Treatment of Patellofemoral Pain Syndrome with Dielectric Radiofrequency Diathermy: A Preliminary Single-Group Study with Six-Month Follow-Up

Manuel Albornoz-Cabello, Cristo Jesús Barrios-Quinta, Isabel Escobio-Prieto, Raquel Sobrino-Sánchez, Alfonso Javier Ibáñez-Vera, Luis Espejo-Antúnez, Manuel Albornoz-Cabello, Cristo Jesús Barrios-Quinta, Isabel Escobio-Prieto, Raquel Sobrino-Sánchez, Alfonso Javier Ibáñez-Vera, Luis Espejo-Antúnez

Abstract

Background and Objectives: Notwithstanding patellofemoral pain syndrome (PFPS) being one of the most common causes of pain in the front of the knee in outpatients, few studies have shown the effects of radiofrequency on knee pain and function in this population. The aim of the present study was to determine whether outpatients diagnosed with PFPS obtained improvement in pain and function after treatment by dynamic application of monopolar dielectric diathermy by emission of radiofrequency (MDR). Materials and Methods: An experimental study was conducted with 27 subjects with PFPS. Subjects were treated with 10 sessions of MDR in dynamic application. The visual analogue scale (VAS), the Kujala scale, the DN4 questionnaire, the lower extremity function scale (LEFS), the range of movement (ROM) in knee flexion and extension and the daily drug intake were measured pre- and post-intervention and at the time of the follow-up (six months). Results: Statistically significant differences were found in pain perception (VAS: F1,26 = 92.43, p < 0.000, ŋ2 = 0.78 and DN4: F1.26 = 124.15, p < 0.000, ŋ2 = 0.82), as well as improvements in functionality (LEFS: F1.26 = 72.42, p < 0.000, ŋ2 = 0.74 and Kujala: F1.26 = 40.37, p < 0.000, ŋ2 = 0.61]) and in ROM (Flexion: F1.26 = 63.15, p < 0.000, ŋ2 = 0.71). No statistically significant changes in drug intake were found. Conclusions: The present study shows that the dynamic application of MDR seems effective in reducing pain and increasing functionality and knee flexion in patients with PFPS, after a follow-up of six months.

Keywords: health; patellofemoral pain syndrome; physical therapy; quality of life; radiofrequency.

Conflict of interest statement

The authors declare no conflict of interest. The authors alone are responsible for the content and writing of the article.

Figures

Figure 1
Figure 1
Application of MDR.
Figure 2
Figure 2
Flow diagram of participants.
Figure 3
Figure 3
Time per group interaction for VAS, LEFS, Kujala and Flexion range of movement. *: p < 0.05; **: p < 0.001.

