Physio findings: knee pain research, staying in touch using Twitter

In our regular round-up of research that's relevant to physiotherapy staff, Janet Wright looks at the latest research news.

Young people’s knee pain needs more research

Pain around the kneecap is surprisingly common among teenagers and young adults, especially if the young people concerned lead active lives. Patellofemoral pain syndrome is often triggered by climbing stairs, squatting, running or cycling. 
Patients are usually prescribed exercises aimed at strengthening the quadriceps muscle. In recent years, many practitioners have added hip exercises. But there has been little research into the causes of the condition, its long-term effects or the best ways of dealing with it.
‘The natural course of patellofemoral pain syndrome varies considerably and more research is needed to identify the risk factors for prolonged pain and functional deficit, and the potential association with degenerative joint disease,’ say a team of researchers based in the Netherlands who have written a new Cochrane review.
Rianne van der Heijden and colleagues from Erasmus Medical Centre in Rotterdam set out to see whether any form of exercise had proved more successful than others. They searched through databases, trial registers and conference abstracts. But although they identified 31 relevant trials covering 1,690 participants, many were badly designed or didn’t have enough participants to draw reliable conclusions. 
The team looked at studies in which exercisers were compared with a control group that either did nothing, or did a different kind of exercise, or had another non-surgical treatment.
Despite the overall low quality of the studies, the team found consistent evidence that exercise could reduce pain, improve function and enhance long-term recovery. And there was enough evidence to suggest that adding hip exercises to knee exercises could improve pain relief.
‘Before further studies are done, research is needed to identify priority questions and achieve better consensus on diagnostic criteria and measurement of outcome,’ say the authors. Van der Heijden RA et al. Exercise for treating patellofemoral pain syndrome, Cochrane Database of Systematic  Reviews 2015.

Stay in touch with Twitter

There’s more to Twitter than catching up with news and chat. It can be a valuable tool to keep health professionals abreast of the latest developments in their field.
Physiotherapists are using it for research, networking, tipping off other physios about relevant new studies and debating work-related issues. Following the CSP (@thecsp) will keep you up to date with physiotherapy news.
And as librarians at the University of York explain, Twitter is a boon to researchers.  It shouldn’t take long to build up a network of physios with similar interests, all streamlining their research by tweeting each other the latest evidence. 
Numerous health bodies and medical journals have Twitter feeds, for example the National Institute for Health Research and the BMJ.


Newcomers Twitter can avoid potential pitfalls by reading CSP's social media guidance before plunging in. See physiotalk professionalism and twitter.

To take part in discussions around a pre-arranged topic, visit Physiotalk. Their next tweet chat is planned for Monday 30 March at 8pm BST. 
The theme is using social media to join international physiotherapy conversations. 

Comments and conclusions

Three Austrian men have undergone the world’s first ‘bionic reconstruction’ operations, allowing them to use a robotic prosthetic hand controlled by their minds. Aszmann OC et al.Lancet 2015.  
People doing manual work in awkward positions are eight times more likely to develop back pain, say researchers in Australia. Working while tired or distracted also increases the risk, and back injuries are most likely to occur in the morning. But when doing heavy lifting, older people are at lower risk than younger ones, possibly thanks to their skill and experience. Steffens D et al. Arthritis Care and Research 2015.  
People with attention deficit hyperactivity disorder are twice as likely as others to die prematurely, particularly from accidents. Women are especially at risk, say researchers. Dalsgaard S et al. Lancet 2015
The risk of heart attack rises sharply during the two hours after a bout of intense anger or anxiety, say researchers in Australia who studied 313 patients. Buckley T et al. European Heart Journal Acute Cardiovascular Care 2015; http://dx.doi. org/10.1177/ 2048872615568969 
Overweight adults with diabetes who took up an intensive programme of diet and exercise were 15 per cent less likely to develop knee pain during the following year than a group of others who only received diabetes support and education. White DK et al. Arthritis Care & Research 2015.  
CSP member Alexandra Hough has published an extra online index for her book Physiotherapy in respiratory and cardiac care: an evidence-based approach to respiratory and cardiac management. The index is available here.  Now in its fourth edition, the book can be bought from the Book Depository for £37.99.
Janet Wright

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