Understanding the biopsycosocial nature of patellofemoral pain: integration of biomechanical, clinical and psychological factors

Author(s)

Danilo de Oliveira Silva

• Document type: Doctoral Thesis
• Press: Presidente Prudente. 2019-06-12.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2019-05-24
• Advisor: Fábio Mícolis de Azevedo; Fernando Henrique Magalhães

Abstract

The main focus of this thesis was to investigate the biopsychosocial aspects of patellofemoral pain (PFP). PFP is characterized by anterior knee pain exacerbated by activities that overload the patellofemoral joint. For many years PFP-related research was purely biomechanical. Recently, with a greater focus on the biopsychosocial model, researchers and clinicians are trying to enhance their understanding on clinical and psychological aspects of PFP. This thesis aimed to advance in the understanding whether there is an integration of biomechanical, clinical and psychological factors in the individual with PFP. Seven original studies were conducted with the general aim of understanding the biopsychosocial nature of PFP investigating the integration among biomechanical, clinical and psychological factors. The studies specifically addressed the following topics: (i) The first study addresses biomechanical characteristics of women with PFP climbing stairs compared to asymptomatic women; (ii) The second study aims to understand the influence of pain on the biomechanics of women with PFP; (iii) The third study addresses the influence of knee crepitus on biomechanical, clinical and psychological aspects of women with PFP and asymptomatic women; (iv) The fourth study is a systematic review investigating the pain processing characteristics in women with PFP; (v) The fifth study addresses whether women with PFP have higher levels of kinesiophobia and catastrophic pain compared to asymptomatic women and the impact of these factors on clinical aspects of women with PFP; (vi) The sixth study investigates the relationship between kinesiophobia and kinematics during climbing stairs and torque of the knee extensor muscles of women with PFP; (vii) The seventh study is a randomized clinical trial aiming to consider biomechanical, clinical, and psychological factors in the treatment of individuals with PFP. The studies included in this thesis indicated there seems to have an integration among biomechanical, clinical and psychological aspects of individuals with PFP. Additionally, including these factors in a rehabilitation program seems to benefit individuals with PFP. (AU)

• FAPESP's process: 15/11534-1 - INFLUENCE OF PAIN IN THE ANALYSIS OF PROXIMAL, LOCAL AND DISTAL KINEMATIC PARAMETERS IN FEMALES WITH PATELLOFEMORAL PAIN DURING STAIR ASCENT AND DESCENT
• Grantee: Danilo de Oliveira Silva
• Support Opportunities: Scholarships in Brazil - Doctorate