Research Article
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Another neglected symptom among the overweight young: an analysis of the self-reported anterior knee pain scores of the secondary school children

Year 2023, Volume: 14 Issue: 48, 25 - 30, 30.04.2023
https://doi.org/10.17944/interdiscip.1285723

Abstract

Objective: Knee pain is the most common joint complaint among the young and is linked with excessive weight by the World Health Organization. The study aimed to define the prevalence of anterior knee pain in secondary school children and search its’ relations to weight and academic performance.

Method: The cross-sectional and descriptive study was conducted in Adana, between Sept 15 and Oct 15, 2020. Middle school students aged between 10 and 18 years were included. Anterior knee pain was assessed using the Anterior Knee Pain Scale short form (AKPS-SF), and the numerical rating scale (NRS) was used for pain intensity. Data were collected by questionnaires sent by e-mail.

Results: There were 709 replies eligible for analysis. The NRS mean score was 0.78±1.47 for 249 (35.12 %) participants who reported knee pain. The number of students with an AKPS-SF score of ≤40 in the study group was 46 (6.40%). AKPS-SF scores showed weak negative linear associations with weight and the school year (r=-0.346/p=0.019, and r=-0.292/p=0.049, respectively), and no correlations were found with academic performance.

Conclusion: The study has shown that more than a third of the students reported various levels of knee pain. The inverse correlation of AKPS-SF with weight and the weak link with the school year might attract the attention of healthcare givers to pay more attention to knee examination and help avoid future impairments in the knee joints of school age children.

