Michael Skovdal Rathleff

Aalborg University · Department of Health Science and Technology

The aim of this study was to investigate the effectiveness of shoe inserts and plantar fascia-specific stretching vs shoe inserts and high-load strength training in patients with plantar fasciitis. Forty-eight patients with ultrasonography-verified plantar fasciitis were randomized to shoe inserts and daily plantar-specific stretching (the stretch...

Background: More than 670,000 total knee replacements are performed annually in the United States; however, high-quality evidence to support the effectiveness of the procedure, as compared with nonsurgical interventions, is lacking. Methods: In this randomized, controlled trial, we enrolled 100 patients with moderate-to-severe knee osteoarthriti...

Background Patellofemoral pain (PFP) is common among adolescents and associated with long-lasting pain and disability. Patient education and exercise therapy are commonly used treatments in primary and secondary care but the effect of these treatments in adolescents is unknown. We aimed to determine the effect of exercise therapy as an add-on thera...

Introduction We aimed to describe Quality of life (QoL) among adolescents with Patellofemoral Pain (PFP) and Osgood-Schlatter Disease (OSD) according to the QoL subscale of The Knee injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol 5-dimensions (EQ-5D) and to investigate the characteristics associated with QoL. Methods This individual...

Background: One in three people worldwide will experience chronic musculoskeletal pain (CMP). Due to the long-standing nature of CMP, it is inevitable that people with CMP will have to engage in some form of self-management. As highlighted by multiple clinical practice guidelines, it becomes pivotal that healthcare professionals provide effective s...

Objective This study aimed to develop a clinical decision-support tool (The MAP-Knee Tool) to improve the management of adolescents with non-traumatic knee pain. Methods This multi-step study consisted of five steps ((1-4) initial development and (5) end-user testing with adolescents with or without non-traumatic knee pain and medical doctors). It...

Evidence and gap maps (EGM) can be used to identify gaps within specific research areas and help guide future research agendas and directions. Currently, there are no EGMs within the broad domain of chronic musculoskeletal (MSK) pain in adults. The aim of this study was to create a contemporary EGM of interventions and outcomes used for research in...

De ziekte van Osgood-Schlatter komt veel voor bij fysiek actieve kinderen en adolescenten. Ze krijgen pijn in een knie tijdens of na het sporten. Dat kan op die leeftijd grote invloed hebben op de lichamelijke en psychische gesteldheid. De klachten verdwijnen meestal vanzelf als de patiënt rust houdt en de knie belast op geleide van de pijn, maar h...

INTRODUCTION Perceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand “what’s wrong with me” . Our aim is to develop credible explanations (trustworthy and understandable explanation of the condition) for adolescents suffering from chronic non-traumatic knee pain. METHODS This mul...

Objectives The main objective was to investigate 5-year outcomes in patients with knee osteoarthritis, randomised to one of two non-surgical treatments. Setting Two outpatient clinics. Participants At baseline, 100 patients with radiographic and symptomatic knee osteoarthritis not found eligible for knee replacement (KR) were included. Main exclu...

BACKGROUND Longstanding knee pain is one of the most common reasons for adolescents (age 10-19) to consult general practice. One in two adolescents will continue to experience pain after 2 years, but exercises and self-management education can improve the prognosis. However, adherence to exercises and self-management education interventions remain...

The aim was to evaluate patient-reported outcomes before and after a patient-centered management strategy targeting concurrent proximal musculoskeletal complaints (MSCs) in patients with an isolated hand/forearm complaint. A prospective interventional study included 66 patients. Intervention targeting concurrent MSCs was implemented as a patient-ce...

Objectives: The aim of this study was to examine how the “wait-and-see” recommendation affects adolescents’ understanding of their illness and symptoms and their care-seeking behavior. Methods: This study included brief qualitative, semistructured online interviews. Adolescents (age 10–19 years) with long-term knee pain, who had been recommended “...

