Different pain responses to distinct levels of physical activity in women with patellofemoral pain

Ronaldo V Briani, Marcella F Pazzinatto, Danilo De Oliveira Silva, Fábio M Azevedo, Ronaldo V Briani, Marcella F Pazzinatto, Danilo De Oliveira Silva, Fábio M Azevedo

Abstract

Background: Physical activity levels seem to play a role in patellofemoral pain (PFP); however, few studies have been conducted to confirm this hypothesis.

Objectives: To determine the reported pain levels of women with and without PFP who maintain different levels of physical activity; to determine the capability of these levels to predict pain; and to test the capability of two stair-negotiation protocols, with and without external load, to equalize pain between groups.

Method: Four groups were divided based on the women's physical activity levels: moderate activity PFP group (28), moderate activity control group (23), intense activity PFP group (22), and intense activity control group (22). All participants were asked to perform 15 repetitions of stair negotiation with and without external load on a seven-step staircase on two separate days. Pain levels were reported using a visual analog scale at five distinct moments: previous month, before stair negotiation, after stair negotiation, before patellofemoral joint (PFJ) loading protocol, and after PFJ loading protocol.

Results: The intense activity PFP group showed higher levels of pain than the moderate activity PFP group (F(8,158)=11.714, p=0.000, η2=0.30). The PFJ loading protocol was able to equalize and exacerbate pain in the PFP groups.

Conclusion: Intense physical activity seems to have a higher association with knee pain than moderate physical activity. A PFJ loading protocol may be an alternative to equalize pain in women with PFP during clinical assessments.

Keywords: Knee pain; Movement; Overuse; Physical activity level; Physical therapy; Rehabilitation.

Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1
Figure 1
Pain variation throughout the moments of evaluation for all groups. MAPFPG, moderate activity patellofemoral pain group; IAPFPG, intense activity patellofemoral pain group; MACG, moderate activity control group; IACG, intense activity control group; 1: previous month; 2: before stair negotiation; 3: after stair negotiation; 4: before patellofemoral joint loading protocol; 5: after patellofemoral joint loading protocol. As the control groups had zero pain in all moments of pain evaluation, the lines representing these two groups are overlapped. ‡ Significant difference between the MAPFPG and the IAPFPG.

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