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Individuals with patellofemoral pain have impaired self-reported and performance-based function: Systematic review
Ana Flavia Balotari Botta1, Marina Cabral Waiteman2, Júlia de Cássia Pinto da Silva3
1Ana Flavia Balotari Botta, MS, PT. São Paulo State University, School of Science and Technology, Physical Therapy Department, Presidente Prudente, Brazil. E-mail: anafbbotta@hotmail.com. Twitter: @BalotariBotta.
Objective:
To determine impairments on self-reported/performance-based function in individuals with patellofemoral pain (PFP) as well as physical and non-physical factors potentially related with these impairments.
Data Sources:
We searched MEDLINE, Embase, CINAHL, Web of Science, and SPORTDiscus databases from inception until January 2024.
Study Selection:
We included studies comparing self-reported/performance-based measures of function between individuals with PFP and their pain-free limbs or pain-free individuals.
Data Extraction:
Two independent researchers extracted the key information from each study.
Data Synthesis:
We performed meta-analyses for each self-reported/performance-based measure of function and meta-regressions to identify factors that might explain meta-analyses outcomes. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). We included 83 studies (2807 individuals with PFP and 2518 pain-free individuals). We identified very low to high certainty evidence that individuals with PFP have reduced self-reported (large effect sizes, standardized mean difference [SMD], -1.99; 95% confidence interval [CI]:-2.41,-1.57 to SMD, -4.87; 95% CI:-6.97,-2.77) and performance-based (small to large effect sizes: SMD, -.30; 95% CI:-.58, -.02 to SMD, -1.21; 95% CI:-2.71, -.29) measures of function compared to pain-free individuals, but there are no differences between limbs in individuals with unilateral PFP for the most of performance-based measures of function (small to moderate effect sizes, SMD, -.20; 95% CI:-.68, .27 to SMD, -.49; 95% CI:-1.02, .03). Age, body mass index, duration of symptoms and self-reported pain did not significantly explain self-reported function, whereas age did not significantly explain performance-based function (R2 25 <.01 to .02, p =.145 to .914).
Conclusion:
Our results highlight the negative impact of PFP on self-reported and performance- based function, which seems to also affect the pain-free limb. Self-reported and performance- based measures of function should be considered when assessing individuals with PFP. None of the factors investigated explained impaired self-reported and performance-based function.
