability]. Fizyoterapi Rehabilitasyon. 2011;22(1):44-9. [Link]
- Brooks RG, Jendteg S, Lindgren B, Persson U, Björk S. EuroQol: health-related quality of life measurement. Results of the Swedish questionnaire exercise. Health Policy. 1991;18(1):37-48. [Crossref] [PubMed]
- Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9(2):159-63. [Crossref] [PubMed]
- Kuru T, Dereli EE, Yaliman A. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2010;44(2):152-6. [Crossref] [PubMed]
- Cohen J. The analysis of variance. Statistical Power Analysis For The Behavioral Sciences. 2nd ed. Hilsdale: Lawrence Erlbaum Associates; 1988. p.567. [Link]
- Smith BE, Hendrick P, Bateman M, Moffatt F, Rathleff MS, Selfe J, et al. Current management strategies for patellofemoral pain: an online survey of 99 practising UK physiotherapists. BMC Musculoskelet Disord. 2017;18(1):181. [Crossref] [PubMed] [PMC]
- Barton CJ, Crossley KM, Macri EM. Should we consider changing traditional physiotherapy treatment of patellofemoral pain based on recent insights from the literature? Br J Sports Med. 2018;52(24):1546-7. [Crossref] [PubMed]
- Rathleff MS, Roos EM, Olesen JL, Rasmussen S. Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofemoral pain: a cluster randomised trial. Br J Sports Med. 2015;49(6):406-12. [Crossref] [PubMed]
- Rathleff MS, Graven-Nielsen T, Hölmich P, Winiarski L, Krommes K, Holden S, et al. Activity modification and load management of adolescents with patellofemoral pain: a prospective intervention study including 151 adolescents. Am J Sports Med. 2019;47(7):1629-37. [Crossref] [PubMed]
- Esculier JF, Bouyer LJ, Dubois B, Fremont P, Moore L, McFadyen B, et al. Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain?A randomised clinical trial. Br J Sports Med. 2018;52(10):659-66. [Crossref] [PubMed]
- Maclachlan LR, Matthews M, Hodges PW, Collins NJ, Vicenzino B. The psychological features of patellofemoral pain: a cross-sectional study. Scand J Pain. 2018;18(2):261-71. [Crossref] [PubMed]
- Doménech J, Sanchis-Alfonso V, Espejo B. Changes in catastrophizing and kinesiophobia are predictive of changes in disability and pain after treatment in patients with anterior knee pain. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2295-300. [Crossref] [PubMed]
- Maclachlan LR, Collins NJ, Matthews MLG, Hodges PW, Vicenzino B. The psychological features of patellofemoral pain: a systematic review. Br J Sports Med. 2017;51(9):732-42. [Crossref] [PubMed]
- Laerum E, Indahl A, Skouen JS. What is "the good back-consultation"? A combined qualitative and quantitative study of chronic low back pain patients' interaction with and perceptions of consultations with specialists. J Rehabil Med. 2006;38(4):255-62. [Crossref] [PubMed]
.: İşlem Listesi