How do physiotherapists assess and treat patellofemoral pain syndrome in North Wales? A mixed method study

Abstract

Background/Aim: Little is known about how individual physiotherapists assess, treat and measure outcomes for patients with patellofemoral pain syndrome (PFPS) in the clinic. Previous research has revealed no gold standard methods. This study therefore set out to explore beliefs and practices of physiotherapists working in a non-academic health community in North Wales (NW). Methods: Methodology involved a mixed-method approach. 4 quantitative questionnaire exploring how physiotherapists assess, treat, and measure outcomes in PFPS, was emailed to physiotherapists working in NW. Thirty responded (62.5%) and eleven were then interviewed (qualitative). Interviews were recorded, transcribed, and organised into categories. Number and frequency of the different assessments, treatments, and outcome measures were triangulated against the quantitative survey data. Findings were then synthesised. Findings: Physiotherapists are aware of the different types of presentation of PFPS; however, individual clinical practice differs. Although the questionnaire reported a large number of outcome measures, interviews reported mainly only the visual analogue pain scale and subjective functional tasks. Moreover, physiotherapists treat function, not syndromes. Home exercises aim for simplicity and function rather than complex muscle group specific exercises. Peers were reported to be the most important source of knowledge and influence on their practice. Conclusion: There is a need to develop an evidence-based assessment and outcome measurement protocol for routine clinical practice.