The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia.
Br J Sports Med. 2017 May;51(9):732-742. doi: 10.1136/bjsports-2016-096705. Epub 2017 Mar 20.
Patellofemoral pain (PFP) is prevalent in adolescence and adulthood and often persists. In contrast to other persistent musculoskeletal conditions, for which non-physical, psychological features are implicated, PFP remains largely conceptualised in mechanical terms.
To (1) identify whether the psychological characteristics of individuals with PFP differs from asymptomatic controls and (2) evaluate the correlations between psychological characteristics and PFP severity.
Systematic review METHODS: A systematic review of the literature was conducted according to PRISMA guidelines. The Epidemiological Appraisal Instrument was used to evaluate quality. Studies measuring psychological constructs with patient-reported measures were included. Standardised mean differences were calculated and supported by narrative synthesis.
Twenty-five studies were eligible. Quality results ranged from 28.3% to 61.7%. Psychological constructs were reported under four groupings: mental health, cognitive factors, behavioural factors and other factors. There is limited evidence of mental health and cognitive differences in some individuals with PFP. Features demonstrating linear correlations with pain and physical function included anxiety/depression, catastrophising, praying and hoping and pain-related fear.
Anxiety, depression, catastrophising and fear of movement may be elevated in individuals with PFP and correlate with pain and reduced physical function. These results derive from a limited number of studies. Future research should aim to evaluate if and how psychological factors contribute to PFP.
Patients are likely to benefit from clinician vigilance to the presence of psychological factors.
髌股疼痛（PFP）在青少年和成年期普遍存在，且常持续存在。与其他持续性肌肉骨骼疾病不同，后者与非身体、心理特征有关，而 PFP 在很大程度上仍被概念化为机械问题。
（1）确定 PFP 患者的心理特征是否与无症状对照组不同，以及（2）评估心理特征与 PFP 严重程度之间的相关性。
系统评价
根据 PRISMA 指南进行文献系统评价。使用流行病学评估工具评估质量。纳入了使用患者报告的测量方法测量心理结构的研究。计算了标准化均数差值，并通过叙述性综合进行支持。
有 25 项研究符合条件。质量结果范围从 28.3%到 61.7%。心理结构分为四大类：心理健康、认知因素、行为因素和其他因素。一些 PFP 患者的心理健康和认知差异证据有限。与疼痛和身体功能呈线性相关的特征包括焦虑/抑郁、灾难化、祈祷和希望以及与疼痛相关的恐惧。
焦虑、抑郁、灾难化和对运动的恐惧可能在 PFP 患者中升高，并与疼痛和身体功能下降相关。这些结果来自少数研究。未来的研究应旨在评估心理因素是否以及如何影响 PFP。
患者可能会受益于临床医生对心理因素的关注。
