Comparison of the level of patellofemoral pain, physical activity, and quality of life between female and male adolescents

Marina Cabral Waiteman, Maira Bergamaschi Coura, Cynthia Gobbi, Ronaldo Valdir Briani, Danilo de Oliveira Silva, Fábio Mícolis de Azevedo

Abstract


DOI: 10.15448/1980-6108.2017.1.25250

Aims: To compare the level of pain, physical activity, and quality of life of female and male adolescents with patellofemoral pain.

Methods: A total of 46 female adolescents and 46 male adolescents aged 12 to 18 years were recruited from public and private schools in the town of Presidente Prudente, São Paulo, Brazil. To be included in the study, adolescents needed to report knee pain of insidious onset, exacerbated in some activities, and lasting for at least 6 weeks. In addition, adolescents should report worse pain over the previous week of at least 30 mm on the Visual Analog Scale and could not show signs, symptoms or any occurrence of any other knee dysfunction. The participants were requested to mark their self-reported knee pain in the last month on a Visual Analog Scale. The level of physical activity was evaluated by the Baecke Questionnaire of Habitual Physical Activity and the quality of life subscale of the Knee Outcome in Osteoarthritis Survey questionnaire was used to investigate the participants’ quality of life. The independent t-test was used to find differences between the groups regarding the level of physical activity, quality of life, and knee pain.

Results: According to the Visual Analog Scale, male adolescents presented a level of knee pain of 5.1±1.4 in the previous month and female adolescents, of 4.4±1.6 (p = 0.029). The physical activity score was 8.8±1.3 for male adolescents and 7.5±1.6 for female ones (p<0.001). The quality of life subscale scores were 77.9±19.0 for adolescent girls and 70.8±13.5 for male adolescents (p=0.042).

Conclusions: Among adolescents with patellofemoral pain, males had a higher level of knee pain, higher level of physical activity, and lower quality of life compared to female adolescents.


Keywords


patellofemoral pain syndrome; adolescent; quality of life.

References


Crossley K M, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM, McConnell J, Vicenzino B, Bazett-Jones DM, Esculier J-F, Morrissey D, Callaghan MJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016;50(14):839-43. https://doi.org/10.1136/bjsports-2016-096384

de Oliveira Silva D, Briani RV, Pazzinatto MF, Ferrari D, Aragão FA, Albuquerque CE, Alves N, Azevedo FM. Reliability and differentiation capability of dynamic and static kinematic measurements of rearfoot eversion in patellofemoral pain. Clin Biomech. 2015;30(2):144-8. https://doi.org/10.1016/j.clinbiomech.2014.12.009

de Oliveira Silva D, Coura MB, Waiteman M, Pradela J, Pazzinatto MF, Magalhães FH, Azevedo FM. Patellofemoral pain and sports practice: reduced symptoms and higher quality of life in adolescent athletes as compared to non-athletes. Motriz Rev Educ Fis. 2016;22(1):84-9. https://doi.org/10.1590/S1980-65742016000100011

Briani RV, Silva DO, Pazzinatto MF, Ferreira AS, Ferrari D, Azevedo FM. Delayed onset of electromyographic activity of the vastus medialis relative to the vastus lateralis may be related to physical activity levels in females with patellofemoral pain. J Electromyogr Kinesiol. 2016;26:137-42. https://doi.org/10.1016/j.jelekin.2015.10.012

Mølgaard C, Rathleff MS, Simonsen O. Patellofemoral pain syndrome and its association with hip, ankle, and foot function in 16- to 18-year-old high school students: a single-blind case-control study. J Am Podiatr Med Assoc. 2011;101(3):215-22. https://doi.org/10.7547/1010215

Myer GD, Ford KR, Foss KDB, Goodman A, Ceasar A, Rauh MJ, Divine JG, Hewett TE. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech. 2010;25(7):700-7. https://doi.org/10.1016/j.clinbiomech.2010.04.001

Lankhorst NE, van Middelkoop M, Crossley KM, Bierma-Zeinstra SM, Oei EH, Vicenzino B, Collins NJ. Factors that predict a poor outcome 5–8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. Br J Sports Med. 2015;50(14):881-6. https://doi.org/10.1136/bjsports-2015-094664

de Oliveira Silva D, Briani R, Pazzinatto MF, Ferrari D, Aragão F, Azevedo F. Vertical ground reaction forces are associated with pain and self-reported functional status in recreational athletes with patellofemoral pain. J Appl Biomech. 2015;31(6):409-14. https://doi.org/10.1123/jab.2015-0048

de Oliveira Silva D, Barton CB, Pazzinatto MF, Briani R, Azevedo F. Proximal mechanics during stair ascent are more discriminate of females with patellofemoral pain than distal mechanics. Clin Biomech. 2016;35(5):56-61. https://doi.org/10.1016/j.clinbiomech.2016.04.009