References

    1. Coburn S.L., Barton C.J., Filbay S.R., Hart H.F., Rathleff M.S., Crossley K.M. Quality of life in individuals with patellofemoral pain: A systematic review including meta-analysis. Phys. Ther. Sport. 2018;33:96–108. doi: 10.1016/j.ptsp.2018.06.006.
    1. Crossley K.M., Callaghan M.J., Van Linschoten R. Patellofemoral pain. Br. J. Sports Med. 2016;50:247–250. doi: 10.1136/bjsports-2015-h3939rep.
    1. Andersen R.E., Crespo C.J., Ling S.M., Bathon J.M., Bartlett S.J. Prevalence of significant knee pain among older Americans: Results from the third national health and nutrition examination survey. J. Am. Geriatr. Soc. 1999;47:1435–1438. doi: 10.1111/j.1532-5415.1999.tb01563.x.
    1. Collins N.J., Crossley K.M., Darnell R., Vicenzino B. Predictors of short and long term outcome in patellofemoral pain syndrome: A prospective longitudinal study. BMC Musculoskelet. Disord. 2010;11:11. doi: 10.1186/1471-2474-11-11.
    1. Satkunskiene D., Mickevicius M., Snieckus A., Kamandulis S. Leg stiffness, valgus knee motion, and q-angle are associated with hypertrophic soft patella tendon and idiopathic knee pain in adolescent basketball players. J. Sports Med. Phys. Fit. 2017;57:1003–1013. doi: 10.23736/S0022-4707.17.06911-0.
    1. Hart H.F., Barton C.J., Khan K.M., Riel H., Crossley K.M. Is body mass index associated with patellofemoral pain and patellofemoral osteoarthritis? A systematic review and meta-regression and analysis. Br. J. Sports Med. 2017;51:781–790. doi: 10.1136/bjsports-2016-096768.
    1. Rothermich M.A., Glaviano N.R., Li J., Hart J.M. Patellofemoral Pain. Clin. Sports Med. 2015;34:313–327. doi: 10.1016/j.csm.2014.12.011.
    1. Crossley K., Bennell K., Green S., McConnell J. A systematic review of physical interventions for patellofemoral pain syndrome. Clin. J. Sport Med. 2001;11:103–110. doi: 10.1097/00042752-200104000-00007.
    1. Insall J. Current concepts review: Patellar pain. J. Bone Jt. Surg. Am. Vol. 1982;64:147–152. doi: 10.2106/00004623-198264010-00023.
    1. Logan C.A., Bhashyam A.R., Tisosky A.J., Haber D.B., Jorgensen A., Roy A., Provencher M.T. Systematic review of the effect of taping techniques on patellofemoral pain syndrome. Sports Health A Multidiscip. Approach. 2017;9:456–461. doi: 10.1177/1941738117710938.
    1. Sker F.S., Anbarian M., Yazdani A.H., Hesari P., Babaei-Ghazani A. Patellar bracing affects sEMG activity of leg and thigh muscles during stance phase in patellofemoral pain syndrome. Gait Posture. 2017;58:7–12. doi: 10.1016/j.gaitpost.2017.06.271.
    1. Espí-López G.V., Arnal-Gómez A., Balasch-Bernat M., Inglés M. Effectiveness of manual therapy combined with physical therapy in treatment of patellofemoral pain syndrome: Systematic review. J. Chiropr. Med. 2017;16:139–146. doi: 10.1016/j.jcm.2016.10.003.
    1. Mcconnell J. The management of chondromalacia patellae: A long term solution. Aust. J. Physiother. 1986;32:215–223. doi: 10.1016/S0004-9514(14)60654-1.
    1. Verma C., Krishnan V. Comparison between McConnell patellar taping and conventional physiotherapy treatment in the management of patellofemoral pain syndrome—A randomised controlled trial. J. Krishna Inst. Med. Sci. Univ. 2012;1:95–104.
    1. Albornoz-Cabello M., Ibáñez-Vera A.J., Aguilar-Ferrándiz M.E., Espejo-Antúnez L. Monopolar dielectric diathermy by emission of radiofrequency in patellofemoral pain. A single-blind-randomized clinical trial. Electromagn. Biol. Med. 2020;39:282–289. doi: 10.1080/15368378.2020.1793169.
    1. Bouhassira D., Attal N., Alchaar H., Boureau F., Brochet B., Bruxelle J., Cunin G., Fermanian J., Ginies P., Grun-Overdyking A., et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4) Pain. 2005;114:29–36. doi: 10.1016/j.pain.2004.12.010.
    1. Perez C., Galvez R., Huelbes S., Insausti J., Bouhassira D., Diaz S., Rejas J. Validity and reliability of the Spanish version of the DN4 (Douleur Neuropathique 4 questions) questionnaire for differential diagnosis of pain syndromes associated to a neuropathic or somatic component. Health Qual. Life Outcomes. 2007;5:66. doi: 10.1186/1477-7525-5-66.
