Effect of Two-Week Knee Brace Intervention on Kinesiophobia management in Patellofemoral pain management: A Comprehensive Study

Question

Task: How does a two-week knee brace intervention affect kinesiophobia management in individuals with patellofemoral pain management compared to a minimal intervention with instructional leaflets?

Answer

Introduction

This two-week research assessed the effects of modest intervention with instructional leaflets and knee brace use on kinesiophobia management in patellofemoral pain management (PFP) patients. The idea was that knee braces would make people less claustrophobic. The study also evaluated the impact on levels of physical activity and self-reported and objective function (P, Lack, Garcia, & Azevedo, 2020). 50 PFP volunteers, ages 18 to 40, were enlisted using a variety of methods with rigorous inclusion and exclusion guidelines. The Anterior Knee Pain Scale, Tampa Scale for Kinesiophobia management, International Physical Activity Questionnaire, and Forward Step-Down Test were among the data sources. The brace group, which was randomly allocated to leaflet or brace groups, showed a considerably lower kinesiophobia management but no changes in other outcomes. Due to sampling techniques and a brief follow-up, the study's possible external validity flaws were offset by its strong internal validity.

Aims and Hypothesis of the Study:

The main goal of this study was to investigate the possible impact of wearing a knee brace for two weeks on kinesiophobia management in people with patellofemoral pain management (PFP). When compared to a minor intervention group receiving an instructional leaflet, the researchers hypothesised that individuals with PFP who wore knee braces would have less kinesiophobia management. Beyond this main purpose, the study also aimed to investigate if wearing a knee brace would have any noticeable effects on other significant aspects of the participants' well-being, such as their levels of physical activity and self-reported and objective measures of function (Pazzinatto, Barton, Willy, Ferreira, Azevedo, & Oliveira, 2023).

Essentially, this study sought to clarify whether a very straightforward intervention, such as donning a knee brace, may have an appreciable and advantageous impact on the psychological and physical elements of PFP. In order to enhance the overall experience and treatment of PFP, the researchers hypothesised that reducing kinesiophobia management—the dread of moving because of potential pain or injury—might be an important first step. This study aims to provide important insights into the possible significance of this intervention in boosting the quality of life for those suffering from patellofemoral pain management by examining the diverse effects of a knee brace.

Sample of Participants and Recruitment Methods:

The 50 participants in the research were a diverse bunch, ranging in age from 18 to 40, and they were all coping with the difficult ailment known as patellofemoral pain management (PFP). This cohort was put together using a multimodal recruitment strategy that involved several different routes of communication. These included commercials that were broadcast around college campuses, fitness centres, public places where people exercised, and promotional messages on social media. In order to increase the likelihood that the research's findings may be used in other contexts, a wide-reaching recruiting strategy was used to make sure that individuals from all backgrounds and activity levels were included in the study.

People had to fulfil precise inclusion criteria that were carefully created to identify people who were best suitable for the research in order to participate. The level of their discomfort, the kind and duration of their knee pain, and their ratings on the Anterior Knee Pain Scale—a standardised evaluation instrument for calculating symptoms and functional limitations related to PFP—were all taken into consideration. This thorough screening procedure was essential to ensuring that the participants demonstrated the qualities required to adequately research the study's aims.

In contrast, exclusion criteria were established to omit those with certain medical histories or diseases that would have tainted the study's findings. These included a history of lower limb joint surgery, meniscal damage, patellar subluxation, and other particular diseases or treatments. After confirming their desire to participate in the study and their comprehension of its aims and methods, participants who matched the inclusion criteria and did not possess any of the excluding variables were required to give written informed consent. The study's dedication to ethical research practises was supported by a stringent method to participant selection and consent that also guaranteed the accuracy of the information gathered.

Measurements Used to Collect Data:

Data collection for this study was methodically carried out using a wide range of metrics, including both subjective self-reports and objective functional testing (Hott, Pripp, Juel, Liavaag, & Brox, 2022). The following metrics were carefully selected to provide a comprehensive picture of the participants' experiences and reactions to the interventions:

Tampa Scale for Kinesiophobia management:

This 17-item measure was used to determine how much kinesiophobia management each participant had. A significant psychological trait known as kinesiophobia management is the dread of suffering an injury or reinjury as a result of movement. The researchers wanted to determine how the participants' psychological states changed in response to the therapies, notably the usage of knee braces, therefore they looked into this issue.

Anterior Knee Pain Scale (AKPS):

The AKPS performed a critical role in assessing the intensity of symptoms associated with anterior knee pain and the functional constraints felt by the participants using its 13-item questionnaire. The study concentrated on this self-reported measure in an effort to identify any changes in the participants' symptomatology and functional abilities, providing insight into the overall effect of the therapies on their day-to-day life.

International Physical Activity Questionnaire:

This method made it possible to evaluate the participants' levels of physical activity, which included a range of activities from strenuous workouts to more moderate routines, strolling, and sedentary habits. The study sought to determine if the participants' participation in physical activity was changed by wearing knee braces in order to offer information on the possible applications of the treatments.

Forward Step-Down Test:

Participants in the step-down task for the objective functional evaluation had to follow a predetermined movement pattern. The objective measurement of changes in the participants' functional skills and mobility depended on the results of this test. It included information about whether using knee braces had any noticeable effects on their physical skills and whether doing so may improve their general quality of life.

