Influency of sleep quality on clinical and psychosocial factors of people with and without patellofemoral pain

Abstract

Patellofemoral pain is characterized by diffuse pain in the peri or retro patellar region, with insidious onset. The exacerbation of pain occurs during movements that overload the flexed knee joint, which can be reproduced in clinical tests. There is no specific cause for the development of this condition. Some changes in several biomechanical and psychosocial factors could influence PFP clinical aspects. The psychosocial approach to this condition presents a limited amount of evidence covering variables, such as kinesiophobia, catastrophism, anxiety, and depression. Thereby, some studies were observed that sleep quality has an influence on pain and in the functional activities in different chronic disorders, such as osteoarthritis and low back pain. Evidence shows that an improvement in sleep quality resulted in a reduction in pain and an improvement in function, due to reduced fatigue. In this context, it is worth looking at the sleep quality in subjects with PFP. However, this hypothesis has not been investigated yet. Therefore, the aim of this study is to compare self-reported sleep quality, in subjects with and without PFP and evaluate its correlation with clinical and psychological outcomes. Will be recruited 54 people with PFP and 54 without PFP, which will be instructed to answer 5 questionnaires: Pittsburgh Sleep Quality Index, Anterior Knee Pain Scale, Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale and indicate the worst level of pain experienced in the last month on the Visual Analogue Scale and subsequently will perform the functional Forward step-down test. For the statistical analysis, a comparison of the sleep quality level between groups will be performed using the Student's T for independent samples or the Mann-Whitney U test depending on the data distribution. The correlation between sleep quality, psychosocial and clinical variables on people with and without PFP will be assessed using Pearson's correlation coefficient (r) or Spearman correlation coefficient (Á), depending on the data distribution. The psychosocial and clinical variables that present a significant correlation with sleep quality will be inserted in a simple linear regression model. Furthermore, the variables that present significant values on the simple linear regression model will be inserted in a multiple linear regression - forced entry method to understand how these variables together explain the worst level of pain in the past month, objective function, and self-reported function. (AU)