Project: Clinically Predictive Factors of Patients with Patellofemoral Pain
Can you give me a brief overview of what this project is about?
This project is focused on patellofemoral pain (PFP), or general knee pain under or around the kneecap. The literature surrounding PFP is vast, however, no clear consensus exists about what is causing the pain. Rehabilitation outcomes for patients with PFP are poor, with only a small percentage of patients fully recovering from this pain syndrome and a large percentage of patients continuing to have pain for many years after diagnosis.
The literature suggests that there may be subgroups of patients with PFP who present with similar clinical findings. One possible reason for poor treatment outcomes is that we are treating everyone with PFP the same, instead of identifying their impairments and intervening in a more focused manner. Current research attempting to identify these subgroups has randomly divided patients with PFP into different intervention groups, as a preliminary step to identify if patients with PFP will respond differently to separate interventions.
The purpose of this project is to complete a comprehensive clinical lower extremity evaluation of the hips, knees, ankles and toes of a group of patients with PFP and a healthy population. We will identify through statistical analysis if there are subgroups of PFP with the same clinical presentation. This can help guide future studies on how to group their PFP patients, instead of dividing them randomly. We will also identify how the PFP patients differ from the healthy group on all of the variables collected.
Why are you passionate about this area of research?
I have been conducting research on PFP for a few years, and although we have had innovative studies with significant results, we are keeping everyone with PFP in the same group. We are limited in this manner because we believe there are subgroups of PFP patients who present differently on clinical exam. I am passionate about this particular pain syndrome because we are still unable to produce favorable treatment outcomes for these patients. As a clinician, it is frustrating to identify an issue with a patient but not have a thorough understanding of what’s causing the problem or how to intervene.
Where did the idea for this particular project come from?
In recent years, at the end of studies on PFP patients, the conclusions have stated that it would be best to identify the subgroups of impairments in the PFP patients and complete the study within the subgroups. After years of saying the same thing, we decided that we should attempt to identify these subgroups.
How did you decide to submit a proposal to the Curry IDEA competition?
This study will be the first of its kind in determining clinical predictor rules based on an analysis of the hips, knees, feet, and ankles in those with PFP. Due to the vast amount of data we will be collecting, this study requires upwards of three hours for participation and may increase pain in those with PFP. In order to encourage participation in this study, as we need around 100 patients, we decided to submit a proposal to the Curry IDEA competition to pay our patients. The innovation of this study, combined with the need for a large amount of patients, drove our decision to submit a proposal to the Curry IDEA competition.
What other people and organizations will be involved?
Both athletic trainers and physical therapists from our Exercise and Sport Injury Lab will be involved as researchers in this study.
What goals do you have for this project?
My immediate goals for this project are to identify subgroups of patients with PFP via a clinical analysis of the lower extremity. Future goals include identifying which treatments will be most beneficial to each subgroup.
How will the IDEA grant help you achieve those goals?
The IDEA grant will help in recruiting the patients necessary for this project. Without all of these patients, we will not be able to complete the statistical analysis that is required for the desired outcome.