Effectiveness of a mindfulness program compared to education delivered through on-line rehabilitation for people with patellofemoral pain: randomized clinical trial

Abstract

Patellofemoral Pain (PFP) is one of the main reasons for consultations in orthopedics and physiotherapy clinics mainly affects adolescents and young, physically active individuals. The literature basically addresses the biomechanical changes present in people with PFP in order to explain its etiology, however, there is an important gap about the psychosocial and behavioral factors that seem to influence this disorder. Therefore, assessment and treatment models that include psychosocial factors must be taken into account in order to improve the long-term prognosis of this disorder. In this sense, this research project is based on two studies: study 1: for the first study, a systematic review will be developed to address the effect of mindfulness-based interventions on people with knee and hip disorders, in order to carry out a broad search and bibliographic study of the topic in question, in addition to filling the gaps in the literature. Study 2 (main): For the second study, a randomized clinical trial will be developed in order to explore the effectiveness of a mindfulness program delivered to the patient through online rehabilitation, compared to an education program, also delivered through rehabilitation online, in people with PFP. The outcomes: anxiety, depression, self-reported pain, self-reported function, kinesiophobia, catastrophism, depression, central sensitization symptoms, self-efficacy, pain pressure threshold, mechanical detection and objective function will be assessed in the baseline, then participants will be randomized into two groups: (I) mindfulness or (II) education. There will be 8 sessions distributed over 8 weeks, delivered through video and access to a website. All outcomes will be assessed at the end of the intervention (follow-up 1) and 12 months after the end of the intervention (follow-up 2). The comparisons between the post-intervention groups will be carried out with analysis of variance of mixed models, in addition, a linear regression model will be performed in order to explain whether the changes detected in the clinical outcomes will be associated with the changes found in the psychosocial outcomes. (AU)