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Practice Patterns and Outcomes of Care for Patients with Non-Traumatic Knee Disorders
Jessica B. Albers, Alison M. Nading, Chelsea M. O’Driscoll, Jeremy W. Schmidt, Charlene M. Sheaman, Shannon B. Strimple
School of Physical Therapy, Regis University, Denver, CO

INTRODUCTION METHODS Table 1. Patient Demographics Per Diagnosis Association between Interventions and
Diagnosis # of Visits Impairments
Success vs. Success.
Knee pain is a common ailment among a Procedures: Non-Success
Chi-square statistics revealed that three of
Hamstring Tight,
variety of age-groups.1,2 While 3.9% of •Data collected by Regis University Doctor
PFPS
7.7
ITB Tight,
Success = 50%
Non- Success = 50%
the 20 intervention options were associated
Rectus Femoris Tight
children between 9 and 10 years of age with successful outcome:
of Physical Therapy students during three Hamstring Tight,
Success = 30%
reported chronic knee pain, the prevalence
PROM Pain with • Application of joint mobilization (p = .03)
clinical affiliations on patients with non- Osteoarthritis 11.0
Extension,
Non- Success = 70%

increases to 18.5% by the age of 15 years, Gastroc Tight • Not performing isometric exercise (p = .05)
traumatic knee pain. ITB Tight,
and 20.8% by age 60.1,2 These studies Patella Tender at • Not performing taping/bracing (p = .10)
Lateral Knee Pain Success =54%
suggest that the prevalence of knee pain •Data collection included baseline, weekly, 6.7 Lateral Aspect,
PROM Pain with
Non- Success = 46%
Note: Alpha < 0.10

continues to increase as the population and discharge measurements using the Flexion
DISCUSSION
ages. Lower Extremity Functional Scale (LEFS) Table 2. Weeks 1 – 3 Most Common Interventions Nearly 50% of subjects achieved a successful
and the Numeric Pain Rating Scale Diagnosis
#1 #2 #3 #4 outcome as defined by changes in pain and
Intervention Intervention Intervention Intervention
Knee pain is typically classified as either (NPRS). Patient Joint function, although patients with OA
Stretching PRE
traumatic or non-traumatic. Non- •Patients were classified as successful if
PFPS
(n=23) (n=21)
Education
(n=19)
Mobilization
(n=12)
experienced less success. Interventions
traumatic knee pain includes but is not appeared to match the impairments
they met the minimal clinically important Osteoarthritis
Patient Education PRE A/PROM Stretching

limited to patellofemoral pain syndrome (n=9) (n=9) (n=6) (n=4) identified. Although this was an initial
difference (MCID) values for both of the
(PFPS), osteoarthritis (OA), and lateral Electrical exploratory study, interventions have been
following criteria: Lateral Knee Pain
Patient Education Stretching PRE
Stimulation
knee pain.
(n=12) (n=12) (n=10)
(n=6) identified that are associated with outcomes
•NPRS > 2 point decrease
and could be used in future prospective study
•LEFS > 9 point increase
Although extensive research has been Chart 1 and 2. Change of Primary Outcome Measures designs.
conducted on a variety of knee disorders •Data was coded and statistically analyzed 6
CLINICAL RELEVANCE
including many randomized trials, there is with SPSS 17.0 version primarily consisting 5 Monitoring patient demographics, outcome
currently insufficient data from studies of descriptive and correlative statistics. measures and prioritized interventions can

NPRS Scale
that monitor intervention choices and 4

inform clinical practice. The use of both the

resulting outcomes in patients treated by •Statistical significance set at an alpha < .10 3
LEFS and NPRS appear to be appropriate
student physical therapists and their for Chi-square testing. 2 MCID = 2
measures in tracking changes in patients
clinical instructors. 1
with non-traumatic knee pain. Assessment
RESULTS 0 of a multimodal approach to treating PFPS,
PFPS OA Lat. Knee Pain Overall

•Total Subjects: 65 (F = 36, M = 29) yielded similar results in changes in NPRS (4

Purpose:
35 point change from baseline to discharge) and
•Average age: 37.8 years ± 18.1 the LEFS (14 point change from baseline to
The purpose of this analysis of practice was
30

•Most Common Diagnoses: discharge).3

to identify the physical therapy 25

interventions and practice References:

LEFS

20
•PFPS (n=26; 48.1%)
patterns implemented by student physical 15 1. Anderson R, Crespo C, Ling S, Batham J, Bartlett S. Prevalence of significant
knee pain among older americans: results from the third national health and nutrition
therapists in the treatment of PFPS, OA, •Osteoarthritis (n=11; 20.4%) 10
MCID = 9 examination survery. J Am Geriatr Soc. 1999;47:1435-1438.
2.Vanasarja V. Prevalence of chronic knee pain in children and adolescence in
and lateral knee pain. •Lateral Knee Pain (n=13; 24.1%)
5
northern Finland. Acta Pediatric. 1995;84:803-805.
0 3. Lowry C, Cleland J, Dyke K. Management of patients with patellofemoral pain
PFPS OA Lat. Knee Pain Overall syndrome using a multimodal approach: a case series. J Orthop Sport Phys Ther.
2008; 38: 691-702