Klinische Untersuchung, psychosoziale Faktoren und Biomechanik bei Kindern und Jugendlichen zwischen 10 und 18 Jahren mit patellofemoralem Schmerzsyndrom

Zusammenfassung

Das patellofemorale Schmerzsyndrom (PFS) ist bei Kindern und Jugendlichen mit einer Prävalenz von 29% häufig, doch das Zusammenspiel von Ursachen und beitragenden Faktoren wird kontrovers diskutiert. Im Rahmen dieser Querschnittstudie werden klinische, psychosoziale und biomechanische Parameter bei Kindern und Jugendlichen mit PFS erfasst und die Fragestellung „Inwiefern hängen Befunde aus der körperlichen Untersuchung mit berichtetem Schmerz, Einschränkungen in Funktion und Lebensqualität und Abweichungen der Beinachse unter Belastung bei Kindern mit PFS zusammen?“ untersucht.

Zwölf Kinder im Alter von 10–18 Jahren mit PFS wurden mittels Fragebögen (Knee Injury and Osteoarthritis Outcome Score Children KOOS-Child, Deutscher Schmerzfragebogen für Kinder und Jugendliche DSF-KJ), klinischer Untersuchungen (Druckschmerzschwelle, Beweglichkeit, Kraft, Muskellängen) sowie funktioneller Belastungstests (Single Leg Squat (SLS), Vertical Drop Jump (VDJ), Single Leg Drop Vertical Jump (SLDVJ)) untersucht. Die Zusammenhänge wurden mittels Pearsons r, Spearman’s Rho (ρ) und Eta-Koeffizient (η) ermittelt.

Die Ergebnisse zeigen statistisch signifikante Zusammenhänge zwischen körperlichen Merkmalen und empfundenen Schmerzen sowie Einschränkungen hinsichtlich Aktivitäten des täglichen Lebens (ADL) und Lebensqualität (LQ). Basierend auf Einflussfaktoren auf PFS wurden 9 Zusammenhangshypothesen gebildet und überprüft.

Die Studie zeigt statistisch signifikante Zusammenhänge zwischen klinischen, biomechanischen und patient*innenberichteten psychosozialen Parametern bei Kindern und Jugendlichen mit PFS auf, die teilweise entgegengesetzt zu bestehenden Studien sind. Die Arbeit liefert Grundlagen für weitere Untersuchungen der Pathogenese und Ätiologie von PFS.

Abstract

Patellofemoral pain syndrome (PFPS) is common in children and adolescents, with a prevalence of 29%, but the interaction of causes and contributing factors remains controversial. In this cross-sectional study, clinical, psychosocial and biomechanical parameters are collected in children and adolescents with PFPS. The research question “To what extent are findings from the clinical examination related to reported pain, limitations in function and quality of life and deviations of the leg axis under stress in children with PFPS?” is investigated.

Twelve children aged 10–18 years with PFS were examined using questionnaires (Knee Injury and Osteoarthritis Outcome Score Children KOOS-Child, German Pain Questionnaire for Children and Adolescents DSF-KJ), clinical examinations (pressure pain threshold, mobility, strength, muscle lengths) and functional exercise tests (Single Leg Squat (SLS), Vertical Drop Jump (VDJ), Single Leg Drop Vertical Jump (SLDVJ)). Correlations were determined using Pearson's r, Spearman's Rho (ρ) and Eta coefficient (η).

The results show statistically significant correlations between physical characteristics and perceived pain as well as limitations in activities of daily living (ADL) and quality of life (QoL). A total of nine correlation hypotheses based on factors influencing PFPS were tested.

The study shows statistically significant correlations between clinical, biomechanical and patient-reported psychosocial parameters in children and adolescents with PFPS, some of which are contrary to existing studies. Our work paves the ground for further research on the pathogenesis and etiology of PFPS.

Schlüsselwörter

Patellofemorales Schmerzsyndrom - Kinder - Jugendliche - klinische Untersuchung - instrumentelle Bewegungsanalyse - Malalignment

Keywords

patellofemoral pain syndrome - children - adolescents - clinical examination - instrumented movement analysis - malalignment

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