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Four Outcome Measures for Patellofemoral Joint Problems

Part 1. Development and validity
  • Author Footnotes
    1 J Selfe PhD MA MCSP is a lecturer in the Division of Physiotherapy, School of Health Studies, University of Bradford.
    ,
    Author Footnotes
    Funding J Selfe was funded to take part in this project as part of ongoing PhD funding from the University of Bradford. EMS (Greenham) Wantage, Oxon, kindly loaned Biotrac 2 biofeedback units.
    ,
    Author Footnotes
    Contributions J Selfe conceived the idea and carried out all the data processing. L Harper liaised with Burnley NHS Trust management to ensure support was given to the project, and was one of the treating physiotherapists. J Breen-Turner was one of the treating physiotherapists. I Pedersen helped design the clinical assessment and inclusion/exclusion criteria and was one of the treating physiotherapists. J Wareing helped design the clinical assessment and inclusion/exclusion criteria.
    J Selfe
    Correspondence
    Address for Correspondence Dr J Selfe, Division of Physiotherapy, School of Health Studies, University of Bradford, 25 Trinity Road, Bradford BD5 0BB
    Footnotes
    1 J Selfe PhD MA MCSP is a lecturer in the Division of Physiotherapy, School of Health Studies, University of Bradford.
    Funding J Selfe was funded to take part in this project as part of ongoing PhD funding from the University of Bradford. EMS (Greenham) Wantage, Oxon, kindly loaned Biotrac 2 biofeedback units.
    Contributions J Selfe conceived the idea and carried out all the data processing. L Harper liaised with Burnley NHS Trust management to ensure support was given to the project, and was one of the treating physiotherapists. J Breen-Turner was one of the treating physiotherapists. I Pedersen helped design the clinical assessment and inclusion/exclusion criteria and was one of the treating physiotherapists. J Wareing helped design the clinical assessment and inclusion/exclusion criteria.
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  • Author Footnotes
    2 L Harper MCSP is a senior physiotherapist at Burnley General Hospital and a private practitioner.
    L Harper
    Footnotes
    2 L Harper MCSP is a senior physiotherapist at Burnley General Hospital and a private practitioner.
    Search for articles by this author
  • Author Footnotes
    3 I Pedersen MCSP is a senior private physiotherapist in Denmark.
    I Pedersen
    Footnotes
    3 I Pedersen MCSP is a senior private physiotherapist in Denmark.
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  • Author Footnotes
    4 J Breen-Turner BSc MCSP is a senior physiotherapist at Gloucester Royal Hospital.
    J Breen-Turner
    Footnotes
    4 J Breen-Turner BSc MCSP is a senior physiotherapist at Gloucester Royal Hospital.
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  • Author Footnotes
    5 J Waring MCSP is currently studying for a PhD in marine biology at the University of Liverpool.
    J Waring
    Footnotes
    5 J Waring MCSP is currently studying for a PhD in marine biology at the University of Liverpool.
    Search for articles by this author
  • Author Footnotes
    1 J Selfe PhD MA MCSP is a lecturer in the Division of Physiotherapy, School of Health Studies, University of Bradford.
    2 L Harper MCSP is a senior physiotherapist at Burnley General Hospital and a private practitioner.
    3 I Pedersen MCSP is a senior private physiotherapist in Denmark.
    4 J Breen-Turner BSc MCSP is a senior physiotherapist at Gloucester Royal Hospital.
    5 J Waring MCSP is currently studying for a PhD in marine biology at the University of Liverpool.
    Funding J Selfe was funded to take part in this project as part of ongoing PhD funding from the University of Bradford. EMS (Greenham) Wantage, Oxon, kindly loaned Biotrac 2 biofeedback units.
    Contributions J Selfe conceived the idea and carried out all the data processing. L Harper liaised with Burnley NHS Trust management to ensure support was given to the project, and was one of the treating physiotherapists. J Breen-Turner was one of the treating physiotherapists. I Pedersen helped design the clinical assessment and inclusion/exclusion criteria and was one of the treating physiotherapists. J Wareing helped design the clinical assessment and inclusion/exclusion criteria.

      Summary

      Background and Purpose

      This work represents part of a PhD project investigating outcome measures for patellofemoral joint problems – critical angle and angular velocity as measured by video analysis of an eccentric step test, a treadmill test and a Modified Functional Index Questionnaire (MFIQ). This paper describes the development of the outcome measures and provides experimental data to support their validity.

      Methods

      A controlled repeated measures study was carried out in the physiotherapy department at Burnley General Hospital, where 88 patients were considered for inclusion. Comparing experimental data collected from the patients with those previously published provided estimates of the validity of the outcome measures.

      Results

      Mean critical angle was 57.8° and mean angular velocity was 93°/sec. The eccentric step test was found painful by 74% of patients. Data from the treadmill test were right censored with 49% of patients completing 300 seconds without pain. Cronbach's alpha for the MFIQ was 0.83.

      Conclusion

      When comparing video data from this patient group to a previous study of 100 healthy subjects the patients demonstrate an earlier critical angle and faster angular velocity. These data suggest that the measurements of critical angle and angular velocity through video analysis of an eccentric step test are valid measures of patellofemoral joint dysfunction. As treadmill test data are right censored it suggests that the test in the form used in this study is valid for only about 50% of the patients. The high value recorded for Cronbach's alpha suggests that the MFIQ is internally consistent, which in turn suggests it is also a valid measure of patellofemoral dysfunction.

      Key Words

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