Development of a clinical tool and patient questionnaire for evaluation of patellofemoral pain syndrome patients.

Abstract

To develop an evaluation tool for patellofemoral pain syndrome (PFPS) patients. Exploratory, descriptive content validation study. Convenience sample, three groups of clinicians: 15 sports physical therapists, 9 sports medicine physicians, and 10 physical therapists and physicians with limited experience with PFPS. Selection based on specialization qualifications and experience with PFPS patients. DESCRIPTION OF TESTS: Content validation questionnaire to determine importance of clinical outcomes in determining change in PFPS patients. Using 10-cm visual analogue scales, reviewers rated the importance of five domains and rated the importance of twenty-one clinical tests; using a categorical scale, determined appropriateness and clarity of potential patient questionnaire items. Correlation values indicated significant correlation (p < 0.01) between pain and functional limitations (r = 0.068) and activity and functional limitations (r = 0.67), indicating that functional limitation may not be a unique component, but is integrated with pain and activity. A set of five pain questions, twelve function questions and six activity questions was developed. No statistical differences (p < 0.05) between the three groups of clinicians for the majority of clinical tests. Statistical differences (p < 0.05) between the three groups for rating of importance of flexibility of hip flexor and flexibility of gastrocnemius-soleus muscle groups, knee swelling, and radiographs. Good internal consistency among the 21 clinical tests (Cronbach's alpha = 0.84). The five top rated tests considering mean score values and standard deviations: lower extremity alignment, patellar orientation, patellar mobility, and flexibility of rectus femoris and tensor fasciae latae muscle groups. The results provide evidence of content validity for the components of PFPS evaluation investigated. The findings provide a basis of design of an evaluation tool for PFPS patients consisting of patient self-report questionnaire items and clinical tests.