Purpose: Identify patients with patellofemoral pain syndrome (PFPS) who will likely have a positive immediate response to lumbopelvic manipulation.
Rule:
1. Difference in hip internal rotation greater than 14 degrees
2. Ankle dorsiflexion with knee flexed greater than 16 degrees
3. Navicular drop greater than 3mm
4. No stiffness with sitting 20 min
5. Squatting is most painful activity
| Item | 2+ variable | 3+ variables | 4+ variables |
| SN | 0.82 | 0.55 | 0.25 |
| SP | 0.35 | 0.66 | 0.95 |
| +LR | 2.1 | 9.4 | infinite |
| -LR | |||
| POS | 63% | 94% | ~100% |
SN = sensitivity – ‘SnOut’ helps rule out a disease (higher number is better – >0.9 is excellent)
SP = Specificity – ‘SpIn’ helps rule in a disease (higher number is better – greater than 0.90 is excellent))
+LR = positive likelihood ratio – ratio of positive test results in a patients with the pathology (true positives) higher number is better (> 10 is excellent)
-LR = negative likelihood ratio – ratio of negative test results in a patients with the pathology (false negatives) lower number is better (< 0.1 is excellent)
POS = Probability of success – positive treatment outcome
References:
1. Crowell MS, et al. Lumbopelvic manipulation in patients with patellofemoral pain syndrome. J Man Manip Ther. 2012; 20(3): 113–120.
2. Iverson CA, et al. Lumbopelvic Manipulation for the Treatment of Patients With Patellofemoral Pain Syndrome: Development of a Clinical Prediction Rule. J Orthop Sports Phys Ther. 2008; 38(6): 297–312.
