Objective

To determine whether the addition of a brief psychologically informed video to traditional physical therapy influenced function (primary aim), pain, and psychological beliefs (secondary aims) among adolescents with patellofemoral pain (PFP).

Design

Double-blind randomized controlled trial.

Setting

Outpatient physical therapy clinics of a single pediatric hospital.

Participants

Sixty-six adolescents with PFP (14.8±1.7 years old, 65% female).

Intervention

Adolescents were randomly assigned to view a brief psychologically informed video (n=34) or control video (n=32). The psychologically informed video targeted pain-related fear and pain catastrophizing, and the control video related basic anatomy and factors involved in PFP.

Main Outcome Measures

The primary outcome was change in function (Anterior Knee Pain Scale). Secondary outcomes were change in psychological beliefs (fear-avoidance beliefs, kinesiophobia, pain catastrophizing) and pain. Outcomes were assessed at baseline, immediately post intervention, at 2 weeks, at 6 weeks, and at 3 months.

Results

Using a 2-way mixed analysis of variance, change in function in the intervention group was greater than the control group, with a moderate treatment effect noted (P=.001, partial η²=0.1). Post hoc testing revealed that there was a significant interaction between the intervention and time from baseline to 2 weeks, but no interaction was noted between 2 weeks and 3 months. The psychologically informed video significantly reduced maladaptive psychological beliefs (P=.01, η²=0.32). No significant between-group differences in pain were noted.

Conclusions

Incorporating a brief one-time psychologically informed video into standard physical therapy care significantly reduced pain-related fear, reduced pain catastrophizing, and improved function among adolescents with PFP. The immediate effect noted on function did not continue throughout the course of care.

中文翻译：

---

心理知情干预治疗青少年髌股关节疼痛的效果：一项随机对照试验

客观的

确定在传统物理治疗中添加简短的心理告知视频是否会影响患有髌股关节疼痛 (PFP​​) 的青少年的功能（主要目标）、疼痛和心理信念（次要目标）。

设计

双盲随机对照试验。

环境

一家儿科医院的物理治疗门诊。

参与者

66 名患有 PFP 的青少年（14.8±1.7 岁，65% 是女性）。

干涉

青少年被随机分配观看简短的心理告知视频 (n=34) 或控制视频 (n=32)。心理告知视频针对与疼痛相关的恐惧和疼痛灾难化，控制视频与 PFP 相关的基本解剖结构和因素有关。

主要观察指标

主要结果是功能的变化（前膝关节疼痛量表）。次要结果是心理信念（恐惧回避信念、运动恐惧症、疼痛灾难化）和疼痛的变化。在基线、干预后即刻、2 周、6 周和 3 个月时评估结果。

结果

使用2-way混合方差分析，干预组的功能变化大于对照组，治疗效果中等（P =.001，部分η ² =0.1）。事后测试显示干预与从基线到 2 周的时间之间存在显着的交互作用，但在 2 周和 3 个月之间没有发现交互作用。心理知情视频显着减少了适应不良的心理信念（P =.01, η ² =0.32）。没有注意到疼痛的显着组间差异。

结论

将一段简短的一次性心理视频纳入标准物理治疗护理，可显着减少 PFP 青少年与疼痛相关的恐惧，减少疼痛灾难并改善功能。在整个护理过程中，注意到的对功能的直接影响并未持续。