References

  • Fulkerson JP, Arendt EA. Anterior knee pain in females. Clinical Orthopaedics and Related Research. 2000;3(372): 69–73. https://doi.org/10.1097/00003086-200003000-00009
  • Rathleff MS, Roos EM, Olesen JL, Rasmussen S. High prevalence of daily and multi-site pain – a cross-sectional population-based study among 3000 Danish adolescents. BMC Pediatrics. 2013;13(1): 191-201. https://doi.org/10.1186/1471-2431-13-191
  • Murray CJ, Richards MA, Newton JN, Fenton KA, Anderson HR, Atkinson C, et al. UK health performance: findings of the Global Burden of Disease Study 2010. The Lancet. 2013;381(9871): 997–1020. https://doi.org/10.1016/S0140-6736(13)60355-4
  • Wolf M. Knee Pain in Children, Part III: Stress Injuries, Benign Bone Tumors, Growing Pains. Pediatrics in Review. 2016;37(3): 114–118. https://doi.org/10.1542/pir.2015-0042
  • Slotkin S, Thome A, Ricketts C, Georgiadis A, Cruz A, Seeley M. Anterior Knee Pain in Children and Adolescents: Overview and Management. The Journal of Knee Surgery. 2018;31(05): 392–398. https://doi.org/10.1055/s-0038-1632376
  • WHO Consultation on Obesity (1999: Geneva, Switzerland)||World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Report number: 894, 2000 [Accessed 23rd January 2022]. p. 252. https://apps.who.int/iris/handle/10665/42330 [Accessed 23rd January 2022]
  • Rincón-Gallardo Patiño S, Rajamohan S, Meaney K, Coupey E, Serrano E, Hedrick VE, et al. Development of a Responsible Policy Index to Improve Statutory and Self-Regulatory Policies that Protect Children’s Diet and Health in the America’s Region. International Journal of Environmental Research and Public Health. 2020;17(2): 495-516. https://doi.org/10.3390/ijerph17020495
  • Sowers MR, Karvonen-Gutierrez CA. The evolving role of obesity in knee osteoarthritis. Current Opinion in Rheumatology. 2010;22(5): 533–537. https://doi.org/10.1097/BOR.0b013e32833b4682
  • Stovitz SD, Pardee PE, Vazquez G, Duval S, Schwimmer JB. Musculoskeletal pain in obese children and adolescents. Acta Paediatrica. 2008;97(4): 489–493. https://doi.org/10.1111/j.1651-2227.2008.00724.x
  • Bout-Tabaku S, Michalsky MP, Jenkins TM, Baughcum A, Zeller MH, Brandt ML, et al. Musculoskeletal Pain, Self-reported Physical Function, and Quality of Life in the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Cohort. JAMA Pediatrics. 2015;169(6): 552-559. https://doi.org/10.1001/jamapediatrics.2015.0378
  • Myer GD, Barber Foss KD, Gupta R, Hewett TE, Ittenbach RF. Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24(3): 653–660. https://doi.org/10.1007/s00167-014-3004-7
  • Bout-Tabaku S, Briggs MS, Schmitt LC. Lower Extremity Pain Is Associated With Reduced Function and Psychosocial Health in Obese Children. Clinical Orthopaedics and Related Research. 2013;471(4): 1236–1244. https://doi.org/10.1007/s11999-012-2620-0
  • Rathleff MS, Rathleff CR, Olesen JL, Rasmussen S, Roos EM. Is Knee Pain During Adolescence a Self-limiting Condition?: Prognosis of Patellofemoral Pain and Other Types of Knee Pain. The American Journal of Sports Medicine. 2016;44(5): 1165–1171. https://doi.org/10.1177/0363546515622456
  • Fatoye F, Palmer S, Macmillan F, Rowe P, van der Linden M. Proprioception and muscle torque deficits in children with hypermobility syndrome. Rheumatology. 2009;48(2): 152–157. https://doi.org/10.1093/rheumatology/ken435
  • Adib N, Davies K, Grahame R, Woo P, Murray KJ. Joint hypermobility syndrome in childhood. A not so benign multisystem disorder? Rheumatology. 2005;44(6): 744–750. https://doi.org/10.1093/rheumatology/keh557
  • Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6): 1003–1007. https://doi.org/10.1097/j.pain.0000000000000160
  • Ittenbach RF, Huang G, Barber Foss KD, Hewett TE, Myer GD. Reliability and Validity of the Anterior Knee Pain Scale: Applications for Use as an Epidemiologic Screener. PLOS ONE. 2016;11(7): e0159204. https://doi.org/10.1371/journal.pone.0159204
