Journal CME May 2025, Differences in content of care and outcomes between a clinical practice guideline adherent program and usual care for patellofemoral pain: A retrospective pilot study-PM R - 2025 - Farrokhi - Differences in content of care and outcomes between a clinical practice guideline adherent program

PM R - 2025 - Farrokhi - Differences in content of care and outcomes between a clinical practice guideline adherent program

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The study, led by Shawn Farrokhi and colleagues, explores the differences in care and outcomes between Clinical Practice Guidelines (CPG)-adherent care and usual care for patellofemoral pain (PFP) treatment in military service members. This retrospective pilot study compared 32 patients receiving CPG-adherent care to 46 receiving usual care in military outpatient physical therapy clinics. <br /><br />CPG-adherent care involved classifying patients into subcategories based on CPG-recommended examination and providing targeted interventions. The study found that patients in the CPG-adherent group attended more physical therapy visits (10.6 on average) compared to the usual care group (6.1 visits) and received a greater proportion of knee-targeted exercises, neuromuscular reeducation, patient education, patellar taping, and foot orthoses. The usual care group utilized more modalities and less manual therapy.<br /><br />The study also measured patient-reported outcomes using the Anterior Knee Pain Scale (AKPS), Defense and Veterans Pain Rating Scale (DVPRS), and Global Rating of Change (GROC). CPG-adherent patients reported more substantial improvements over 1 and 3 months than those under usual care. Notably, the CPG-adhered group reported more significant improvements in AKPS, DVPRS, and GROC, suggesting meaningful benefits associated with CPG adherence. However, the study noted that additional controlled trials are needed to conclusively establish effectiveness.<br /><br />This research highlights the potential advantages of adhering to CPGs in treating PFP, suggesting that comprehensive, guided treatments may lead to better patient outcomes. However, the study underscores the logistical and training challenges in implementing such detailed guidelines in standard clinical practice.

Keywords

patellofemoral pain

Clinical Practice Guidelines

CPG-adherent care

military service members

physical therapy

patient outcomes

Anterior Knee Pain Scale

Defense and Veterans Pain Rating Scale

Global Rating of Change

retrospective pilot study