Musculoskeletal Care. 2025 Sep;23(3):e70165. doi: 10.1002/msc.70165.

ABSTRACT

OBJECTIVES: To evaluate the beliefs of people with patellofemoral pain (PFP) about their condition’s development and persistence, and treatment options, before and after self-directed access to a web-based education platform.

DESIGN: Pre- and post-intervention trial.

METHODS: Fifty-eight people with PFP completed custom questionnaires (open-ended and multiple choice) before and 6 weeks after accessing the “My Knee Cap” web-based education platform. Questions covered beliefs about causes and persistence of pain, effectiveness of treatments, and willingness to undergo surgery. Open-ended responses were analysed thematically. McNemar’s test with Yates correction compared changes between pre- and post-intervention for multiple choice questions.

RESULTS: At baseline and 6 weeks, PFP onset was primarily attributed to loading. At baseline, pain persistence was linked to loading, structure, and muscle impairments, with muscle impairments being replaced by sedentary behaviour at the 6-week follow-up. At baseline, most participants (69%-81%) believed that taping, bracing, foot orthoses, and exercises were effective treatment options. Fewer participants (16%-22%) believed that dry needling, injections, ultrasound, and surgery were effective. At 6 weeks, beliefs about the effectiveness of exercise (16% increase, ES = 0.15), injections (13% decrease, ES = 0.44), and ultrasound (15% decrease, ES = 0.50) changed. At baseline and 6 weeks, most participants (93%-95%) believed exercise was more effective than surgery, and 46%-59% were willing to undergo surgery if imaging revealed abnormalities.

CONCLUSION: Beliefs about the causes and persistence of PFP centred on loading and pathoanatomical factors, remaining largely unchanged after self-directed web-based education. Web-based education may help to promote the benefits of exercise and reduce beliefs that injection and ultrasound are helpful.

PMID:40736481 | DOI:10.1002/msc.70165