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Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this investigation was to estimate and document the reliability and validity of the Anterior Knee Pain Scale (AKPS) and to estimate its relative prediction accuracy of anterior knee pain in young females.

Methods

Data from a prospective, epidemiologic study to diagnose patellofemoral knee pain among female athletes (n = 499) using the Anterior Knee Pain Scale (AKPS). Data were treated in 4 phases (descriptive phase, reliability phase, scale refinement phase) and a final validation stage that was focused on an effort to test and document the validation of the AKPS short form and perform head-to-head comparisons of the 6-item short form with the original, 13-item form.

Results

The AKPS was reduced from 13 items (αCoeff = 0.77, σSEM = 0.004) to 6 items (αCoeff = 0.78, σSEM = 0.004). Point-biserial correlations with patellofemoral pain diagnosis were comparable: r [498] = 0.70 (R 2 = 0.49, short form) and r [498] = 0.71 (R 2 = 0.51, long form), as was sensitivity: 84 % (short form) and 80 % (long form), and specificity: 89 % (short form) and 90 % (long form; AUC = 0.94 both).

Conclusion

The current analyses indicate that a subset of measures from the AKPS is responsive to patellofemoral pain symptoms and may support screening for related diagnoses. A simpler and quicker scale optimized for diagnostic accuracy could reduce the demand on patients, clinicians and research teams focused on the identification and management of patellofemoral pain.

Level of evidence

III.

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Acknowledgments

The authors would like to thank Boone County Kentucky, School District, especially School Superintendent Randy Poe, for participation in this study. We would also like to thank Mike Blevins, Ed Massey, Dr. Brian Blavatt and the athletes of Boone County public school district for their participation in this study. All authors are independent of any commercial funder, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. This work was supported by the National Institutes of Health/NIAMS Grants #R01-AR049735, #R01-AR05563 and #R01-AR056259.

Conflict of interest

The authors have no competing interests to declare.

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Correspondence to Gregory D. Myer.

Additional information

This study was approved by the Cincinnati Children’s Hospital Institutional Review Board.

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Myer, G.D., Barber Foss, K.D., Gupta, R. et al. Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents. Knee Surg Sports Traumatol Arthrosc 24, 653–660 (2016). https://doi.org/10.1007/s00167-014-3004-7

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