Background Running is a popular sport with widely recognized health benefits. Given the high rates of knee injury in runners and the growing prevalence of knee osteoarthritis (KOA), it may be useful to assess perceptions about running and knee joint health. Purpose The objectives of this study were to (1) explore and compare the perceptions of the...

Introduction Variable eligibility criteria across studies on plantar heel pain may result in compromising the generalisability of meta-analyses when heterogeneity is not accounted for. We aimed to explore: (i) heterogeneity of participant eligibility criteria in studies that have investigated plantar heel pain, and (ii) associations between key eli...

Background The heel fat pad is an important structure of the foot as it functions as a cushion to absorb shock and distribute plantar force during ambulation. Clinical practice guidelines or decision support platforms emphasize that heel fat pad syndrome (HFPS) is a distinct pathology contributing to plantar heel pain. We aimed to identify and synt...

Objectives Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to estab...

BACKGROUND AND OBJECTIVES Up to one third of children may be diagnosed with growing pains, but considerable uncertainty surrounds how to make this diagnosis. The objective of this study was to detail the definitions of growing pains in the medical literature. METHODS Scoping review with 8 electronic databases and 6 diagnostic classification system...

Importance: Corticosteroid injections and exercise therapy are commonly used to treat chronic midportion Achilles tendinopathy, but the evidence for this combination is limited. Objective: To investigate the effect of corticosteroid injection and exercise therapy compared with placebo injection and exercise therapy for patients with Achilles ten...

Background: Musculoskeletal (MSK) pain is one of the most common reasons for consulting the general practitioner (GP) who can provide several treatments for managing MSK pain. One treatment option is pain medication. The aim of the present study was to explore the GPs’ attitudes towards: 1) management of MSK pain; 2) prescription of pain medication...

Background: In recent decades, navigation in modern healthcare has become increasingly difficult. Since the 1970s, the term health literacy (HL), defined as an individual’s ability to access, understand, appraise, and apply health information, has been increasingly used in the field of health science. Research indicates that low HL may interfere wi...

"What is the big deal about back pain in children and adolescents? Doesn't it just go away if you give it time and rest?" [...].

Background : The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of...

Objective Patellofemoral pain (PFP) is a common musculoskeletal condition, which has a negative effect on physical activity and function. Currently, it is unknown how and why individuals with PFP modify their physical activity. The purpose of this qualitative study was to explore the experience of knee pain on physical activity and everyday life in...

Background : The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of...

Objective To investigate firstly the efficacy of three different dosages of one home-based, knee-extensor resistance exercise on knee-extensor strength in patients eligible for knee replacement, and secondly, the influence of exercise on symptoms, physical function and decision on surgery. Method One-hundred and forty patients eligible for knee re...

Objective To identify challenges confronting patients and physiotherapists in managing patellofemoral pain by seeking their perspectives via generative activities involving critique, ideation and formulating shared visions for future treatments. Design Two Future Workshops, Reflexive Thematic Analysis. Methods We recruited 8 patients (median age...

Synopsis: To understand pain, professionals need a basic understanding of neuroscience. The "pain science in practice" series is aimed at clinicians and explains key elements of pain-related sciences and the role they play in clinical practice, from clinical reasoning to management. J Orthop Sports Phys Ther 2022;52(3):125-126. doi:10.2519/jospt.2...

Aim: The aim of this study was to assess the care-seeking behaviour among adolescents with patellofemoral pain (PFP). Methods: This retrospective study included data on 121 adolescents with PFP enrolled in a randomized controlled trial. A questionnaire was sent to the general practitioner (GP) of each adolescent, assessing information on the consul...

Achilles tendinopathy is among the most frequent tendon injuries in sport. Despite evidence-based management, a significant proportion of patients continue to experience symptoms. This is the first randomised trial to investigate the effect of tendoscopic treatment of midportion Achilles tendinopathy compared with placebo at baseline, 3, 6 and 12 m...

