Targeted physiotherapy for patellofemoral joint osteoarthritis: A protocol for a randomised, single-blind controlled trial

被引:40
作者
Crossley, Kay M. [1 ]
Vicenzino, Bill [2 ]
Pandy, Marcus G. [1 ]
Schache, Anthony G. [1 ]
Hinman, Rana S. [3 ]
机构
[1] Univ Melbourne, Melbourne Sch Engn, Dept Mech Engn, Melbourne, Vic, Australia
[2] Univ Queensland, Sch Hlth & Rehabil Sci, Div Physiotherapy, Brisbane, Qld, Australia
[3] Univ Melbourne, Sch Physiotherapy, Ctr Hlth Exercise & Sports Med, Melbourne, Vic, Australia
基金
英国医学研究理事会;
关键词
D O I
10.1186/1471-2474-9-122
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The patellofemoral joint (PFJ) is one compartment of the knee that is frequently affected by osteoarthritis (OA) and is a potent source of OA symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJ OA. Therefore, this project aims to evaluate whether a physiotherapy treatment, targeted to the PFJ, results in greater improvements in pain and physical function than a physiotherapy education intervention in people with symptomatic and radiographic PFJ OA. Methods: 90 people with PFJ OA (PFJ-specific history, signs and symptoms and radiographic evidence of PFJ OA) will be recruited from the community and randomly allocated into one of two treatments. A randomised controlled trial adhering to CONSORT guidelines will evaluate the efficacy of physiotherapy (8 individual sessions over 12 weeks, as well as a home exercise program 4 times/week) compared to a physiotherapist-delivered OA education control treatment (8 individual sessions over 12 weeks). Physiotherapy treatment will consist of (i) quadriceps muscle retraining; (ii) quadriceps and hip muscle strengthening; (iii) patellar taping; (iv) manual PFJ and soft tissue mobilisation; and (v) OA education. Resistance and dosage of exercises will be tailored to the participant's functional level and clinical state. Primary outcomes will be evaluated by a blinded examiner at baseline, 12 weeks and 9 months using validated and reliable pain, physical function and perceived global effect scales. All analyses will be conducted on an intention-to-treat basis using linear mixed regression models, including respective baseline scores as a covariate, subjects as a random effect, treatment condition as a fixed factor and the covariate by treatment interaction. Conclusion: This RCT is targeting PFJ OA, an important sub-group of knee OA patients, with a specifically designed conservative intervention. The project's outcome will influence PFJ OA rehabilitation, with the potential to reduce the personal and societal burden of this increasing public health problem.
引用
收藏
页数:9
相关论文
共 49 条
  • [1] Access Economics Pty Limited, 2007, PAINF REAL EC IMP AR
  • [2] Altman DG, 1996, BRIT MED J, V313, P570
  • [3] Altman RD, 2000, ARTHRITIS RHEUM-US, V43, P1905
  • [4] ALTMAN RD, 1995, OSTEOARTHR CARTILAGE, V3, P3
  • [5] BELLAMY N, 1988, J RHEUMATOL, V15, P1833
  • [6] Exercise as a treatment for osteoarthritis
    Bennell, K
    Hinman, R
    [J]. CURRENT OPINION IN RHEUMATOLOGY, 2005, 17 (05) : 634 - 640
  • [7] Boegård T, 1998, ACTA RADIOL, V39, P24
  • [8] Electromyographic changes in the gluteus medius during stair ascent and descent in subjects with anterior knee pain
    Brindle, TJ
    Mattacola, C
    McCrory, J
    [J]. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2003, 11 (04) : 244 - 251
  • [9] Association of pain with radiological changes in different compartments and views of the knee joint
    Cicuttini, FM
    Baker, J
    Hart, DJ
    Spector, TD
    [J]. OSTEOARTHRITIS AND CARTILAGE, 1996, 4 (02) : 143 - 147
  • [10] Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome
    Cowan, SM
    Bennell, KL
    Hodges, PW
    Crossley, KM
    McConnell, J
    [J]. ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2001, 82 (02): : 183 - 189