Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs)
Identifieur interne : 000341 ( Pmc/Curation ); précédent : 000340; suivant : 000342Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs)
Auteurs : James Selfe [Royaume-Uni] ; Jessie Janssen [Royaume-Uni] ; Michael Callaghan [Royaume-Uni] ; Erik Witvrouw [Qatar] ; Chris Sutton [Royaume-Uni] ; Jim Richards [Royaume-Uni] ; Maria Stokes [Royaume-Uni] ; Denis Martin [Royaume-Uni] ; John Dixon [Royaume-Uni] ; Russell Hogarth [Royaume-Uni] ; Vasilios Baltzopoulos [Royaume-Uni] ; Elizabeth Ritchie [Royaume-Uni] ; Nigel Arden [Royaume-Uni] ; Paola Dey [Royaume-Uni]Source :
- British Journal of Sports Medicine [ 0306-3674 ] ; 2016.
Abstract
Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible.
The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests.
130 participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean body mass index 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7–60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (1) ‘strong’, (2) ‘weak and tighter’ and (3) ‘weak and pronated foot’.
We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other data sets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes.
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DOI: 10.1136/bjsports-2015-094792
PubMed: 26834185
PubMed Central: 4975826
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A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs)</title><author><name sortKey="Selfe, James" sort="Selfe, James" uniqKey="Selfe J" first="James" last="Selfe">James Selfe</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Janssen, Jessie" sort="Janssen, Jessie" uniqKey="Janssen J" first="Jessie" last="Janssen">Jessie Janssen</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Callaghan, Michael" sort="Callaghan, Michael" uniqKey="Callaghan M" first="Michael" last="Callaghan">Michael Callaghan</name><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Institute for Inflammation and Repair, Centre for Musculoskeletal Research, University of Manchester</institution>,<addr-line>Manchester</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Witvrouw, Erik" sort="Witvrouw, Erik" uniqKey="Witvrouw E" first="Erik" last="Witvrouw">Erik Witvrouw</name><affiliation wicri:level="1"><nlm:aff id="af3"><institution>Aspetar, Orthopaedic and Sports Medicine Hospital</institution>,<addr-line>Doha</addr-line>,<country>Qatar</country></nlm:aff><country xml:lang="fr">Qatar</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sutton, Chris" sort="Sutton, 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id="af4"><addr-line>Faculty of Health Sciences</addr-line>,<institution>University of Southampton</institution>,<addr-line>Southampton</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Martin, Denis" sort="Martin, Denis" uniqKey="Martin D" first="Denis" last="Martin">Denis Martin</name><affiliation wicri:level="1"><nlm:aff id="af5"><institution>Teesside University</institution>,<addr-line>Middlesbrough</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dixon, John" sort="Dixon, John" uniqKey="Dixon J" first="John" last="Dixon">John Dixon</name><affiliation wicri:level="1"><nlm:aff id="af5"><institution>Teesside University</institution>,<addr-line>Middlesbrough</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hogarth, Russell" sort="Hogarth, Russell" uniqKey="Hogarth R" first="Russell" last="Hogarth">Russell Hogarth</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Baltzopoulos, Vasilios" sort="Baltzopoulos, Vasilios" uniqKey="Baltzopoulos V" first="Vasilios" last="Baltzopoulos">Vasilios Baltzopoulos</name><affiliation wicri:level="1"><nlm:aff id="af6"><institution>Brunel University London</institution>,<addr-line>Uxbridge</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ritchie, Elizabeth" sort="Ritchie, Elizabeth" uniqKey="Ritchie E" first="Elizabeth" last="Ritchie">Elizabeth Ritchie</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Physiotherapy</addr-line>,<institution>Harrogate & District NHS Foundation Trust, Harrogate District Hospital</institution>,<addr-line>Harrogate, North Yorkshire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Arden, Nigel" sort="Arden, Nigel" uniqKey="Arden N" first="Nigel" last="Arden">Nigel Arden</name><affiliation wicri:level="1"><nlm:aff id="af8"><institution>University of Oxford, Nuffield Orthopaedic Centre</institution>,<addr-line>Oxford</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dey, Paola" sort="Dey, Paola" uniqKey="Dey P" first="Paola" last="Dey">Paola Dey</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26834185</idno><idno type="pmc">4975826</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975826</idno><idno type="RBID">PMC:4975826</idno><idno type="doi">10.1136/bjsports-2015-094792</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000341</idno><idno type="wicri:Area/Pmc/Curation">000341</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs)</title><author><name sortKey="Selfe, James" sort="Selfe, James" uniqKey="Selfe