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The Journal of Orthopaedic and Sports Physical Therapy


Adolescent, Anterior knee pain, Education, Fear avoidance, Kinesiophobia



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OBJECTIVE: To test whether a series of brief, psychologically informed educational videos added to physical therapy improved function among adolescents with patellofemoral pain (PFP). The secondary aims were to assess pain and psychological beliefs.

DESIGN: A double-blinded randomized controlled trial.

METHODS: Sixty-eight adolescents with PFP were randomly assigned to view brief, psychologically-informed videos (n=34) or control videos (n=34) in addition to usual care physical therapy. The psychologically-informed videos targeted fear-avoidance beliefs, kinesiophobia, and pain catastrophizing. The control videos conveyed basic anatomy, biomedical factors, and lower extremity mechanics. Outcomes were assessed at baseline, three weeks, six weeks (primary endpoint), and three months. The primary outcome was change in the Anterior Knee Pain Scale (AKPS). Secondary outcomes were changes in Numeric Pain Rating Scale (NPRS) and psychological beliefs (Modified Fear-Avoidance Beliefs Questionnaire-Physical Activity, Tampa Kinesiophobia Scale-11, and Pain Catastrophizing Scale-Child).

RESULTS: Adolescents in the psychologically-informed group experienced significantly greater improvements in function (AKPS mean difference = 8 points, 95% CI: 2.2, 13.2; p-value = 0.01) and pain (NPRS mean difference 1.2 points, 95% CI: 0.1, 2.4; p-value = 0.04) at six weeks compared to the control group. The psychologically-informed group had significantly greater reductions in psychological beliefs over time than the control group (p-value=

CONCLUSION: Incorporating psychologically-informed education into physical therapy care improved function, pain, and psychological beliefs to a greater extent than the control group.


Funding: American Academy of Sports Physical Therapy Legacy Fund

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.



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