The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study
Abstract Background Targeted treatment, matched according to specific clinical criteria e.g. hip muscle weakness, may result in better outcomes for people with patellofemoral pain (PFP). However, to ensure the success of future trials, a number of questions on the feasibility of a targeted treatment...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2017-08-01
|
Series: | BMC Musculoskeletal Disorders |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12891-017-1698-7 |
id |
doaj-69d7d013c85348a4a37c4a31daa33107 |
---|---|
record_format |
Article |
spelling |
doaj-69d7d013c85348a4a37c4a31daa331072020-11-25T02:46:15ZengBMCBMC Musculoskeletal Disorders1471-24742017-08-0118111110.1186/s12891-017-1698-7The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility studyBenjamin T. Drew0Philip G. Conaghan1Toby O. Smith2James Selfe3Anthony C. Redmond4Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton HospitalNIHR Leeds Biomedical Research CentreSchool of Health Sciences, University of East AngliaDepartment of Health Professions, Manchester Metropolitan UniversityLeeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton HospitalAbstract Background Targeted treatment, matched according to specific clinical criteria e.g. hip muscle weakness, may result in better outcomes for people with patellofemoral pain (PFP). However, to ensure the success of future trials, a number of questions on the feasibility of a targeted treatment need clarification. The aim of the study was to explore the feasibility of matched treatment (MT) compared to usual care (UC) management for a subgroup of people with PFP determined to have hip weakness and to explore the mechanism of effect for hip strengthening. Methods In a pragmatic, randomised controlled feasibility study, 24 participants with PFP (58% female; mean age 29 years) were randomly allocated to receive either MT aimed specifically at hip strengthening, or UC over an eight-week period. The primary outcomes were feasibility outcomes, which included rates of adherence, attrition, eligibility, missing data and treatment efficacy. Secondary outcomes focused on the mechanistic outcomes of the intervention, which included hip kinematics. Results Conversion to consent (100%), missing data (0%), attrition rate (8%) and adherence to both treatment and appointments (>90%) were deemed successful endpoints. The analysis of treatment efficacy showed that the MT group reported a greater improvement for the Global Rating of Change Scale (62% vs. 9%) and the Anterior Knee Pain Scale (−5.23 vs. 1.18) but no between-group differences for either average or worst pain. Mechanistic outcomes showed a greatest reduction in peak hip internal rotation angle for the MT group (13.1% vs. −2.7%). Conclusion This feasibility study indicates that a definitive randomised controlled trial investigating a targeted treatment approach is achievable. Findings suggest the mechanism of effect of hip strengthening may be to influence kinematic changes in hip function in the transverse plane. Trial registration This study was registered retrospectively. ISRCTN74560952 . Registration date: 2017–02-06.http://link.springer.com/article/10.1186/s12891-017-1698-7KneeStrength trainingTherapeutic exercisePatellofemoral painHip strengthening |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benjamin T. Drew Philip G. Conaghan Toby O. Smith James Selfe Anthony C. Redmond |
spellingShingle |
Benjamin T. Drew Philip G. Conaghan Toby O. Smith James Selfe Anthony C. Redmond The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study BMC Musculoskeletal Disorders Knee Strength training Therapeutic exercise Patellofemoral pain Hip strengthening |
author_facet |
Benjamin T. Drew Philip G. Conaghan Toby O. Smith James Selfe Anthony C. Redmond |
author_sort |
Benjamin T. Drew |
title |
The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study |
title_short |
The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study |
title_full |
The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study |
title_fullStr |
The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study |
title_full_unstemmed |
The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study |
title_sort |
effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2017-08-01 |
description |
Abstract Background Targeted treatment, matched according to specific clinical criteria e.g. hip muscle weakness, may result in better outcomes for people with patellofemoral pain (PFP). However, to ensure the success of future trials, a number of questions on the feasibility of a targeted treatment need clarification. The aim of the study was to explore the feasibility of matched treatment (MT) compared to usual care (UC) management for a subgroup of people with PFP determined to have hip weakness and to explore the mechanism of effect for hip strengthening. Methods In a pragmatic, randomised controlled feasibility study, 24 participants with PFP (58% female; mean age 29 years) were randomly allocated to receive either MT aimed specifically at hip strengthening, or UC over an eight-week period. The primary outcomes were feasibility outcomes, which included rates of adherence, attrition, eligibility, missing data and treatment efficacy. Secondary outcomes focused on the mechanistic outcomes of the intervention, which included hip kinematics. Results Conversion to consent (100%), missing data (0%), attrition rate (8%) and adherence to both treatment and appointments (>90%) were deemed successful endpoints. The analysis of treatment efficacy showed that the MT group reported a greater improvement for the Global Rating of Change Scale (62% vs. 9%) and the Anterior Knee Pain Scale (−5.23 vs. 1.18) but no between-group differences for either average or worst pain. Mechanistic outcomes showed a greatest reduction in peak hip internal rotation angle for the MT group (13.1% vs. −2.7%). Conclusion This feasibility study indicates that a definitive randomised controlled trial investigating a targeted treatment approach is achievable. Findings suggest the mechanism of effect of hip strengthening may be to influence kinematic changes in hip function in the transverse plane. Trial registration This study was registered retrospectively. ISRCTN74560952 . Registration date: 2017–02-06. |
topic |
Knee Strength training Therapeutic exercise Patellofemoral pain Hip strengthening |
url |
http://link.springer.com/article/10.1186/s12891-017-1698-7 |
work_keys_str_mv |
AT benjamintdrew theeffectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT philipgconaghan theeffectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT tobyosmith theeffectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT jamesselfe theeffectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT anthonycredmond theeffectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT benjamintdrew effectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT philipgconaghan effectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT tobyosmith effectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT jamesselfe effectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy AT anthonycredmond effectoftargetedtreatmentonpeoplewithpatellofemoralpainapragmaticrandomisedcontrolledfeasibilitystudy |
_version_ |
1724759597981368320 |