Targeted Functional Movement Retraining to Improve Pain, Function, and Biomechanics in Subjects With Anterior Knee Pain: A Case Series

Leibbrandt, Dominique; Louw, Quinette

doi:10.1123/jsr.2016-0164

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…Our initial assessment level of function for the low back and lower extremity injuries were similar to baseline level of function in other studies (Oswestry 75.6±12.4%, compared to another study (70-80%) 24 , and LEFS 61.5%±22.9 compared with other studies examining patella femoral pain syndrome or anterior knee pain (61-75%). 27,28 ) However our mean DASH score (74.2±20.8%) was a generally higher compared to other studies. For example, the DASH score for other conditions include: hand, elbow and shoulder pathologies (65%) 33 , carpal tunnel syndrome (59%±20) 33 and rotator cuff tendinopathy (43.7%).…”

Section: Baseline Level Of Functioncontrasting

confidence: 81%

“…The minimal clinically important difference is 9 points 26 , also equivalent to 11.25%. The Lower Extremity Functional Scale also demonstrates good construct validity (correlations with another scale ranging from 0.8 to 0.64 26 ) and reliability (test re-test r score ranging between 0.94 and 0.98) and is responsive for use in patients with lower extremity musculoskeletal dysfunction that include anterior knee pain 27 , patello-femoral pain syndrome. 28 Moreover, LEFS was the most used PROM for hip and knee dysfunctions 4 .…”

Section: Lower Extremity Functional Scale (Lefs)mentioning

confidence: 99%

“…Binkley et al determined that the LEFS was reliable and responsive O n l i n e F i r s t 10 when tested during a mean duration of 6 weeks. 26 Previous studies also used the 6-week timeframe when evaluating subject-specific rehabilitation outcomes using the LEFS at baseline, follow-up and at discharge 27 , the DASH for rotator cuff tendinopathy 34 and the ODI in low back pain patients 35 . While we agree that not all injuries will recover fully in 6 weeks, previous studies suggest that 6 weeks is enough time to see a difference in these patient-reported outcome measures.…”

Section: Participants and Protocol Proceduresmentioning

confidence: 99%

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Patient Outcomes After Treatment by Athletic Therapy Students

Lebel¹,

DeMont²,

Eberman³

et al. 2021

Journal of Athletic Training

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Context: Patient-reported outcome measures (PROMs) should be used in athletic training but are rarely incorporated in athletic training and athletic therapy internships. Student-run clinics are common in other health professions and provide effective treatment and a valuable learning environment.1–3 To our knowledge, no one has evaluated rehabilitation outcomes in patients treated by athletic training/athletic therapy students (ATSs). Objective: The purpose of our study was to measure the improvement in function in injured patients seeking treatment at an ATS-clinic. Design: Cohort study. Setting: ATS-clinic. Participants: Fifty-nine patients from the community with a variety of low back, lower extremity, and upper extremity injuries participated in this study. Interventions: ATSs were responsible for the injury assessment and rehabilitation program of their patients while being supervised by a certified AT. Main Outcome Measures: At baseline and at 6-week follow-up, all patients completed one of three scales depending on injury location to assess their injured level of function. Scales included the: Oswestry Disability Index (ODI) for low back injuries, Lower Extremity Functional Scale (LEFS) for lower extremity injuries and Disabilities of the Arm Shoulder and Hand (DASH) for upper extremity injuries. Results: On average, patients received 4.7±1.8 treatments across 48.8±16.1 days. Patients experienced a significant increase in function between assessment and follow-up (18.8%±20.3, p<0.001,d =1.06). Moreover, the amount of functional improvement was clinically significant, being greater than the minimal clinical difference for each scale. There was no significant difference in the efficacy of treatment regarding internship experience of ATSs. Conclusions: Patients improved their function significantly after treatment delivered by an ATS. Patient-reported outcome measures were useful for the students to monitor patient improvement however, more research is needed regarding effective treatment for chronic pain patients. Our results suggest that ATS-clinics provide effective treatments for patients, service to the community, and a learning opportunity for students.

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Section: Baseline Level Of Functioncontrasting

confidence: 81%

Section: Lower Extremity Functional Scale (Lefs)mentioning

confidence: 99%

Section: Participants and Protocol Proceduresmentioning

confidence: 99%

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Patient Outcomes After Treatment by Athletic Therapy Students

Lebel¹,

DeMont²,

Eberman³

et al. 2021

Journal of Athletic Training

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“…This instrument has been used to assess a participant’s initial function as well as ongoing response to treatment for lower extremity pain (Binkley et al 1999 ; Lieberz et al 2022 ; Mehta et al 2016 ). The LEFS has been reported to have strong construct validity and test–retest reliability (Binkley et al 1999 ) and has been reported to be appropriate for use in individuals with lower extremity musculoskeletal dysfunction and pain (Binkley et al 1999 ; Fukuda et al 2010 ; Leibbrandt and Louw 2018 ). The scale is composed of 20 items that are evaluated on a Likert scale (0 = extreme difficulty; 4 = no difficulty) across many activities of daily living.…”