Background Eight percent of all child and adolescent general practice consultations are due to musculoskeletal conditions, with pain as the most frequent symptom. Despite the commonality of musculoskeletal pain, limited knowledge exists about care-seeking children and adolescents with musculoskeletal pain. The purpose of this study was to describe...

Background Medical imaging can be used to assist with the diagnosis of plantar heel pain. The aim of this study was to synthesise medical imaging features associated with plantar heel pain. Methods This systematic review and meta-analysis conducted searches in MEDLINE, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to 12th Feb...

Introduction Each year, 8% of children and adolescents consult their general practitioner (GP) due to musculoskeletal conditions, with pain the most frequent symptom. There is limited knowledge about this care-seeking population. The purpose of this study is to describe children and adolescents consulting their GP due to musculoskeletal pain. Mate...

Introduction Plantar heel pain (PHP) used to be considered a self-limiting condition, where pain was thought to resolve within a year after onset. A number of studies with varying quality of oucomes and small sample-sizes have questioned the benign nature of PHP. The aim of this study was to explore the long-term prognosis of individuals treated fo...

Objective: To decide clinical and research priorities on pain features and psychological factors in persons with patellofemoral pain. Design: Consensus development process. Methods: We undertook a 3-stage process consisting of (1) updating 2 systematic reviews on quantitative sensory testing of pain features and psychological factors in patell...

Background Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to estab...

Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless,...

Objectives The prevalence of pain medication use for adolescent knee pain and factors associated with use are not well understood. This study aimed to determine the self-reported use of pain medication for knee pain and identify factors associated with use in adolescents (age 10–19) with longstanding knee symptoms. Methods In this exploratory cros...

Objective: To determine whether the effect of hip exercise on patellofemoral pain is mediated through changes in hip muscle strength or psychological factors. Design: Secondary mediation analysis of a randomized clinical trial, in which 218 participants with patellofemoral pain were randomly assigned to receive foot orthoses or hip exercises. M...

Background: Osgood-Schlatter disease (OSD) is a non-traumatic knee problem that primarily observed in sports active children and adolescents between the age of 8 and 15. Aim: The objective of this study was to determine the incidence of OSD and to gain insight into the management of children and adolescents with OSD in general practice. Design...

Objective To test if 1) the 45-s Anterior Knee Pain Provocation Test (AKPP-test) could differentiate between adolescents with patellofemoral pain (PFP) and pain-free controls and; 2) whether improvements in the AKPP-test over 12 weeks were associated with improvements in self-reported knee function and pain. Design Prospective cohort. Patients 15...

The cover image is based on the Review Article A systematic review of imaging findings in patients with Osgood-Schlatter disease by Line Bay Sørensen et al., https://doi.org/10.1002/tsm2.281.

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinici...

Patient education is essential to enable rehabilitation and self-management of longstanding knee pain in adolescents. Currently, a lack of insights into the socio-cognitive processes governing adolescents’ self-management remains an obstacle for enhancing treatment efficacy. This study developed a conceptual model for integrating adolescents’ chall...

Objectives Musculoskeletal pain is common among children and adolescents. Despite the lack of evidence regarding harms and benefits, musculoskeletal pain is often managed with pain medication. The aim of this systematic review is to assess the prevalence of pain medication use for musculoskeletal pain among children and adolescents and the factors...

Background Each year, 8% of all child and adolescent consultations in general practice are due to musculoskeletal conditions, with pain as the most frequent symptom. Despite the commonality of musculoskeletal pain, limited knowledge exists about care-seeking children and adolescents with musculoskeletal pain. The purpose of this study was to descri...

Background The objective was to investigate the feasibility of blood flow restricted exercise (BFRE) as a rehabilitation modality in patients with a unilateral ankle fracture. Methods Feasibility study with a prospective cohort design. Inclusion criteria were above 18 years of age and unilateral ankle fractures. Exclusion criteria: history of card...

