2013 http://informahealthcare.com/dre ISSN 0963-8288 print/ISSN 1464-5165 online Disabil Rehabil, 2013; 35(26): 2181–2190 ! 2013 Informa UK Ltd. DOI: 10.3109/09638288.2013.774061 REVIEW Psychometric evidence of self-reported questionnaires for patellofemoral pain syndrome: a systematic review Jean-Francois Esculier 1,2 , Jean-Se ´bastien Roy 1,2 , and Laurent Julien Bouyer 1,2 1 Centre Interdisciplinaire de Recherche en Re ´adaptation et Inte ´gration Sociale (CIRRIS) and 2 Faculty of Medicine, Universite ´ Laval, Quebec City, Canada Abstract Purpose: To conduct a systematic review of psychometric properties of self-reported questionnaires used to assess the level of symptoms and disability in individuals with patellofemoral pain syndrome (PFPS). Methods: A structured search was conducted in four databases (Medline, Embase, CINAHL, SportDiscus). A total of 24 studies about five different self-reported questionnaires were analyzed. A pair of independent raters extracted data on validity, reliability and responsiveness to change, and performed critical appraisal (0–100%). Results: Activities of Daily Living Scale (ADLS), Anterior Knee Pain Scale (AKPS), International Knee Documentation Committee (IKDC) and Lysholm Scale (LS) present excellent test–retest reliability (weighted average intraclass correlation coefficients [ICC]40.80), whereas Functional Index Questionnaire (FIQ) is moderately reliable (ICC ¼ 0.61). Minimal detectable change is 8.3% for ADLS, 9.0% for AKPS, 19% for FIQ, 8.5% for IKDC and 30% for LS. ADLS, AKPS, IKDC and LS are highly responsive (effect size/standardized response mean 4 0.95) in individuals with PFPS, while FIQ is lowly responsive (effect size ¼ 0.49). Conclusion: Based on available evidence, ADLS presents the best psychometric properties and should be preferred when evaluating patients with PFPS. AKPS and IKDC are also adequate, while FIQ and LS are not recommended for individuals with PFPS. ä Implications for Rehabilitation  While several questionnaires have been developed to assess symptoms and functional limitations caused by knee pain, their psychometric properties can vary depending on the condition presented by the patient.  The Activities of Daily Living Scale of the Knee Outcome Survey should be preferred by clinicians when evaluating a patient with PFPS.  The Anterior Knee Pain Scale and International Knee Documentation Committee Subjective knee evaluation are also adequate for use with this population.  The Functional Index Questionnaire and Lysholm Scale are not recommended for PFPS. Keywords Anterior knee pain, pain, patellofemoral pain syndrome, psychometric properties, questionnaires History Received 6 September 2012 Revised 24 January 2013 Accepted 4 February 2013 Published online 29 April 2013 Introduction Knee pain affects approximately 20–30% of the population and is one of the most prevalent musculoskeletal (MSK) conditions [1,2]. Among knee pain diagnoses in sports medicine clinics, patellofemoral pain syndrome (PFPS) is one of the most common with approximately 25% of all medical consultations for knee pain [3]. PFPS has been described as anterior or retropatellar knee pain or pain along the lateral and medial borders of the patella, which could be caused by anterior knee structures such as the infrapatellar fat pad, patellar subchondral bone, anterior synovium and medial or lateral retinaculae [3,4]. It is associated with activities that load the patellofemoral joint such as going up and down stairs, kneeling or running [5]. It is therefore recognized that PFPS is an activity-limiting condition that contributes to disability and impacts health-related quality of life [6]. Several self-administered scales have been developed to assess the level of symptoms and disability of persons affected by knee pain. In clinical trials involving individuals with PFPS, question- naires are often used as primary outcomes to evaluate the effects of interventions such as rehabilitation or surgery [7,8]. In clinical settings, self-reported questionnaires are used in this population as a basis for treatment decision-making, and for the determination of treatment effectiveness following an episode of care. Therefore, psychometric properties such as validity, reliability and respon- siveness to change need to be established in order to justify the choice of using a given scale. Both clinicians and researchers need to have a clear portrait of the measurement properties of these Address for correspondence: Jean-Se ´bastien Roy, PhD, PT, Centre Interdisciplinaire de Recherche en Re ´adaptation et Inte ´gration Sociale (CIRRIS), Universite ´ Laval, Quebec City, G1M 2S8, Canada. Tel: 1-418- 529-9141, Ext 6005. E-mail: jean-sebastien.roy@fmed.ulaval.ca Disabil Rehabil Downloaded from informahealthcare.com by University of Laval on 02/13/15 For personal use only.