  • Kuru T, Dereli EE, Yaliman A. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthopaedica Et Traumatologica Turcica. 2010;44(2): 152–156. https://doi.org/10.3944/AOTT.2010.2252
  • Tsze DS, von Baeyer CL, Pahalyants V, Dayan PS. Validity and Reliability of the Verbal Numerical Rating Scale for Children Aged 4 to 17 Years With Acute Pain. Annals of Emergency Medicine. 2018;71(6): 691-702.e3. https://doi.org/10.1016/j.annemergmed.2017.09.009
  • Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, et al. Pain in children and adolescents: a common experience. Pain. 2000;87(1): 51–58. https://doi.org/10.1016/S0304-3959(00)00269-4
  • Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome: Epidemiology of patellofemoral pain. Scandinavian Journal of Medicine & Science in Sports. 2010;20(5): 725–730. https://doi.org/10.1111/j.1600-0838.2009.00996.x
  • David ME, Ball SJ, Davies J, Reay D. Gender Issues in Parental Involvement in Student Choices of Higher Education. Gender and Education. 2003;15(1): 21–36. https://doi.org/10.1080/0954025032000042121
  • Selhorst M, Fernandez-Fernandez A, Cheng MS. Rasch analysis of the anterior knee pain scale in adolescents with patellofemoral pain. Clinical Rehabilitation. 2020;34(12): 1512–1519. https://doi.org/10.1177/0269215520942950
  • Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study. The American Journal of Sports Medicine. 2000;28(4): 480–489. https://doi.org/10.1177/03635465000280040701
  • D Myer G. Diagnostic Differences for Anterior Knee Pain between Sexes in Adolescent Basketball Players. Journal of Athletic Enhancement. 2014;03(01):1-10. https://doi.org/10.4172/2324-9080.1000139
  • Kim N, Browning RC, Lerner ZF. The effects of pediatric obesity on patellofemoral joint contact force during walking. Gait & Posture. 2019;73(1): 209–214. https://doi.org/10.1016/j.gaitpost.2019.07.307
  • Selhorst M, Rice W, Degenhart T, Jackowski M, Tatman M. Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. International Journal of Sports Physical Therapy. 2015;10(2): 178–188.
  • Hott A, Liavaag S, Juel NG, Brox JI, Ekeberg OM. The reliability, validity, interpretability, and responsiveness of the Norwegian version of the Anterior Knee Pain Scale in patellofemoral pain. Disability and Rehabilitation. 2021;43(11): 1605–1614. https://doi.org/10.1080/09638288.2019.1671499
  • Pacey V, Tofts L, Adams RD, Munns CF, Nicholson LL. Exercise in children with joint hypermobility syndrome and knee pain: a randomised controlled trial comparing exercise into hypermobile versus neutral knee extension. Pediatric Rheumatology. 2013;11(30):1-11. https://doi.org/10.1186/1546-0096-11-30
  • Muntaner-Mas A, Palou P, Vidal-Conti J, Esteban-Cornejo I. A Mediation Analysis on the Relationship of Physical Fitness Components, Obesity, and Academic Performance in Children. The Journal of Pediatrics. 2018;198(1): 90-97.e4. https://doi.org/10.1016/j.jpeds.2018.02.068
  • Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of Family Medicine and Primary Care. 2015;4(2): 187–192. https://doi.org/10.4103/2249-4863.154628
  • Macfarlane GJ, de Silva V, Jones GT. The relationship between body mass index across the life course and knee pain in adulthood: results from the 1958 birth cohort study. Rheumatology. 2011;50(12): 2251–2256. https://doi.org/10.1093/rheumatology/ker276
  • Zhou H, Roberts P, Horgan L. Association between self-report pain ratings of child and parent, child and nurse and parent and nurse dyads: meta-analysis. Journal of Advanced Nursing. 2008;63(4): 334–342. https://doi.org/10.1111/j.1365-2648.2008.04694.x
  • von Baeyer CL. Children’s Self-Reports of Pain Intensity: Scale Selection, Limitations and Interpretation. Pain Research and Management. 2006;11(3): 157–162. https://doi.org/10.1155/2006/197616
Year 2023, Volume: 14 Issue: 48, 25 - 30, 30.04.2023
https://doi.org/10.17944/interdiscip.1285723

