Publications by authors named "Marcella F Pazzinatto"

9 Publications

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Altmetric Score Has a Stronger Relationship With Article Citations Than Journal Impact Factor and Open Access Status: A Cross-Sectional Analysis of 4,022 Sports Science Articles.

J Orthop Sports Phys Ther 2021 Jul 1:1-19. Epub 2021 Jul 1.

La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Melbourne, VIC, Australia.

Objective: To assess the relationship of individual article citations in the Sport Sciences field to (i) journal impact factor; (ii) each article's open access status; and (iii) Altmetric score components.

Design: Cross-sectional.

Methods: We searched the ISI Web of Knowledge InCites Journal Citation Reports database "Sport Sciences" category for the 20 journals with the highest 2-year impact factor in 2018. We extracted the impact factor for each journal and each article's open access status (yes or no). Between September 2019 and February 2020, we obtained individual citations, Altmetric scores and details of Altmetric components (e.g. number of tweets, Facebook posts, etc.) for each article published in 2017. Linear and multiple regression models were used to assess the relationship between the dependent variable (citation number) and the independent variables article Altmetric score and open access status, and journal impact factor.

Results: 4,022 articles were included. Total Altmetric score, journal impact factor and open access status, respectively explained 32%, 14%, and 1% of the variance in article citations (when combined, the variables explained 40% of the variance in article citations). The number of tweets related to an article was the Altmetric component that explained the highest proportion of article citations (37%).

Conclusion: Altmetric scores in Sports Sciences journals have a stronger relationship with number of citations than does journal impact factor or open access status. Twitter may be the best social media platform to promote a research article as it has a strong relationship with article citations. .
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http://dx.doi.org/10.2519/jospt.2021.10598DOI Listing
July 2021

Women with patellofemoral pain and knee crepitus have reduced knee flexion angle during stair ascent.

Phys Ther Sport 2021 Mar 17;48:60-66. Epub 2020 Dec 17.

University of Toledo, School of Exercise and Rehabilitation Sciences, Toledo, OH, USA. Electronic address:

Objectives: To compare trunk and knee biomechanics of women with and without patellofemoral pain (PFP) and knee crepitus during stair ascent.

Design: Cross-sectional.

Setting: Laboratory-based study.

Participants: 29 women with PFP and knee crepitus (PFP); 28 women with PFP and no knee crepitus (PFP); 17 pain-free women with knee crepitus (Pain-free); and 29 pain-free women without knee crepitus (Pain-free).

Main Outcome Measures: Peak trunk flexion, peak knee flexion, mean knee angular velocity, knee extensor moment at peak knee flexion, peak and impulse of the knee extensor moment.

Results: PFP group performed the stair ascent task with reduced peak knee flexion compared to Pain-free (p = 0.04; Effect size = -0.85) and Pain-free (p = 0.03; Effect size = -0.75). No significant differences among groups were found for peak trunk flexion (p = 0.979), knee angular velocity (p = 0.420), knee extensor moment at peak knee flexion (p = 0.933), peak (p = 0.290) and impulse (p = 0.122) of the knee extensor moment.

Conclusion: Women with concomitant PFP and knee crepitus demonstrated reduced knee flexion during stair ascent, but no significant differences for trunk flexion and knee extensor moment variables were found.
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http://dx.doi.org/10.1016/j.ptsp.2020.12.013DOI Listing
March 2021

Fear of movement and (re)injury is associated with condition specific outcomes and health-related quality of life in women with patellofemoral pain.

Physiother Theory Pract 2020 Oct 27:1-10. Epub 2020 Oct 27.

La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.

Objectives: Investigate the association of fear of movement and (re)injury with clinical outcomes in women with patellofemoral pain (PFP).

Methods: This cross-sectional study included 92 women with PFP who completed the TAMPA scale for kinesiophobia. The TAMPA score and its two subscales - activity avoidance and somatic focus were correlated with BMI, physical activity level, pain catastrophizing scale, health-related quality of life, pain sensitivity via pressure pain threshold, self-reported disability, and worst knee pain in last month.

