Background. Unfavourable treatment outcomes for people with patellofemoral pain (PFP) have been attributed to the potential existence of subgroups that respond differently to treatment.
Objectives: This study aimed to identify subgroups within PFP by combining modifiable clinical, biomechanical and imaging features and exploring the prognosis of these subgroups.
Methods. Longitudinal cohort with baseline cluster analyses. Baseline data were analysed using a two-stage cluster analysis; 10 features were analysed within health domains before being combined at the second stage. Prognosis of the subgroups was assessed at 12-months with subgroup differences in the Global Rating of Change Scale analysed using an exploratory logistic regression adjusted for known confounders.
Results. 70 participants were included (mean age 31 years; 43 (61%) female). Cluster analysis revealed 4 subgroups: ‘Strong’, ‘Pronation & Malalignment’, ‘Weak’ and ‘Active & Flexible’. Descriptively, compared to the Strong subgroup (55% favourable), the odds of a favourable outcome were lower in the Weak subgroup (31% favourable; adjusted odds ratio [OR] 0.30; 95% confidence intervals [CI] 0.07, 1.36) and Pronation & Malalignment subgroup (50%; OR 0.64; 95% CI 0.11, 3.66),
and higher in the Active & Flexible subgroup (63%; OR 1.24 (95% CI 0.20, 7.51). Page 5 of 61 JOSPT, 1033 N. Fairfax St., Suite 304, Alexandria, VA 22314, ph. 877-766-3450 Journal of Orthopaedic & Sports Physical Therapy Review Copy Data-driven diagnostic subgroups in patellofemoral pain After adjustment, compared to the Strong subgroup, differences between some subgroups remained substantive but none were statistically significant
Conclusion. In this relatively small cohort, 4 PFP subgroups were identified which show potentially different outcomes at 12 months. Further research is required to determine whether a stratified treatment approach using these subgroups would improve outcomes for people with PFP
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)