Lower Mechanical Pressure Pain Thresholds in Female Adolescents With Patellofemoral Pain Syndrome

Abstract

Study Design Cross-sectional study. Objectives To compare pressure pain thresholds (PPTs) between adolescent females diagnosed with patellofemoral pain syndrome (PFPS) and gender- and age-matched controls without musculoskeletal pain. Background PFPS is prevalent among adolescents and may be associated with reduced PPT both locally and remotely from the site of reported pain. This may indicate altered central processing of nociceptive information. However, this has never been investigated in adolescents with PFPS. Methods Adolescents with PFPS and a comparison group without musculoskeletal pain were recruited from a population-based cohort of students from 4 upper secondary schools, aged 15 to 19 years. All 2846 students within that age range were invited to answer an online questionnaire regarding musculoskeletal pain. The students who reported knee pain were contacted by telephone and offered a clinical examination by an experienced rheumatologist, who made a diagnosis. PPTs were measured at 4 sites around the knee and 1 site on the tibialis anterior in the 57 female adolescents diagnosed with PFPS and in 22 female adolescents without musculoskeletal pain. Results Adolescents with PFPS, compared to controls, had significantly lower PPTs (26%–37% [100–178 kPa]) at each of the 4 sites around the knee, suggesting localized hyperalgesia. On the tibialis anterior, adolescents with PFPS had a 33% (159 kPa) lower PPT (distal hyperalgesia) compared with controls. Conclusion These findings suggest that adolescent females with PFPS have localized and distal hyperalgesia. These findings may have implications for treating PFPS, as both peripheral and central mechanisms may be driving the pain. Registered at clinicaltrials.gov (NCT01438762). J Orthop Sports Phys Ther 2013;43(6):414–421. Epub 18 March 2013. doi:10.2519/jospt.2013.4383

Patellofemoral Pain in Adolescence and Adulthood: Same Same, but Different?

“…Among adolescents, the population prevalence is 6-7 % [1,8]. No population-based studies have been conducted among adults, leaving the exact incidence and prevalence unknown in adults.…”

“…Long-standing PFP is associated with high pain intensity, low quality of life and increased risk of ceasing all sports participation [1][2][3]. At present, the aetiology is unknown and the diagnosis is made as a ''diagnosis by exclusion'' in the absence of other identifiable pathology such as meniscal injury, tendinopathy, bursitis or apophysitis.…”

Comparação do nível de dor femoropatelar, atividade física e qualidade de vida entre adolescentes do sexo feminino e masculino

“…Na maioria dos casos, adolescentes com DFP apresentam sintomatologia de mais de três anos [11], e apenas 5% reportam duração da dor por menos de seis meses [12]. Além da dor a longo prazo, adolescentes com DFP reportam reduções no nível funcional e na qualidade de vida [13]. Sabe-se, também, que adolescentes praticam altos níveis de atividade física e esse fator está associado com a persistência da dor [14].…”

“…De Oliveira Silva et al [3] reportaram que a gravidade dos sintomas da DFP associa-se com a redução na qualidade de vida de atletas adolescentes com DFP. De maneira semelhante, Cheung et al [15] [3,13,19]: (1) possuir idade entre 12 e 18 anos; (2) referir dor anterior ou retropatelar de início insidioso com no mínimo seis semanas de duração; (3) reportar dor em no mínimo duas das seguintes atividades: agachamento, subir e/ou descer escadas, permanecer sentado por tempo prolongado, corrida, prática de esportes e saltos/ aterrisagens; (4) reportar pior dor ao longo da semana anterior de pelo menos 30 mm na Escala Visual Analógica (EVA) de 100 milímetros. Era necessário que os participantes apresentassem todos os critérios para serem considerados com DFP.…”

Pressure thresholds and stiffness on the plantar surface of the human foot

“…The pain pressure threshold is described as the minimum pressure that induces pain (Fischer, 1987). The importance of PPT has been recognized in recent times (Huang et al, 2015;Makhsous, et al, 2012;Rathleff, et al, 2013). However, pressure discomfort threshold (PDT) is more suitable as a design criteria in product design (Goonetilleke, 2001).…”