Abstract

References

  • Fulkerson JP, Arendt EA. Anterior knee pain in females. Clinical Orthopaedics and Related Research. 2000;3(372): 69–73. https://doi.org/10.1097/00003086-200003000-00009
  • Rathleff MS, Roos EM, Olesen JL, Rasmussen S. High prevalence of daily and multi-site pain – a cross-sectional population-based study among 3000 Danish adolescents. BMC Pediatrics. 2013;13(1): 191-201. https://doi.org/10.1186/1471-2431-13-191
  • Murray CJ, Richards MA, Newton JN, Fenton KA, Anderson HR, Atkinson C, et al. UK health performance: findings of the Global Burden of Disease Study 2010. The Lancet. 2013;381(9871): 997–1020. https://doi.org/10.1016/S0140-6736(13)60355-4
  • Wolf M. Knee Pain in Children, Part III: Stress Injuries, Benign Bone Tumors, Growing Pains. Pediatrics in Review. 2016;37(3): 114–118. https://doi.org/10.1542/pir.2015-0042
  • Slotkin S, Thome A, Ricketts C, Georgiadis A, Cruz A, Seeley M. Anterior Knee Pain in Children and Adolescents: Overview and Management. The Journal of Knee Surgery. 2018;31(05): 392–398. https://doi.org/10.1055/s-0038-1632376
  • WHO Consultation on Obesity (1999: Geneva, Switzerland)||World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Report number: 894, 2000 [Accessed 23rd January 2022]. p. 252. https://apps.who.int/iris/handle/10665/42330 [Accessed 23rd January 2022]
  • Rincón-Gallardo Patiño S, Rajamohan S, Meaney K, Coupey E, Serrano E, Hedrick VE, et al. Development of a Responsible Policy Index to Improve Statutory and Self-Regulatory Policies that Protect Children’s Diet and Health in the America’s Region. International Journal of Environmental Research and Public Health. 2020;17(2): 495-516. https://doi.org/10.3390/ijerph17020495
  • Sowers MR, Karvonen-Gutierrez CA. The evolving role of obesity in knee osteoarthritis. Current Opinion in Rheumatology. 2010;22(5): 533–537. https://doi.org/10.1097/BOR.0b013e32833b4682
  • Stovitz SD, Pardee PE, Vazquez G, Duval S, Schwimmer JB. Musculoskeletal pain in obese children and adolescents. Acta Paediatrica. 2008;97(4): 489–493. https://doi.org/10.1111/j.1651-2227.2008.00724.x
  • Bout-Tabaku S, Michalsky MP, Jenkins TM, Baughcum A, Zeller MH, Brandt ML, et al. Musculoskeletal Pain, Self-reported Physical Function, and Quality of Life in the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Cohort. JAMA Pediatrics. 2015;169(6): 552-559. https://doi.org/10.1001/jamapediatrics.2015.0378
  • Myer GD, Barber Foss KD, Gupta R, Hewett TE, Ittenbach RF. Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24(3): 653–660. https://doi.org/10.1007/s00167-014-3004-7
  • Bout-Tabaku S, Briggs MS, Schmitt LC. Lower Extremity Pain Is Associated With Reduced Function and Psychosocial Health in Obese Children. Clinical Orthopaedics and Related Research. 2013;471(4): 1236–1244. https://doi.org/10.1007/s11999-012-2620-0
  • Rathleff MS, Rathleff CR, Olesen JL, Rasmussen S, Roos EM. Is Knee Pain During Adolescence a Self-limiting Condition?: Prognosis of Patellofemoral Pain and Other Types of Knee Pain. The American Journal of Sports Medicine. 2016;44(5): 1165–1171. https://doi.org/10.1177/0363546515622456
  • Fatoye F, Palmer S, Macmillan F, Rowe P, van der Linden M. Proprioception and muscle torque deficits in children with hypermobility syndrome. Rheumatology. 2009;48(2): 152–157. https://doi.org/10.1093/rheumatology/ken435
  • Adib N, Davies K, Grahame R, Woo P, Murray KJ. Joint hypermobility syndrome in childhood. A not so benign multisystem disorder? Rheumatology. 2005;44(6): 744–750. https://doi.org/10.1093/rheumatology/keh557
  • Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6): 1003–1007. https://doi.org/10.1097/j.pain.0000000000000160
  • Ittenbach RF, Huang G, Barber Foss KD, Hewett TE, Myer GD. Reliability and Validity of the Anterior Knee Pain Scale: Applications for Use as an Epidemiologic Screener. PLOS ONE. 2016;11(7): e0159204. https://doi.org/10.1371/journal.pone.0159204
  • Kuru T, Dereli EE, Yaliman A. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthopaedica Et Traumatologica Turcica. 2010;44(2): 152–156. https://doi.org/10.3944/AOTT.2010.2252
