Effect of neurofeedback training on psychological features and plantar pressure distribution symmetry in patients with patellofemoral pain: A ransdomized controlled trial

Abstract

ObjectiveThe evidence shows changes in plantar pressure asymmetry are associated with patellofemoral joint overloading and may be effective in patellofemoral pain (PFP) etiology. Psychological factors such as catastrophizing and kinesiophobia causes a change in movement behavior which can lead to a plantar pressure distribution asymmetry. This study evaluated the effect of neurofeedback training (NFBT) on psychological variables and plantar pressure distribution symmetry in patients with PFP. MethodThirty males with PFP were recruited for clinical trials. They were randomly divided into experimental and control groups (each group had 15 patients). The patients in the experimental group received NFBT for 12 weeks. The primary outcome was psychological variables inclusive of pain, catastrophizing, and kinesiophobia. The secondary outcome was plantar pressure distribution symmetry which was assessed in standing conditions. The covariance statistical method was used for data analysis. ResultsAfter 12 weeks of NFBT, there was a significant difference in the pain (P = 0.001, ηp2 = 0.467), the kinesiophobia (P = 0.001, ηp2 = 0.459), and the catastrophizing (P = 0.011, ηp2 = 0.218). However, despite the slight normalization, no significant difference in plantar pressure distribution symmetry of inter-limbs foot (η2 = 0.113, P = 0.075), forward and backward of right foot (η2 = 0.120, P = 0.066), and forward and backward of left foot (η2 = 0.104, P = 0.088). ConclusionNFBT reduces pain intensity, kinesiophobia, and catastrophizing by modulating areas related to pain processing and cognitive. However, NFBT has a small effect on normalizing plantar pressure. Therefore, it is recommended that adding NFBT to physical rehabilitation can have a better effect on improving clinical symptoms.