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Association Between Impairments and Function in Individuals with Patellofemoral Pain Syndrome

Piva, Sara Regina (2005) Association Between Impairments and Function in Individuals with Patellofemoral Pain Syndrome. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Purpose: To identify baseline impairments associated with physical function and to identify what changes in impairments are associated with functional outcome in patients with PFPS following a standardized physical therapy (PT) treatment at 2 and 6-month follow-ups. Subjects: 74 patients diagnosed with PFPS and referred to PT treatment. Methods: Correlational, predictive design. Baseline measurement session was performed to complete demographic questionnaires, self-reported measures, and undergo a physical exam. Impairments measured during physical exam included quadriceps strength, hip abduction strength, hip external rotation strength, hamstrings length, quadriceps length, plantar flexors length, ITB/TFL complex length, lateral retinacular length, foot pronation, Q-angle, tibial torsion, quality of movement, pain, and anxiety. Following the baseline, subjects participated in a standardized PT program. Then, measurement sessions were performed at 2 and 6-month follow-ups. Analyses: Association between baseline impairment and function used a stepwise multiple regression in which potential confounder variables (age, sex, activity level, height and weight) were forced into the model as a single block. Then, impairment measures were entered in a stepwise procedure. Function measured by the Activity of Daily Living Scale (ADLS) was the criterion variable. Association between changes in impairment and function outcome was investigated with two stepwise multiple regressions, one with the 2 and the other with the 6-month follow-up data. The criterion variable was the ADLS of the respective follow-up controlled by the baseline ADLS. First, potential confounders were forced into the model as a single block. Then, changes in impairments and baseline pain were entered in a stepwise procedure. Results and Clinical Relevance: At baseline our study indicates that after controlling the confounders, pain and tightness of lateral retinaculum predicted baseline function. Data suggested that pain may mediate the relationship between anxiety and function in patients with PFPS and the role of pain and anxiety in the prediction of function should be considered together with this population. At the 2 and 6-month follow-ups, after controlling the confounders, increased gastrocnemius length and increased quadriceps length predicted functional outcome, respectively. It seems that clinicians should specifically target impairments of soft tissue length in an attempt to improve functional outcome in patients with PFPS.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Piva, Sara Reginasrpst24@pitt.eduSRPST24
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairFitzgerald, G Kelley
Committee MemberDelitto, Anthony
Committee MemberIrrgang, James J
Committee MemberFritz, Julie M
Committee MemberWisniewski, Steven
Date: 16 May 2005
Date Type: Completion
Defense Date: 21 April 2005
Approval Date: 16 May 2005
Submission Date: 16 May 2005
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: function; impairment; knee; patella; prediction; reliability
Other ID:, etd-05162005-115955
Date Deposited: 10 Nov 2011 19:44
Last Modified: 15 Nov 2016 13:43


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