J Orthop Sports Phys Ther. 2024 Aug;54(8):541-550. doi: 10.2519/jospt.2024.12258.
Can physical therapists who are treating patients with patellofemoral pain (PFP) predict the outcome of a 12-week exercise intervention based on initial assessment, and what are the physical therapists' reasons for prediction? Secondary analysis of a randomized trial. After the initial assessment, physical therapists were asked to predict the prognosis of 200 patients with PFP who were allocated to 12 weeks of quadriceps exercises (QEs) or hip exercises (HEs) on a 1-to-10 Likert scale, and to describe their reasoning for the prediction score. measures were changes from baseline to weeks 12 and 26 on the Anterior Knee Pain Scale (range 0-100) and a transition questionnaire (TransQ). Linear mixed-effects models were used to assess the prediction. Secondly, we used a qualitative approach to summarize the physical therapists' reasoning (written notes) when predicting the outcome. There was no association between physical therapists' prognosis and changes in Anterior Knee Pain Scale for QE or HE at weeks 12 and 26 (slopes: -0.14 to -0.51 with wide 95% confidence intervals). There was no association between physical therapists' assessment of prognosis using TransQ for QE or HE at weeks 12 and 26 (odds ratio: 0.99 to 1.17 with wide 95% confidence intervals). Physical therapists' prognosis based on initial assessment was not associated with outcomes after 12 weeks of either quadriceps or hip exercise therapy among patients with PFP. Physical therapists' prognoses were not useful as a source of information and to identify PFP patients with poor or good projected outcomes. .
物理治疗师在治疗髌股疼痛(PFP)患者时能否根据初始评估预测 12 周运动干预的结果,以及他们预测的依据是什么?一项随机试验的二次分析。在初始评估后,物理治疗师被要求在 1 到 10 的李克特量表上预测 200 名接受股四头肌(QE)或髋关节(HE)运动 12 周的 PFP 患者的预后,并描述他们预测评分的依据。测量指标为髌股疼痛量表(范围 0-100)和过渡问卷(TransQ)从基线到第 12 周和第 26 周的变化。线性混合效应模型用于评估预测。其次,我们使用定性方法总结物理治疗师在预测结果时的推理(书面说明)。物理治疗师的预后与 QE 或 HE 在第 12 周和第 26 周的髌股疼痛量表的变化之间没有关联(斜率:-0.14 至-0.51,95%置信区间较宽)。物理治疗师对 QE 或 HE 在第 12 周和第 26 周使用 TransQ 评估预后之间也没有关联(比值比:0.99 至 1.17,95%置信区间较宽)。在 PFP 患者中,接受股四头肌或髋关节运动治疗 12 周后,物理治疗师基于初始评估的预后与结果无关。物理治疗师的预后不能作为信息来源,也不能识别预后不良或良好的 PFP 患者。