Section: Methodsmentioning

confidence: 99%

Topical cannabidiol is well tolerated in individuals with a history of elite physical performance and chronic lower extremity pain

et al. 2023

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Introduction Cannabidiol (CBD) is a potential therapeutic for pain management. Yet, there exists a dearth of studies of its tolerability and efficacy, especially in special populations. Former elite athletes are a special population both susceptible to chronic pain and also highly trained and attuned to assess medication tolerability concerns. The purpose of the present open-label pilot study was to assess the tolerability of CBD in this population. Materials and methods Retrospective analysis was conducted in deidentified data from 20 individuals who were all previously professional athletes in US/American football, track and field, or basketball, with careers ranging from 4 to 10 years. Participants received topical CBD (10 mg twice daily by controlled dispenser) for chronic pain resulting from acute lower extremity injuries. Assessments of tolerability and secondary analyses of pain, pain-related disability, and activities of daily living were collected by self-report over the 6-week study period. Data were analyzed by descriptive statistics, pairwise t-test, and linear regression. Results Seventy percent of participants completed the study. Of the individuals who completed the study, 50% reported minor adverse effects, none of which required medical attention, and 50% did not report any adverse effects. The mostly commonly reported effects were skin dryness (43% of study completers) and skin rash (21% of study completers), which rapidly resolved. There was a significant improvement in self-reported pain levels (intake mean 3.5 ± 0.29; exit mean 1.7 ± 0.23; P < 0.001) and pain-related disability, including family and home responsibilities, life support activities, occupational activities, recreational activities, self-care, sexual function, and social activities (all P < 0.001). Discussion To the best of our knowledge, this is the first study to assess CBD treatment in elite athletes, who are disproportionally susceptible to disabling injuries. Topical administration of CBD was tolerated well by this population and resulted in only minor adverse effects. As elite athletes are trained and attuned to assess their own bodies due to their professional lives, this population is likely to detect tolerability concerns. However, this study was limited to a convenience sample and self-reported data. These pilot findings warrant further study of topical CBD in randomized and controlled studies of elite athletes.

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“…Examples of the individually tailored exercises over the 6-week period can be seen as supplementary online data. The therapist’s instructions to the patient as well as criteria for progression has been described in detail in a previous study26 ) .…”

Section: Participants and Methodsmentioning

confidence: 99%

The effect of an individualised functional retraining intervention on pain, function and biomechanics in participants with patellofemoral pain: a series of n of 1 trial

Leibbrandt

Louw

2019

J Phys Ther Sci

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[Purpose] To determine the effect of an individualised functional retraining intervention on pain, function, kinematics and self-reported recovery in participants with PFP. [Participants and Methods] Thirty-one participants with unilateral PFP between the ages of 14–40 were included. Data collection and treatment sessions were conducted at the Tygerberg 3D Motion Analysis Laboratory and Physiotherapy Clinic at the University of Stellenbosch Medical School in Cape Town, South Africa. Participants underwent motion analysis testing pre- and post-intervention and attended physiotherapy weekly for a 6-week individualised intervention. [Results] Thirty of the thirty-one participants (96.8%) demonstrated improved pain levels (NPRS) post intervention. Participants demonstrated a statistically significant improvement in function (AKPS) immediately post intervention and continued to improve with greater functional scores at 6-month follow up. Fifteen participants (48.4%) rated themselves as fully recovered on a 7-point Likert scale at 6-month follow up. Nineteen of the 31 participants (61.3%) demonstrated a clinically significant improvement in their priority kinematic outcome post intervention. [Conclusion] Individualised functional retraining may improve pain, function, kinematics and long-term recovery in participants with PFP presenting with kinematic contributing factors. Clinicians need to be educated on common biomechanical contributing factors and how to tailor treatment accordingly.

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Targeted Functional Movement Retraining to Improve Pain, Function, and Biomechanics in Subjects With Anterior Knee Pain: A Case Series

Abstract: A subject-specific functional movement retraining intervention may be successful in the treatment of subjects with AKP presenting with biomechanical risk factors. Research on a larger sample is required to further investigate this approach.

Cited by 7 publications

References 25 publications

Patient Outcomes After Treatment by Athletic Therapy Students

Patient Outcomes After Treatment by Athletic Therapy Students

Topical cannabidiol is well tolerated in individuals with a history of elite physical performance and chronic lower extremity pain

The effect of an individualised functional retraining intervention on pain, function and biomechanics in participants with patellofemoral pain: a series of n of 1 trial

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