Adaptation, validity and reliability of the modified painDETECT questionnaire for patients with subacromial pain syndrome

Background The identification of a neuropathic component to subacromial pain may lead to different pain management strategies. The purpose of this study was to adapt the Dutch modified painDETECT (mPDQ-NL) Knee, which discriminates between nociceptive and neuropathic pain, to fit patients with subacromial pain syndrome and subsequently assess its validity and reliability. Methods The mPDQ-NL Knee was adapted into the mPDQ-NL Shoulder to fit and use for patients with subacromial pain syndrome. The study population consisted of patients suffering from subacromial pain syndrome who were asked to fill in the Dutch mPDQ-NL Shoulder, the self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and the Disabilities of the Arm, Shoulder and Hand (DASH) to determine construct validity (structural validity, hypotheses testing) of the mPDQ-NL Shoulder. Regarding reliability, internal consistency was determined and the mPDQ-NL Shoulder was assessed a second time with a two-week interval to determine measurement error and reliability. Results A total of 107 patients were included in the validity analysis and 58 in the reliability analysis. Validity (86% of predefined hypotheses met), internal consistency (Cronbach's alpha 0.8) and reliability (ICC 0.7) of the mPDQ-NL Shoulder were good, however, a systematic bias might be present. Conclusion The mPDQ-NL Shoulder was successfully modified from the mPDQ-NL Knee. This study shows that the mPDQ-NL Shoulder seems to reflect neuropathic-like pain symptoms experienced by patients with SAPS. Whether it may also be used as a tool to record change over time or after treatment has to be further assessed

Het effect van een patellabandje op de pijn bij sporters met een patellatendinopathie

Introduction: Athletes with patellar tendinopathy (jumper’s knee) often use an infrapatellar strap in order to reduce their pain during knee loading activities like jumping and landing. However, no studies have been performed to investigate the effectiveness of this orthosis. Aim of this study is to analyze the effect of an infrapatellar strap on pain during patellar tendon loading activities. Hypothesis of this study is a reduction in pain when and short after using an infrapatellar strap during patellar tendon loading activities. Methods: Fifty adult athletes (male (n=36) and female (n=14); mean age 28.4 (range 18-48) years) with patellar tendinopathy (mean VISA-P 55.6±14.6; median duration of symptoms 24 (range 3-300) months) performed ten single leg decline squats, the maximal jumping test and the triple hop test with and without an infrapatellar strap. Pain during this functional patellar tendon loading tests was recorded on a visual analogue scale. Athletes also used the straps during training and games and were asked for satisfaction with and side effects of the strap. Results: Pain reported differed significantly when performing ten single leg decline squats without and with a strap, 4.2±2.5 and 3.4±2.3 respectively (p<0.001) and when jumping three times on one leg 3.4±2.7 and 2.8±2.2 respectively (p=0,020). Jump height on one leg differed significantly with and without a strap, 27.2±7.8 and 24.5±6.5 centimeters respectively (p<001). Pain reporterd five minutes after removing the strap and performing ten single leg decline squats also differed significantly with the first series of ten decline squats, 3.6±2.2 and 4.2±2.5 respectively (p<0.001). Sixty percent of the athletes reported that the strap reduced their pain during and after their sporting activities. The only side effect reported was an irritating feeling in the popliteal space when using the strap and sliding down of the strap. Conclusion: An infrapatellar strap can reduce pain experienced by athletes with patellar tendinopathy who perform patellar tendon loading activities.