Scripties UMCG - Rijksuniversiteit Groningen
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Association between psychological factors and clinical symptoms in patients with patellar and Achillestendinopathy: a cross-sectional study

(2017) Bernts, D.J.A.

INTRODUCTION – Patellar and Achilles tendinopathy are overuse injuries of the tendon
which are characterized by disability and pain. Tendinopathy can have a negative influence on
an athlete’s sport carrier and can give limitations in daily life. In contrast to the clinical
presentation, little is known about the role of psychological factors in patellar and Achilles
tendinopathy. OBJECTIVES – The aim of this study is to gain insight into the effect of
having tendinopathy on psychological factors by investigating the relation between
psychological factors and clinical symptoms in patients with tendinopathy. DESIGN – Crosssectional
study. METHODS – 30 participants, from whom 13 patellar tendinopathy and 17
Achilles tendinopathy patients were included in this study. Paper questionnaires were used to
collect demographic and health information, scores on clinical outcome measures and scores
on questionnaires assessing psychological factors. Outcome measures were severity of clinical
symptoms, pain, pain catastrophizing, kinesiophobia, the psychological readiness to return to
sport, the multidimensional health locus of control internal, expectations, motivation and
satisfaction. Spearmans correlation coefficient was used to determine the relation between
clinical symptoms and psychological factors. The Mann-Whitney U test was used to test for
differences between groups based on severity of symptoms, level of pain, gender, type of
tendinopathy and duration of symptoms. RESULTS – Clinical severity of symptoms was
moderately correlated with the psychological readiness to return to sport (r=.66), pain
catastrophizing (r=-.63) and helplessness (r=-.63). Males had a significant higher level of
kinesiophobia than females (p<.01). Patellar tendinopathy patients had a significantly higher
level of pain catastrophizing and helplessness than Achilles tendinopathy patients (P<.05)
CONCLUSION – The psychological readiness to return to sport and pain catastrophizing are
associated with the clinical severity of tendinopathy. Tendinopathy patients with more clinical
symptoms, male tendinopathy patients and patella tendinopathy patients seems to be at risk
for developing psychological problems.

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