Rathleff MS, Vicenzino B, Middelkoop M, Graven-Nielsen T, van Linschoten R, Hölmich P, Thorborg K. Patellofemoral pain in adolescence and adulthood: same same, but different? Sport Med. 2015;45(11):1489-95. https://doi.org/10.1007/s40279-015-0364-1

Rathleff CR, Baird WN, Olesen JL, Roos EM, Rasmussen S, Rathleff MS. Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain: a cross-sectional population-based study. PLoS One. 2013;8(11):e79153. https://doi.org/10.1371/journal.pone.0079153

Rathleff MS, Roos EM, Olesen JL, Rasmussen S. Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofemoral pain: a cluster randomised trial. Br J Sports Med. 2015 Mar;49(6):406-12. https://doi.org/10.1136/bjsports-2014-093929

Rathleff MS, Roos EM, Olesen JL, Rasmussen S, Arendt-Nielsen L. Lower mechanical pressure pain thresholds in female adolescents with patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2013;43(6):414-21. https://doi.org/10.2519/jospt.2013.4383

Rathleff CR, Olesen JL, Roos EM, Rasmussen S, Rathleff MS. Half of 12-15-year-olds with knee pain still have pain after one year. Dan Med J. 2013;60(11): A4725.

Cheung RT, Zhang Z, Ngai SP. Different relationships between the level of patellofemoral pain and quality of life in professional and amateur athletes. PM R. 2013;5(7):568-72. https://doi.org/10.1016/j.pmrj.2012.12.007

Rathleff CR, Roos EM, Olesen JL, Rasmussen S, Rathleff MS. Prevalence and severity of patellofemoral pain among adolescents: a population-based study. Proceedings of the 3rd International Patellofemoral Pain Research Retreat; 2013 Sep; Vancouver, CA.

Harrison AD, Ford KR, Myer GD, Hewett TE. Sex differences in force attenuation: a clinical assessment of single-leg hop performance on a portable force plate. Br J Sports Med. 2011;45(3):198-202. https://doi.org/10.1136/bjsm.2009.061788

Rathleff MS, Samani A, Olesen JL, Roos EM, Rasmussen S, Christensen BH, Madeleine P. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain. Med Sci Sports Exerc. 2013;45(9):1730-9. https://doi.org/10.1249/MSS.0b013e318292be30

de Oliveira Silva D, Briani RV, Pazzinatto MF, Gonçalves AV, Ferrari D, Aragão FA, Azevedo FM. Q-angle static or dynamic measurements, which is the best choice for patellofemoral pain? Clin Biomech. 2015;30(10):1083-7. https://doi.org/10.1016/j.clinbiomech.2015.09.002

Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil. 2004;85(5):815-22. https://doi.org/10.1016/S0003-9993(03)00613-0

Baecke JA, Burema J, Frijters JE. A short questionanaire for the measuremnet of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36(5):936-42.

Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS): development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88-96. https://doi.org/10.2519/jospt.1998.28.2.88

Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sport. 2010;20(5):725-30. https://doi.org/10.1111/j.1600-0838.2009.00996.x

Wallace D, Salem GJ, Salinas R, Powers CM. Patellofemoral joint kinetics while squatting with and without an external load. J Orthop Sports Phys Ther. 2002;32(4):141-48. https://doi.org/10.2519/jospt.2002.32.4.141

Farrokhi S, Keyak JH, Powers CM. Individuals with patellofemoral pain exhibit greater patellofemoral joint stress: a finite element analysis study. Osteoarthritis Cartilage. 2011;19(3):287-94. https://doi.org/10.1016/j.joca.2010.12.001

Pazzinatto MF, De Oliveira Silva D, Barton C, Rathleff MS, Briani RV, Azevedo FM. Female adults with patellofemoral pain are characterized by widespread hyperalgesia, which is not affected immediately by patellofemoral joint loading. Pain Med. 2016;17(10):1953-61. https://doi.org/10.1093/pm/pnw068

Rathleff MS, Rathleff CR, Olesen JL, Rasmussen S, Roos EM. Is knee pain during adolescence a self-limiting condition? Prognosis of patellofemoral pain and other types of knee pain. Am J Sports Med. 2016;44(5):1165-71. https://doi.org/10.1177/0363546515622456

Tammelin T, Näyhä S, Laitinen J, Rintamäki H, Järvelin MR. Physical activity and social status in adolescence as predictors of physical inactivity in adulthood. Prev Med. 2003;37(4):375-81. https://doi.org/10.1016/S0091-7435(03)00162-2

McLeod TCV, Bay RC, Parsons JT, Sauers EL, Snyder AR. Recent injury and health-related quality of Life in adolescent athletes. J Athl Train. 2009;44(6):603-10. https://doi.org/10.4085/1062-6050-44.6.603

Rathleff MS. Patellofemoral pain during adolescence: much more prevalent than appreciated. Br J Sports Med. 2016;50(14):831-2. https://doi.org/10.1136/bjsports-2016-096328




DOI: http://dx.doi.org/10.15448/1980-6108.2017.1.25250

e-ISSN: 1980-6108 | ISSN-L: 1806-5562


Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.