Relationship between biopsychosocial factors and performance in functional clinical tests with and without the use of knee bracing in women with patellofemoral pain

Abstract

Patellofemoral pain (PFP) is characterized by pain around or behind the patella, which affects mostly young and physically active individuals. Pain is exacerbated in daily activities that flex the knee increasing the load on the knee joint. Such activities can be reproduced in a clinical environment through functional clinical tests. However, the etiology of PFP it is unknown as well as the best strategy to the treatment of such condition. In this line of reasoning, the relationship between biopsychosocial factors and PFP is still neglected. Recent evidences indicate that clinical improvements in pain and disability in individuals with PFP are associated with the reduction of kinesiophobia and catastrophism. In this sense, individuals with biopsychosocial alterations may benefit from interventions that provide a sense of security and self-confidence, such as knee bracing, however, this hypothesis has not yet been investigated. Therefore, the aim of this study is to investigate the relationship between the kinesiophobia and catastrophism in the performance of functional clinical tests with and without the use of knee bracing in asymptomatic woman and woman with PFP. Twenty-six women with PFP and 26 asymptomatic women will be recruited and instructed to perform three functional clinical tests (forward step down test, single leg hop test and star excursion balance test) first without knee bracing and after a 10-minute interval with the knee bracing. Furthermore, they will fulfill two questionnaires in order to evaluate biopsychosocial factors (Tampa Scale for Kinesiophobia (TSK) and Pain Catastro-phizing Scale (PCS)). The comparisons between the groups and the conditions (with and without bracing) will be performed through analysis of variance (mixed design) and the relationship between biopsychosocial factors and performance in the functional tests will be performed through Pearson or Spearman correlations depending on the distribution of the data. (AU)