This systematic review aimed to describe the imaging characteristics of Osgood‐Schlatter (OSD) compared with controls and imaging findings over time. A systematic search was conducted in Embase, CINAHL, and PubMed from inception until July 2021. Forty studies were eligible and included based on inclusion criteria on OSD diagnosis, the number of pat...

Background : The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of...

Background Osgood-Schlatter disease (OSD), an apophyseal injury of the tibial tuberosity, affects up to 1 in 10 adolescents. This condition has previously been assumed to be innocuous and to self-resolve with limited intervention. Purpose To investigate the 24-month prognosis of OSD and examine if ultrasound (US) classification is associated with...

Background Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain. Method A systematic search on Medline identified the literature on clinical te...

Patellofemoral pain is a common and often debilitating musculoskeletal condition. Clinical translation and evidence synthesis of patellofemoral pain research are compromised by heterogenous and often inadequately reported study details. This consensus statement and associated checklist provides standards for REPORTing of quantitative PatelloFemoral...

Background: A strong recommendation against subacromial decompression surgery was issued in 2019. This leaves nonoperative care as the only treatment option, but recent studies suggest that the dose of strengthening exercise is not sufficient in current nonoperative care. At this point, it is unknown if adding more strengthening to current nonoper...

Introduction: Multi-site pain has not been investigated among adolescents suffering from knee pain. This study aimed to examine the trajectory of pain in adolescents with knee-pain, to determine if multi-site pain in adolescents together with other established prognostic factors (frequency of pain, sex, sports participation, Health Related Quality...

Aim: To determine the knowledge and confidence of physiotherapists in managing knee osteoarthritis (OA) and patellofemoral pain (PFP); and explore their learning behaviors and preferences related to the management of these knee conditions. Methods: One hundred and sixteen Australian and Canadian Physiotherapists were recruited via social media, e-m...

Objectives To firstly investigate the efficacy of three different dosages of home-based, knee-extensor strength exercise on isometric knee-extensor strength in patients eligible for knee replacement due to severe knee osteoarthritis, and secondly, the influence of exercise on symptoms, physical function and decision on surgery. Design Randomized do...

Objective To develop a best practice guide for managing people with plantar heel pain (PHP). Methods Mixed-methods design including systematic review, expert interviews and patient survey. Data sources Medline, Embase, CINAHL, SPORTDiscus, Cochrane Central Register of Controlled Trials, trial registries, reference lists and citation tracking. Sem...

Musculoskeletal pain is common in the general pediatric population and is a challenge to youth, their parents, and society. The majority of children experiencing musculoskeletal pain will recover; however, a small subgroup of youth develops chronic pain. There is limited understanding of the factors that affect the transition from acute to chronic...

Objective We assessed past-season, pre-season and in-season risk factors to investigate their association with an in-season groin problem in male amateur football players. Methods Past-season groin-pain information and pre-season short-lever and long-lever adductor squeeze strength were obtained at baseline, together with anthropometrics (weight,...

Adolescent knee pain has a propensity for chronicity, impacting physical activity and health into adulthood. The aim of this study is to investigate prognostic factors in adolescents with knee pain using Individual Participant Data (IPD) meta-analysis. Studies were identified through a systematic search and a collaborative group. We included IPD fr...

This study investigated the weekly prevalence of groin problems over a 3-week football pre-season, compared to a 39-week competitive in-season. We registered time-loss groin injuries, and self-reported weekly groin-pain in 17 amateur male football teams (386 players). The average weekly prevalence of groin problems (prevalence ratio (PR)) was 1.8 t...

Objective: In a future full-scale randomised controlled trial, we plan to compare satisfaction with a standard website versus satisfaction with a participatory driven web-application. The participatory driven web-application may facilitate the delivery of targeted evidence-based advice and information to patients with low back pain in general prac...