Clinical value of questionnaires & physical tests for patellofemoral pain: Validity, reliability and predictive capacity

Objectives: Todetermine the most appropriate method of functional assessment for "patellofemoral pain" (PFP)/“chondromalacia patella” for its diagnostic value, (validity, reliability, sensitivity, specificity, predictive value and clinical applicability); to outline initial interpretations of the questionnaires and their appropriateness, through the cut-off points determined in their scores based on physical test and Magnetic Resonance Imaging (MRI); to establish which methods should be used in conjunction with each other to obtain clinical diagnoses that are robust effective and efficient. Methods (1)Intra- and inter-observer reliability and of the relationship among PFP questionnaires/ physical tests validated. (2)Predictive capacity of the questionnaires. Subject: 113 knees with PFP, assessed using “Knee-injury-and-Osteoarthritis Outcome-Score-for-Patellofe moral-pain-and-osteoarthritis” (KOOS-PF), “Kujala-Patellofemoral-Score” (KPS), “Victo rian-Institute-of-Sports-Assessment-for-Patellar-tendons-questionnaire” (VISA-P), and the physical tests: “patellar-palpation”, “patellar-tilt”, “patellar-apprehension”, “Clarke” and “squat”. Results Questionnaires correlations themselves was 0.78<r<0.86. Tests intra-rater reliability was “excellent”. Squat inter-rater reliability was “excellent”/“good”. Palpation, tilt, Clarke and squat showed astatistically significant relationship (p<0.05) with all questionnaires/specific items. AUC of the questionnaires showed a "useful" accuracy, except for Tilt. No statistically significant differences were found between grades 0 and 1 chondromalacia (by MRI) knee scores, but between 1 and ≥ 2.AUCofthequestionnaires showed "useful" accuracy. Conclusions KOOS-PF,KPSandVISA-Pdemonstratedtheirdiagnostic value in PFP/chondromalacia (validity, reliability, sensitivity, specificity, predictive value and clinical applicability). KOOS PFwasthemostversatile, and the most appropriate in mild cases and for early detection andprevention. Squat was