Browsing by Author "Richards, Jim"

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    Hot and cold knees: exploring differences in patella skin temperature in patients with patellofemoral pain
    (2020) Janssen, Jessie; Selfe, James; Gichuru, Phillip; Richards, Jim; Yosmaoglu, Hayri Baran; Sonmezer, Emel; Erande, Renuka; Resteghini, Peter; Dey, Paola; 32711228
    Objectives To investigate the distribution of patella skin temperature (Tsk) measurements and to explore the presence of temperature subgroups in patellofemoral pain (PFP) patients. Design Cross-sectional observational study design. Participants One dataset of 58 healthy participants and 232 PFP patients from three different datasets. Main outcome measures Patella skin temperature, measured by physiotherapists using a low cost hand held digital thermometer. The distribution of patella skin temperature was assessed and compared across datasets. To objectively determine the clinically meaningful number of subgroups, we used the average silhouette method. Finite mixture models were then used to examine the presence of PFP temperature subgroups. Receiver operating characteristic curves were used to estimate optimal patella Tsk thresholds for allocation of participants into the identified subgroups. Results In contrast to healthy participants, the patella skin temperature had an obvious bimodal distribution with wide dispersion present across all three PFP datasets. The fitted finite mixture model suggested three temperature subgroups (cold, normal and hot) that had been recommended by the average silhouette method with discrimination cut-off thresholds for subgroup membership based on receiver operating curve analysis of Cold = <30.0 degrees C; Normal 30.0-35.2 degrees C; Hot >= 35.2 degrees C. Conclusion A low cost hand held digital thermometer appears to be a useful clinical tool to identify three PFP temperature subgroups. Further research is recommended to deepen understanding of these clinical findings and to explore the implications to different treatments. (C) 2020 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
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    Targeted Treatment Protocol in Patellofemoral Pain: Does Treatment Designed According to Subgroups Improve Clinical Outcomes in Patients Unresponsive to Multimodal Treatment?
    (2019) Yosmaoglu, Hayri Baran; Selfe, James; Sonmezer, Emel; Sahin, Ilknur Ezgi; Duygu, Senay Cerezci; Ozkoslu, Manolya Acar; Richards, Jim; Jenssen, Jessica; 31750786; AAA-4826-2020
    Background: Targeted intervention for subgroups is a promising approach for the management of patellofemoral pain. Hypothesis: Treatment designed according to subgroups will improve clinical outcomes in patients unresponsive to multimodal treatment. Study Design: Prospective crossover intervention. Methods: Patients with patellofemoral pain (PFP; n = 61; mean age, 27 +/- 9 years) were enrolled. Patients with PFP received standard multimodal treatment 3 times a week for 6 weeks. Patients not responding to multimodal treatment were then classified into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot) using 6 simple clinical tests. They were subsequently administered 6 further weeks of targeted intervention, designed according to subgroup characteristics. Visual analog scale (VAS), perception of recovery scale (PRS), 5-Level European Quality 5 Dimensions (EQ-5D-5L), and self-reported version of the Leeds Assessment of Neuropathic Symptoms and Signs scale (S-LANSS) were used to assess pain, knee function, and quality of life before and after the interventions. Results: In total, 34% (n = 21) of patients demonstrated recovery after multimodal treatment. However, over 70% (n = 29/40) of nonresponders demonstrated recovery after targeted treatment. The VAS, PRS, S-LANSS, and EQ-5D-5L scores improved significantly after targeted intervention compared with after multimodal treatment (P < 0.001). The VAS score at rest was significantly lower in the "weak and pronated foot" and the "weak and tight" subgroups (P = 0.011 and P = 0.008, respectively). Posttreatment pain intensity on activity was significantly lower in the "strong" subgroup (P = 0.006). Conclusion: Targeted treatment designed according to subgroup characteristics improves clinical outcomes in patients unresponsive to multimodal treatment.