100 / 225
100
· DOS Abstracts
The effect of load management in adolescents between
10 and 14 years of age with patellofemoral pain – a
prospective single-cohort intervention study including
151 adolescents
Michael Skovdal Rathleff, Thomas Graven-Nielsen, Per Hölmich, Lukasz Winiarski, Kasper
Krommes, Kristian Thorborg
Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg
University; Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Sci-
ence and Technology, Faculty of Medicine, Aalborg University; Sports Orthopedic Re-
search Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenha-
gen University Hospital; Department of Occupational Therapy and Physiotherapy, Aal-
borg University Hospital; Sports Orthopedic Research Center-Copenhagen (SORC-C),
Department of Orthopaedic Surgery, Copenhagen University Hospital; Sports Ortho-
pedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery,
Copenhagen University Hospital
Background:
Patellofemoral pain (PFP) affects 7% of adolescents, especially the highly
sports active. Current exercise-focused treatments are only effective for 30%. Previous
exercise-focused treatments have not modified and controlled sports activity. Thus, a
different treatment strategy is warrented as many adolescents continue to engage in the
same high level sports despite knee pain.
Purpose / Aim of Study:
The purpose of this study was to investigate the effect of a
novel treatment strategy focusing on load management among adolescents with PFP.
Materials and Methods:
This pre-registered prospective cohort study included 151
adolescents from 10-14 years of age with PFP. The intervention lasted 12 weeks and in-
cluded four visits with a physiotherapist. The intervention included activity modification
(week 0-4) to reduce loading of the patellofemoral joint using an activity ladder para-
digm including pain monitoring, progressive home-based strengthening exercises (week
4-12), and a progression model for return to sport (week 4-12). Primary outcome was
self-reported recovery at 3 months on a 7-point Likert- scale ranging from “much im-
proved” to “much worse”. Adolescents were considered recovered if they reported “much
improved” or “improved”.
Findings / Results:
The median age was 13 years and the median symptom duration
was 18 months. 83% participated regularly in sports while 24% used analgesics for their
knee pain at baseline. At 12 week follow-up, 87% completed the questionnaire, of which
86% reported they were recovered and 7% used analgesics. 90% were satisfied with the
result of the treatment and 95% would recommend it to a friend.
Conclusions:
Activity modification, progressive strengthening exercises, and return to
sports following a progression model appears highly effective compared to previous ex-
ercise-focused trials among adolescents with PFP.
No conflicts of interest reported
52.