Confidence and Knowledge of Athletic Trainers in Managing Patellofemoral Pain

Erika K Zambarano; David M Bazett-Jones; Danilo de Oliveira Silva; Christian J Barton; Neal R Glaviano

doi:10.4085/1062-6050-0279.21

Confidence and Knowledge of Athletic Trainers in Managing Patellofemoral Pain

J Athl Train. 2022 Jan 1;57(1):79-91. doi: 10.4085/1062-6050-0279.21.

Authors

Erika K Zambarano¹, David M Bazett-Jones¹, Danilo de Oliveira Silva², Christian J Barton^{2

3}, Neal R Glaviano⁴

Affiliations

¹ School of Exercise and Rehabilitation Sciences, University of Toledo, OH.
² La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services, and Sport, La Trobe University, Bundoora, Australia.
³ Department of Surgery, St Vincent's Hospital, University of Melbourne, Australia.
⁴ Department of Kinesiology, University of Connecticut, Storrs.

Abstract

Context: Patellofemoral pain (PFP) is prevalent and challenging to manage. Most patients with PFP are unsatisfied with their knee function at 6 months after treatment and report ongoing pain up to 16 years after diagnosis. The confidence and knowledge of athletic trainers (ATs) in providing evidence-based care to people with PFP is unknown.

Objective: To investigate the confidence and knowledge of ATs in the diagnosis, risk factors, prognosis, and treatment with current evidence for PFP.

Design: Cross-sectional study.

Setting: Online survey.

Patient or other participants: A random sample of 3000 ATs were invited to participate; 261 completed the survey (10% participation rate, 88% completion rate).

Main outcome measures(s): We surveyed AT demographics, confidence in PFP management, and knowledge related to diagnosis, risk factors, prognosis, and treatment. The confidence and knowledge of ATs in managing PFP was assessed. Their beliefs about evidence were compared with the available evidence (ie, consensus statements, position statements, systematic reviews).

Results: Of the ATs surveyed, 91% were confident that their management of PFP aligned with the current evidence, but only 59% were confident in identifying risk factors for PFP development. In addition, 91% to 92% of ATs agreed that quadriceps and hip muscle weakness were risk factors for PFP, which aligns with the current evidence for the former but not the latter. Moreover, 93% to 97% of ATs' responses related to therapeutic exercise aligned with current evidence. However, 35% to 48% supported the use of passive treatments, such as electrophysical agents and ultrasound, which did not align with the current evidence.

Conclusions: Most ATs were aware of supporting evidence for therapeutic exercise in PFP management and were confident providing it, creating a strong foundation for evidence-based care. However, varying levels of awareness of the evidence related to risk factors and passive treatments for PFP highlight the need for professional development initiatives to better align ATs' knowledge with the current evidence.

Keywords: anterior knee pain; rehabilitation; risk factors.

MeSH terms

Cross-Sectional Studies
Humans
Patellofemoral Pain Syndrome* / diagnosis
Patellofemoral Pain Syndrome* / therapy
Sports Medicine*
Sports*
Surveys and Questionnaires