Pain assessment in patellar tendinopathy using pain pressure threshold algometry: an observational study

Pain Med. 2013 Nov;14(11):1769-75. doi: 10.1111/pme.12178. Epub 2013 Jun 26.

Abstract

Objective: Assessing pain in patellar tendinopathy (PT) is difficult to perform in a standardized way. With this study, we measured pain in athletes with PT by means of pain pressure threshold (PPT) algometry in a standardized manner. Subsequently, the goal of this study is to determine normative values for clinical use.

Design: Observational study.

Setting: Patients and healthy subjects were recruited from an outpatient clinic of a university medical center and at different sports clubs in northern Netherlands.

Subjects: A total of 234 athletes, 114 diagnosed with PT and 120 healthy controls, were included.

Outcome measures: PPT, Victorian Institute of Sport Assessment-Patellar tendinopathy questionnaire, and visual analog scale-pain.

Results: PPT scores of PT athletes with tendinopathy were significantly lower compared with healthy athletes (Mann-Whitney U-test; U = 293.5; P < 0.001). With a receiver operating characteristic (ROC) curve, the optimal cut-off point to distinguish between healthy athletes and PT athletes was calculated at 36.8 N. The area under the ROC curve was 0.98 (95% CI: 0.96-1.0). There was a positive predictive value of 96.5% that athletes with a PPT below 36.8 N. had PT.

Conclusions: PPT algometry should be considered by clinicians as a pain assessment tool in patients with PT. The optimal cut-off point for the PPT to distinguish between PT athletes and healthy athletes was 36.8 N.

Keywords: Jumper's Knee; Overuse Injuries; VISA-P.

Publication types

  • Observational Study

MeSH terms

  • Athletes
  • Female
  • Humans
  • Knee Injuries / diagnosis*
  • Male
  • Pain Measurement / methods*
  • Pain Threshold*
  • Patellar Ligament
  • Pressure
  • Tendinopathy / diagnosis*
  • Young Adult