J" first="James" last="Selfe">James Selfe</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Janssen, Jessie" sort="Janssen, Jessie" uniqKey="Janssen J" first="Jessie" last="Janssen">Jessie Janssen</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Callaghan, Michael" sort="Callaghan, Michael" uniqKey="Callaghan M" first="Michael" last="Callaghan">Michael Callaghan</name><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Institute for Inflammation and Repair, Centre for Musculoskeletal Research, University of Manchester</institution>,<addr-line>Manchester</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Witvrouw, Erik" sort="Witvrouw, Erik" uniqKey="Witvrouw E" first="Erik" last="Witvrouw">Erik Witvrouw</name><affiliation wicri:level="1"><nlm:aff id="af3"><institution>Aspetar, Orthopaedic and Sports Medicine Hospital</institution>,<addr-line>Doha</addr-line>,<country>Qatar</country></nlm:aff><country xml:lang="fr">Qatar</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sutton, Chris" sort="Sutton, Chris" uniqKey="Sutton C" first="Chris" last="Sutton">Chris Sutton</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Richards, Jim" sort="Richards, Jim" uniqKey="Richards J" first="Jim" last="Richards">Jim Richards</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Stokes, Maria" sort="Stokes, Maria" uniqKey="Stokes M" first="Maria" last="Stokes">Maria Stokes</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Faculty of Health Sciences</addr-line>,<institution>University of Southampton</institution>,<addr-line>Southampton</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Martin, Denis" sort="Martin, Denis" uniqKey="Martin D" first="Denis" last="Martin">Denis Martin</name><affiliation wicri:level="1"><nlm:aff id="af5"><institution>Teesside University</institution>,<addr-line>Middlesbrough</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dixon, John" sort="Dixon, John" uniqKey="Dixon J" first="John" last="Dixon">John Dixon</name><affiliation wicri:level="1"><nlm:aff id="af5"><institution>Teesside University</institution>,<addr-line>Middlesbrough</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hogarth, Russell" sort="Hogarth, Russell" uniqKey="Hogarth R" first="Russell" last="Hogarth">Russell Hogarth</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Baltzopoulos, Vasilios" sort="Baltzopoulos, Vasilios" uniqKey="Baltzopoulos V" first="Vasilios" last="Baltzopoulos">Vasilios Baltzopoulos</name><affiliation wicri:level="1"><nlm:aff id="af6"><institution>Brunel University London</institution>,<addr-line>Uxbridge</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ritchie, Elizabeth" sort="Ritchie, Elizabeth" uniqKey="Ritchie E" first="Elizabeth" last="Ritchie">Elizabeth Ritchie</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Physiotherapy</addr-line>,<institution>Harrogate & District NHS Foundation Trust, Harrogate District Hospital</institution>,<addr-line>Harrogate, North Yorkshire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Arden, Nigel" sort="Arden, Nigel" uniqKey="Arden N" first="Nigel" last="Arden">Nigel Arden</name><affiliation wicri:level="1"><nlm:aff id="af8"><institution>University of Oxford, Nuffield Orthopaedic Centre</institution>,<addr-line>Oxford</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dey, Paola" sort="Dey, Paola" uniqKey="Dey P" first="Paola" last="Dey">Paola Dey</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">British Journal of Sports Medicine</title><idno type="ISSN">0306-3674</idno><idno type="eISSN">1473-0480</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible.</p></sec><sec><title>Method</title><p>The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests.</p></sec><sec><title>Results</title><p>130 participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean body mass index 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7–60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (1) ‘strong’, (2) ‘weak and tighter’ and (3) ‘weak and pronated foot’.</p></sec><sec><title>Conclusions</title><p>We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other data sets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Domenech, J" uniqKey="Domenech J">J Domenech</name></author><author><name sortKey="Sanchis Alfonso, V" uniqKey="Sanchis Alfonso V">V Sanchis-Alfonso</name></author><author><name sortKey="L Pez, L" uniqKey="L Pez L">L López</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stathopulu, E" uniqKey="Stathopulu E">E Stathopulu</name></author><author><name sortKey="Baildam, E" uniqKey="Baildam E">E Baildam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Price, Aj" uniqKey="Price A">AJ Price</name></author><author><name sortKey="Jones, J" uniqKey="Jones J">J Jones</name></author><author><name sortKey="Allum, R" uniqKey="Allum 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Sports Med</journal-id><journal-id journal-id-type="iso-abbrev">Br J Sports Med</journal-id><journal-id journal-id-type="hwp">bjsports</journal-id><journal-id