Developing Clinical and Research Priorities for Pain and Psychological Features in People With Patellofemoral Pain: An International Consensus Process With Health Care Professionals

Vicenzino, BT, Rathleff, MS, Holden, S, Maclachlan, L, Smith, BE, de Oliveira Silva, D, van Middelkoop, M, Arendt, E, Arvinen-Barrow, MM, Azevedo, F, Barton, C, Bazett-Jones, D, Boudreau, S, Briani, RV, Collins, NJ, Cowan, S, Crossley, K, Domenech, J, Dye, SF, Earl-Boehm, J, Esculier, JF, Glaviano, NR, Kedroff, L, Lack, S, Matthews, M, McConnell, J, O’Donovan, J, Pazzinatto, M, Robertson, C, Sanchis-Alfonso, V, Selfe, J ORCID: https://orcid.org/0000-0001-9931-4998, Selhorst, M, Thompson, C, Tobin, L, van der Heijden, R, van Linschoten, R, Alsaleh, S, Baellow, A, Belvedere, C, Bolgla, L, Boling, M, Callaghan, M ORCID: https://orcid.org/0000-0003-3540-2838, Ferreira, A, Fox, A, Giblin, N, Hart, H, Hill, J, Ho, KY, Hoglund, L, Lally, E, Macri, E, Powers, C, Salsich, G, Sigmund, K, Stewart, B, Taborda, B, Tang, HL, Thomson, C, Thorpe, J, Waiteman, M, Wheatley, M and Willy, R (2022) Developing Clinical and Research Priorities for Pain and Psychological Features in People With Patellofemoral Pain: An International Consensus Process With Health Care Professionals. Journal of Orthopaedic and Sports Physical Therapy, 52 (1). pp. 29-39. ISSN 0190-6011

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Abstract

Objective: To decide clinical and research priorities on pain features and psychological factors in persons with patellofemoral pain. Design: Consensus development process. Methods: We undertook a 3-stage process consisting of (1) updating 2 systematic reviews on quantitative sensory testing of pain features and psychological factors in patellofemoral pain, (2) an online survey of health care professionals and persons with patellofemoral pain, and (3) a consensus meeting with expert health care professionals. Participants responded that they agreed, disagreed, or were unsure that a pain feature or psychological factor was important in clinical practice or as a research priority. Greater than 70% participant agreement was required for an item to be considered important in clinical practice or a research priority. Results: Thirty-five health care professionals completed the survey, 20 of whom attended the consensus meeting. Thirty persons with patellofemoral pain also completed the survey. The review identified 5 pain features and 9 psychological factors—none reached 70% agreement in the patient survey, so all were considered at the meeting. After the meeting, pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy were the only factors considered clinically important. All but the thermal pain tests and 3 psychological factors were considered research priorities. Conclusion: Pain catastrophizing, pain self-efficacy, and fear-avoidance beliefs were factors considered important in treatment planning, clinical examination, and prognostication. Quantitative sensory tests for pain were not regarded as clinically important but were deemed to be research priorities, as were most psychological factors.