Multimodal Rehabilitation Including Strengthening Exercise Is Effective in Improving Fear-Avoidance Beliefs in Individuals With Patellofemoral Pain: A Critically Appraised Topic.
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引用次数: 0
Abstract
Clinical scenario: Individuals with patellofemoral pain (PFP) present with a variety of neuromuscular and psychological deficits, with the "gold-standard" for treatment being rehabilitation programs with strengthening-based exercises. While such interventions primarily target pain and function measures, it is unknown whether psychological measures such as fear-avoidance beliefs (FABs) are also affected.
Clinical question: Is rehabilitation including strengthening exercises effective in improving FABs in individuals with PFP?
Summary of key findings: Three studies met the inclusion criteria and were included in the appraisal. All studies found that rehabilitation including strengthening exercises was effective in improving FABs for physical activity, though such improvements were modest. One study found that supplementing a one-time psychological intervention to rehabilitation including strengthening exercises resulted in greater improvements in FABs than with rehabilitation including strengthening exercises alone. Two studies found associations between changes in FABs and changes in pain and/or function outcomes.
Clinical bottom line: There is consistent evidence that the incorporation of rehabilitation with strengthening exercises is effective in improving FABs in individuals with PFP, though such improvements are modest. Furthermore, supplementation with psychological interventions to rehabilitation including strengthening exercises may produce larger improvements in FABs, particularly in patients with an elevated FABs phenotype. As a result of improving FABs, patient outcomes of pain and function may be improved, though future research is needed. Therefore, at this time, we recommend that rehabilitation, including strengthening exercises with supplemental psychological interventions be prescribed for the treatment of PFP particularly in subgroups with elevated FABs, to improve patient outcomes.
Strength of recommendation: Collectively, the body of evidence included to answer the clinical question aligns with the strength of recommendation of A based on the Strength of Recommendation Taxonomy.
期刊介绍:
The Journal of Sport Rehabilitation (JSR) is your source for the latest peer-reviewed research in the field of sport rehabilitation. All members of the sports-medicine team will benefit from the wealth of important information in each issue. JSR is completely devoted to the rehabilitation of sport and exercise injuries, regardless of the age, gender, sport ability, level of fitness, or health status of the participant.
JSR publishes peer-reviewed original research, systematic reviews/meta-analyses, critically appraised topics (CATs), case studies/series, and technical reports that directly affect the management and rehabilitation of injuries incurred during sport-related activities, irrespective of the individual’s age, gender, sport ability, level of fitness, or health status. The journal is intended to provide an international, multidisciplinary forum to serve the needs of all members of the sports medicine team, including athletic trainers/therapists, sport physical therapists/physiotherapists, sports medicine physicians, and other health care and medical professionals.