journal-id-type="publisher-id">bjsm</journal-id><journal-title-group><journal-title>British Journal of Sports Medicine</journal-title></journal-title-group><issn pub-type="ppub">0306-3674</issn><issn pub-type="epub">1473-0480</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26834185</article-id><article-id pub-id-type="pmc">4975826</article-id><article-id pub-id-type="publisher-id">bjsports-2015-094792</article-id><article-id pub-id-type="doi">10.1136/bjsports-2015-094792</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject></subj-group><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs)</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Selfe</surname><given-names>James</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Janssen</surname><given-names>Jessie</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Callaghan</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Witvrouw</surname><given-names>Erik</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Sutton</surname><given-names>Chris</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Richards</surname><given-names>Jim</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Stokes</surname><given-names>Maria</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Martin</surname><given-names>Denis</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Dixon</surname><given-names>John</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Hogarth</surname><given-names>Russell</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Baltzopoulos</surname><given-names>Vasilios</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Ritchie</surname><given-names>Elizabeth</given-names></name><xref ref-type="aff" rid="af7">7</xref></contrib><contrib contrib-type="author"><name><surname>Arden</surname><given-names>Nigel</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib><contrib contrib-type="author"><name><surname>Dey</surname><given-names>Paola</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib></contrib-group><aff id="af1"><label>1</label><institution>University of Central Lancashire</institution>,<addr-line>Preston, Lancashire</addr-line>,<country>UK</country></aff><aff id="af2"><label>2</label><institution>Institute for Inflammation and Repair, Centre for Musculoskeletal Research, University of Manchester</institution>,<addr-line>Manchester</addr-line>,<country>UK</country></aff><aff id="af3"><label>3</label><institution>Aspetar, Orthopaedic and Sports Medicine Hospital</institution>,<addr-line>Doha</addr-line>,<country>Qatar</country></aff><aff id="af4"><label>4</label><addr-line>Faculty of Health Sciences</addr-line>,<institution>University of Southampton</institution>,<addr-line>Southampton</addr-line>,<country>UK</country></aff><aff id="af5"><label>5</label><institution>Teesside University</institution>,<addr-line>Middlesbrough</addr-line>,<country>UK</country></aff><aff id="af6"><label>6</label><institution>Brunel University London</institution>,<addr-line>Uxbridge</addr-line>,<country>UK</country></aff><aff id="af7"><label>7</label><addr-line>Department of Physiotherapy</addr-line>,<institution>Harrogate & District NHS Foundation Trust, Harrogate District Hospital</institution>,<addr-line>Harrogate, North Yorkshire</addr-line>,<country>UK</country></aff><aff id="af8"><label>8</label><institution>University of Oxford, Nuffield Orthopaedic Centre</institution>,<addr-line>Oxford</addr-line>,<country>UK</country></aff><author-notes><corresp><label>Correspondence to</label> Professor James Selfe, School of Sport Tourism and the Outdoors, University of Central Lancashire, Preston PR1 2HE, UK; <email>JSelfe1@uclan.ac.uk</email></corresp></author-notes><pub-date pub-type="ppub"><month>7</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>1</day><month>2</month><year>2016</year></pub-date><volume>50</volume><issue>14</issue><fpage>873</fpage><lpage>880</lpage><history><date date-type="accepted"><day>16</day><month>11</month><year>2015</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link></license-p></license></permissions><self-uri xlink:title="pdf" xlink:href="bjsports-2015-094792.pdf"></self-uri><abstract><sec><title>Background</title><p>Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible.</p></sec><sec><title>Method</title><p>The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests.</p></sec><sec><title>Results</title><p>130 participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean body mass index 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7–60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (1) ‘strong’, (2) ‘weak and tighter’ and (3) ‘weak and pronated foot’.</p></sec><sec><title>Conclusions</title><p>We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other data sets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes.</p></sec></abstract><kwd-group><kwd>Physiotherapy</kwd><kwd>Knee</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>special-feature</meta-name><meta-value>unlocked</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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