These extensive assessments, which cover psychological, self-reported, and objective functional elements, were chosen to give a holistic perspective of how the individuals responded to the therapies. By using a holistic approach, the study was able to obtain a whole picture of the impact of knee braces on those who have patellofemoral discomfort, allowing for a more complex interpretation of the results.

Procedures in Experimental and Control Groups:

The study used a random assignment technique to assure impartial distribution, splitting the subjects into two different groups: the "brace group" and the "leaflet group." Each group underwent a different intervention method, enabling a comparison of the results of the various groups.

Participants in the brace group were required to wear a knee brace continuously for two weeks. This instruction covered a broad range of daily tasks, especially those that have in the past caused knee discomfort. The flexible, commercially available knee brace that was used for this usage was from the market. This particular course of action was designed to look at the possible advantages of using knee braces in addressing the problems caused by patellofemoral pain management (PFP) (Selhorst, Fernandez-Fernandez, Schmitt, & Hoehn, 2021). It was designed to see if using this particular orthotic device may make a noticeable difference in the participants' experiences and wellbeing.

Participants assigned to the leaflet group, on the other hand, got a booklet giving thorough information about PFP. Throughout the length of the trial, they were specifically told not to use any lower limb orthoses, braces, or bandages. The control condition against which the knee brace intervention could be evaluated was this minimum intervention strategy, which focused on information transmission via the leaflet. It assisted in determining whether any knee brace effects, if any, went beyond merely providing informative assistance.

The study's goal was to identify and evaluate the precise effect of wearing a knee brace on kinesiophobia management and associated variables in people with PFP. To this end, it used these several intervention methodologies and random allocation.

Main Findings of the Study:

The most notable and significant finding from this study was the considerable decrease in kinesiophobia management shown in patellofemoral pain management (PFP) patients who had worn a knee brace for a period of two weeks. Comparing this decrease in kinesiophobia management to the group that had just received an instructional leaflet as a minimum intervention, it was clear that this difference was substantial. It highlights the potential psychological advantage of using knee braces in the treatment of PFP since they seem to make a major contribution to reducing the participants' anxiety of mobility and reinjury, thus improving their psychological health.

It is important to highlight that although while the knee brace had a noticeable effect on kinesiophobia management, there were no statistically significant differences found between the two groups in terms of self-reported or objective function, or even levels of physical activity. This shows that the knee brace's psychological effects—specifically, the participants' anxieties and worries related to movement—are where the knee brace has the most significant psychological impact. The lack of significant adjustments in functional elements or activity levels emphasises the complex nature of PFP management and the demand for extensive, diversified interventions to deal with its complex problems.

Internal Validity Factors:

Compliance:

According to the research, individuals in the brace group exhibited great compliance (92%). High compliance assures that participants followed the intervention's instructions and lessens the chance of non-compliance bias, which lessens the danger to internal validity.

Randomization and Blinding:

The study's design made use of randomization and blinding to reduce bias and improve internal validity. The chance of selection bias is decreased through randomization, which guarantees baseline similarity between individuals in both groups. Measurement bias can be avoided by hiding the group allocation from the evaluater.

External Validity Factors:

Sampling Procedures:

The study used a variety of methods to find participants, including social media, gyms, universities, and public spaces. While using a broad recruiting strategy promotes external validity, it also runs the risk of introducing some bias because not all PFPs may react to these recruitment strategies.

Limited Follow-Up:

The research only had a six-week follow-up period, which was somewhat brief. Due to the short follow-up period and the lack of information on the long-term consequences of using a knee brace, external validity may be affected. It's possible that the findings don't apply to longer-term effects.

The purpose of this study was to examine how a knee brace affected kinesiophobia management and associated outcomes in people with PFP. High compliance and randomization showed strong internal validity, while recruiting practises and the brief follow-up period contributed to external validity. These elements may affect how the study's findings are interpreted and extrapolated.

Bibliography

Hott, A., Pripp, A., Juel, N., Liavaag, S., & Brox, J. (2022). Self-efficacy and emotional distress in a cohort with patellofemoral pain management. Orthopaedic journal of sports medicine, 10(3), retrieved from https://journals.sagepub.com/doi/epub/10.1177/23259671221079672.

P, L. B., Lack, S., Garcia, C., & Azevedo, F. (2020). Two Weeks of Wearing a Knee Brace Compared With Minimal Intervention on Kinesiophobia management at 2 and 6 Weeks in People With Patellofemoral pain management: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 101, 613-23 retrieved from https://doi.org/10.1016/j.apmr.2019.10.190.

Pazzinatto, M., Barton, C., Willy, R., Ferreira, A., Azevedo, F., & Oliveira, S. (2023). Are physical function and fear of movement risk factors for patellofemoral pain management? . Journal of Sport Rehabilitation, 32(1), 24-30 retrieved from https://www.researchgate.net/profile/Danilo-De-Oliveira-Silva-2/publication/362149218_Are_Physical_Function_and_Fear_of_Movement_Risk_Factors_for_Patellofemoral _Pain_A_2-Year_Prospective_Study/links/63c3aa82d7e5841e0bcce4a5/Are-Physic.

Selhorst, M., Fernandez-Fernandez, A., Schmitt, L., & Hoehn, J. (2021). Effect of a psychologically informed intervention to treat adolescents with patellofemoral pain management: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 102(7), 1267-1273 .