A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties

doi:10.1186/s12891-016-1097-5

Clinical Trial

. 2016 May 31:17:237.

doi: 10.1186/s12891-016-1097-5.

A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties

Paola Dey¹, Michael Callaghan², Neil Cook³, Ruth Sephton⁴, Chris Sutton⁵, Elaine Hough⁴, Jonathan James⁴, Rukhtam Saqib⁶, James Selfe²

Affiliations

¹ College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK. MPDey@uclan.ac.uk.
² Department of Health Professions, Manchester Metropolitan University, Manchester, M15 6GX, UK.
³ College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
⁴ 5 Boroughs Partnership NHS Foundation Trust, St Helens Hospital, Marshalls Cross Road, St Helens, WA9 3DA, UK.
⁵ College of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE, UK.
⁶ Stepping Hill Hospital, Stockport Foundation NHS Trust, Poplar Grove, Hazel Grove, Stockport, Cheshire, SK2 7JE, UK.

PMID: 27245443
PMCID: PMC4886395
DOI: 10.1186/s12891-016-1097-5

Clinical Trial

A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties

Paola Dey et al. BMC Musculoskelet Disord. 2016.

. 2016 May 31:17:237.

doi: 10.1186/s12891-016-1097-5.

Authors

Paola Dey¹, Michael Callaghan², Neil Cook³, Ruth Sephton⁴, Chris Sutton⁵, Elaine Hough⁴, Jonathan James⁴, Rukhtam Saqib⁶, James Selfe²

Affiliations

¹ College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK. MPDey@uclan.ac.uk.
² Department of Health Professions, Manchester Metropolitan University, Manchester, M15 6GX, UK.
³ College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
⁴ 5 Boroughs Partnership NHS Foundation Trust, St Helens Hospital, Marshalls Cross Road, St Helens, WA9 3DA, UK.
⁵ College of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE, UK.
⁶ Stepping Hill Hospital, Stockport Foundation NHS Trust, Poplar Grove, Hazel Grove, Stockport, Cheshire, SK2 7JE, UK.

PMID: 27245443
PMCID: PMC4886395
DOI: 10.1186/s12891-016-1097-5

Abstract

Background: Community-based studies of patellofemoral pain (PFP) need a questionnaire tool that discriminates between those with and those without the condition. To overcome these issues, we have designed a self-report questionnaire which aims to identify people with PFP in the community.

Study designs: comparative study and cross-sectional study.

Study population: comparative study: PFP patients, soft-tissue injury patients and adults without knee problems. Cross-sectional study: adults attending a science festival.

Intervention: comparative study participants completed the questionnaire at baseline and two weeks later. Cross-sectional study participants completed the questionnaire once. The optimal scoring system and threshold was explored using receiver operating characteristic curves, test-retest reliability using Cohen's kappa and measurement error using Bland-Altman plots and standard error of measurement. Known-group validity was explored by comparing PFP prevalence between genders and age groups.

Results: Eighty-four participants were recruited to the comparative study. The receiver operating characteristic curves suggested limiting the questionnaire to the clinical features and knee pain map sections (AUC 0.97 95 % CI 0.94 to 1.00). This combination had high sensitivity and specificity (over 90 %). Measurement error was less than the mean difference between the groups. Test-retest reliability estimates suggest good agreement (N = 51, k = 0.74, 95 % CI 0.52-0.91). The cross-sectional study (N = 110) showed expected differences between genders and age groups but these were not statistically significant.

Conclusion: A shortened version of the questionnaire, based on clinical features and a knee pain map, has good measurement properties. Further work is needed to validate the questionnaire in community samples.

Keywords: Diagnosis; Differential; Patellofemoral pain; Reliability; Sensitivity and specificity; Validation studies.

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Figures

**Fig. 2**
Bland Altman plot showing bias and 95 % limits of agreement (sections 2 and 4 combined)

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References

1. Callaghan M, Selfe J. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? Phys Ther Sport. 2007;8:37–43. doi: 10.1016/j.ptsp.2006.07.001. - DOI
1. Rathleff MS, Roos EM, Olesen JL, Rasmussen S. Early intervention for adolescents with patellofemoral pain syndrome--a pragmatic cluster randomised controlled trial. BMC Musculoskelet Disord. 2012;13:9. doi: 10.1186/1471-2474-13-9. - DOI - PMC - PubMed
1. 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;101:215–22. doi: 10.7547/1010215. - DOI - PubMed
1. Utting MR, Davies G, Newman JH. Is anterior knee pain a predisposing factor to patellofemoral osteoarthritis? Knee. 2005;12:362–365. doi: 10.1016/j.knee.2004.12.006. - DOI - PubMed
1. Crossley KM. Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? Br J Sports Med. 2014;48:409–410. doi: 10.1136/bjsports-2014-093445. - DOI - PubMed

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[1] Callaghan M, Selfe J. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? Phys Ther Sport. 2007;8:37–43. doi: 10.1016/j.ptsp.2006.07.001. - DOI

[2] Callaghan M, Selfe J. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? Phys Ther Sport. 2007;8:37–43. doi: 10.1016/j.ptsp.2006.07.001. - DOI

[3] Rathleff MS, Roos EM, Olesen JL, Rasmussen S. Early intervention for adolescents with patellofemoral pain syndrome--a pragmatic cluster randomised controlled trial. BMC Musculoskelet Disord. 2012;13:9. doi: 10.1186/1471-2474-13-9. - DOI - PMC - PubMed

[4] Rathleff MS, Roos EM, Olesen JL, Rasmussen S. Early intervention for adolescents with patellofemoral pain syndrome--a pragmatic cluster randomised controlled trial. BMC Musculoskelet Disord. 2012;13:9. doi: 10.1186/1471-2474-13-9. - DOI - PMC - PubMed

[5] 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;101:215–22. doi: 10.7547/1010215. - DOI - PubMed

[6] 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;101:215–22. doi: 10.7547/1010215. - DOI - PubMed

[7] Utting MR, Davies G, Newman JH. Is anterior knee pain a predisposing factor to patellofemoral osteoarthritis? Knee. 2005;12:362–365. doi: 10.1016/j.knee.2004.12.006. - DOI - PubMed

[8] Utting MR, Davies G, Newman JH. Is anterior knee pain a predisposing factor to patellofemoral osteoarthritis? Knee. 2005;12:362–365. doi: 10.1016/j.knee.2004.12.006. - DOI - PubMed

[9] Crossley KM. Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? Br J Sports Med. 2014;48:409–410. doi: 10.1136/bjsports-2014-093445. - DOI - PubMed

[10] Crossley KM. Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? Br J Sports Med. 2014;48:409–410. doi: 10.1136/bjsports-2014-093445. - DOI - PubMed

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A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties

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A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties

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