  • Tsze DS, von Baeyer CL, Pahalyants V, Dayan PS. Validity and Reliability of the Verbal Numerical Rating Scale for Children Aged 4 to 17 Years With Acute Pain. Annals of Emergency Medicine. 2018;71(6): 691-702.e3. https://doi.org/10.1016/j.annemergmed.2017.09.009
  • Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, et al. Pain in children and adolescents: a common experience. Pain. 2000;87(1): 51–58. https://doi.org/10.1016/S0304-3959(00)00269-4
  • Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome: Epidemiology of patellofemoral pain. Scandinavian Journal of Medicine & Science in Sports. 2010;20(5): 725–730. https://doi.org/10.1111/j.1600-0838.2009.00996.x
  • David ME, Ball SJ, Davies J, Reay D. Gender Issues in Parental Involvement in Student Choices of Higher Education. Gender and Education. 2003;15(1): 21–36. https://doi.org/10.1080/0954025032000042121
  • Selhorst M, Fernandez-Fernandez A, Cheng MS. Rasch analysis of the anterior knee pain scale in adolescents with patellofemoral pain. Clinical Rehabilitation. 2020;34(12): 1512–1519. https://doi.org/10.1177/0269215520942950
  • Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study. The American Journal of Sports Medicine. 2000;28(4): 480–489. https://doi.org/10.1177/03635465000280040701
  • D Myer G. Diagnostic Differences for Anterior Knee Pain between Sexes in Adolescent Basketball Players. Journal of Athletic Enhancement. 2014;03(01):1-10. https://doi.org/10.4172/2324-9080.1000139
  • Kim N, Browning RC, Lerner ZF. The effects of pediatric obesity on patellofemoral joint contact force during walking. Gait & Posture. 2019;73(1): 209–214. https://doi.org/10.1016/j.gaitpost.2019.07.307
  • Selhorst M, Rice W, Degenhart T, Jackowski M, Tatman M. Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. International Journal of Sports Physical Therapy. 2015;10(2): 178–188.
  • Hott A, Liavaag S, Juel NG, Brox JI, Ekeberg OM. The reliability, validity, interpretability, and responsiveness of the Norwegian version of the Anterior Knee Pain Scale in patellofemoral pain. Disability and Rehabilitation. 2021;43(11): 1605–1614. https://doi.org/10.1080/09638288.2019.1671499
  • Pacey V, Tofts L, Adams RD, Munns CF, Nicholson LL. Exercise in children with joint hypermobility syndrome and knee pain: a randomised controlled trial comparing exercise into hypermobile versus neutral knee extension. Pediatric Rheumatology. 2013;11(30):1-11. https://doi.org/10.1186/1546-0096-11-30
  • Muntaner-Mas A, Palou P, Vidal-Conti J, Esteban-Cornejo I. A Mediation Analysis on the Relationship of Physical Fitness Components, Obesity, and Academic Performance in Children. The Journal of Pediatrics. 2018;198(1): 90-97.e4. https://doi.org/10.1016/j.jpeds.2018.02.068
  • Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of Family Medicine and Primary Care. 2015;4(2): 187–192. https://doi.org/10.4103/2249-4863.154628
  • Macfarlane GJ, de Silva V, Jones GT. The relationship between body mass index across the life course and knee pain in adulthood: results from the 1958 birth cohort study. Rheumatology. 2011;50(12): 2251–2256. https://doi.org/10.1093/rheumatology/ker276
  • Zhou H, Roberts P, Horgan L. Association between self-report pain ratings of child and parent, child and nurse and parent and nurse dyads: meta-analysis. Journal of Advanced Nursing. 2008;63(4): 334–342. https://doi.org/10.1111/j.1365-2648.2008.04694.x
  • von Baeyer CL. Children’s Self-Reports of Pain Intensity: Scale Selection, Limitations and Interpretation. Pain Research and Management. 2006;11(3): 157–162. https://doi.org/10.1155/2006/197616
There are 34 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Mehmet Cenk Belibağlı 0000-0002-0074-4611

Nilüfer Aygün Bilecik This is me 0000-0002-5113-2287

Early Pub Date April 30, 2023
Publication Date April 30, 2023
Submission Date March 30, 2022
Published in Issue Year 2023 Volume: 14 Issue: 48

Cite

Vancouver Belibağlı MC, Aygün Bilecik N. Another neglected symptom among the overweight young: an analysis of the self-reported anterior knee pain scores of the secondary school children. Interdiscip Med J. 2023;14(48):25-30.