    1. Gil-Gámez J., Pecos-Martín D., Kujala U.M., Martínez-Merinero P., Montañez-Aguilera F.J., Romero-Franco N., Gallego-Izquierdo T. Validation and cultural adaptation of “Kujala Score” in Spanish. Knee Surg. Sports Traumatol. Arthrosc. 2015;24:2845–2853. doi: 10.1007/s00167-015-3521-z.
    1. Binkley J.M., Stratford P.W., Lott S.A., Riddle D.L. The lower estremity functional scale (LEFS): Scale development, measurement properties, and clinical application. North American orthopaedic rehabilitation research network. Phy. Ther. 1999;79:371–383.
    1. Albornoz-Cabello M., Maya-Martín J., Domínguez-Maldonado G., Espejo-Antúnez L., Heredia-Rizo A.M. Effect of interferential current therapy on pain perception and disability level in subjects with chronic low back pain: A randomized controlled trial. Clin. Rehabil. 2016;31:242–249. doi: 10.1177/0269215516639653.
    1. Albornoz-Cabello M., Rebollo-Roldán J., García-Pérez R. Escala de Aprensión Psicológica Personal (EAPP) en fisioterapia. Rev. Iberoam. Fisioter. Kinesiol. 2005;8:77–87. doi: 10.1016/S1138-6045(05)72785-4.
    1. Albornoz-Cabello M., Ibáñez-Vera A.J., De La Cruz-Torres B. Efficacy of monopolar dielectric transmission radio frequency in panniculus adiposus and cellulite reduction. J. Cosmet. Laser Ther. 2017;19:422–426. doi: 10.1080/14764172.2017.1342041.
    1. Hochsprung A., Escudero-Uribe S., Ibáñez-Vera A., Izquierdo-Ayuso G. Effectiveness of Monopolar dielectric transmission of pulsed electromagnetic fields for multiple sclerosis-related pain: A pilot study. Neurologia. 2018 doi: 10.1016/j.nrleng.2018.03.003. (in press)
    1. Vera A.J.I., Puyalto A.G., Vivancos M.A.I., Diaz D.C., Achalandabaso A., Vega R.L. Effects of dielectric monopolar radiofrequency with vacuumtherapy in the treatment of chronic constipation in patients with intellectual developmental disorders. Neuropsychiatry. 2019;9:2070–2075. doi: 10.4172/neuropsychiatry.1000552.
    1. Rennie S. Electrophysical Agents—Contraindications and precautions: An evidence-based approach to clinical decision making in physical therapy. Physiother. Can. 2010;62:1–80. doi: 10.3138/ptc.62.5.
    1. Hawker G.A., Mian S., Kendzerska T., French M.R. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and measure of Intermittent and Constant Osteopatrhritis Pain (ICOAP) Arthritis Care Res. 2019;63(Suppl. 11):S240–S252. doi: 10.1002/acr.20543.
    1. De Pascalis V., Cacace I., Massicolle F. Focused analgesia in waking and hypnosis: Effects on pain, memory, and somatosensory event-related potentials. Pain. 2008;134:197–208. doi: 10.1016/j.pain.2007.09.005.
    1. Tashjian R.Z., Deloach J., Porucznik C.A., Powell A.P. Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease. J. Shoulder Elb. Surg. 2009;18:927–932. doi: 10.1016/j.jse.2009.03.021.
    1. Apiliogullari S., Dal C.N., Levendoglu F., Ozerbil O.M., Albayrak I. Efficacy of pulsed radiofrequency therapy to dorsal root ganglion adding to TENS and exercise for persistent pain after total knee arthroplasty. J. Knee Surg. 2016;30:134–142. doi: 10.1055/s-0036-1583268.
    1. Kumaran B., Watson T. Skin thermophysiological effects of 448 kHz capacitive resistive monopolar radiofrequency in healthy adults: A randomised crossover study and comparison with pulsed shortwave therapy. Electromagn. Biol. Med. 2018;37:1–12. doi: 10.1080/15368378.2017.1422260.
    1. Albornoz-Cabello M., Barrios-Quinta C., Barrios-Quinta A., Escobio-Prieto I., Cardero-Durán M., Espejo-Antunez L. Effectiveness of tele-prescription of therapeutic physical exercise in patellofemoral pain syndrome during the COVID-19 pandemic. Int. J. Environ. Res. Public Health. 2021;18:1048. doi: 10.3390/ijerph18031048.
    1. Giombini A., Di Cesare A., Safran M.R., Ciatti R., Maffulli N. Short-term effectiveness of hyperthermia for supraspinatus tendinopathy in athletes: A short-term randomized controlled study. Am. J. Sports Med. 2006;34:1247–1253. doi: 10.1177/0363546506287827.
    1. Notarnicola A., Maccagnano G., Gallone M.F., Covelli I., Tafuri S., Moretti B. Short term efficacy of capacitive-resistive diathermy therapy in patients with low back pain: A prospective randomized controlled trial. J. Boil. Regul. Homeost. Agents. 2017;31:509–515.

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