Results: Greater fear of movement and (re)injury, activity avoidance, and somatic focus were correlated with lower local pain sensitivity (rho = -0.29 to -0.55), lower health-related quality of life (rho = -0.38 to -0.42), greater pain catastrophizing (rho = 0.41 to 0.47), and greater self-reported disability (rho = -0.31 to -0.52). Greater fear of movement and (re)injury and activity avoidance were correlated with adjacent and remote pain sensitivity (rho = -0.24 to -0.39). Greater fear of movement and (re)injury and somatic focus were correlated with greater worst knee pain in last month (rho = 0.21 to 0.32). Fear of movement and (re)injury predicted pain measures, disability, and health-related quality of life (p ≤ 0.010).

Conclusion: The relationship of greater fear of movement and (re)injury with greater disability, pain catastrophizing, pain sensitization, and poorer health-related quality of life highlights the potential importance of considering this psychological feature of PFP during assessment and management.
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http://dx.doi.org/10.1080/09593985.2020.1830323DOI Listing
October 2020

Novel Stepped Care Approach to Provide Education and Exercise Therapy for Patellofemoral Pain: Feasibility Study.

J Med Internet Res 2020 07 22;22(7):e18584. Epub 2020 Jul 22.

La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.

Background: Patellofemoral pain (PFP) impairs joint- and health-related quality of life and may be associated with knee osteoarthritis. We developed a novel, 2-phase, stepped-care approach for PFP, combining (1) self-directed web-based education and exercise therapy with (2) physiotherapist-supported education and exercise therapy. Physiotherapy sessions can be provided using 2 different modalities: face-to-face and telerehabilitation.

Objective: This study aims to (1) determine the feasibility of our stepped-care approach, (2) explore patient-reported outcomes following self-directed web-based education and exercise therapy in people with PFP (phase 1), and (3) estimate the differences in treatment effects between face-to-face and telerehabilitation to support further education and exercise therapy (phase 2) in those who had not completely recovered following self-directed care.

Methods: Phase 1 involved 6 weeks of self-directed web-based education and exercise therapy. Phase 2 involved random allocation to a further 12 weeks of physiotherapist-led (up to 8 sessions) education and exercise therapy delivered face-to-face or via telerehabilitation to participants who did not rate themselves as completely recovered following phase 1. Feasibility indicators of process, adherence, and participant retention were collected as primary outcomes alongside patient-reported outcomes on Global Rating of Change and knee pain, disability, knee-related quality of life, pain catastrophism, kinesiophobia, and knee self-efficacy. All participants were assessed at baseline, 6 weeks, and 18 weeks.

Results: A total of 71 participants were screened to identify 35 participants with PFP to enter the study. Overall, 100% (35/35) and 88% (31/35) of the participants were followed up with at 6 and 18 weeks, respectively. In phase 1 of the study, participants accessed the My Knee Cap website for an average of 6 (7.5) days and performed the exercises for an average of 2.5 (3.6) times per week. A total of 20% (7/35) of the participants reported that they had completely recovered at 6 weeks. Furthermore, 93% (26/28) of the participants who were followed up and had not completely recovered at 6 weeks agreed to be enrolled in phase 2. No statistically significant differences were found between the face-to-face and telerehabilitation groups for any outcome. The novel stepped-care approach was associated with marked improvement or complete recovery in 40% (14/35) of the participants following phase 1 and 71% (25/35) of the participants following phase 2.

Conclusions: Self-directed web-based education and exercise therapy for people with PFP is feasible, as noted by the high rate of participant retention and home exercise adherence achieved in this study. Furthermore, 20% (7/35) of people reported complete recovery at 6 weeks. Both face-to-face and telerehabilitation physiotherapy should be considered for those continuing to seek care, as there is no difference in outcomes between these delivery modes. Determining the efficacy of the stepped-care model may help guide more efficient health care for PFP.
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http://dx.doi.org/10.2196/18584DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407256PMC
July 2020

Pain and disability in women with patellofemoral pain relate to kinesiophobia, but not to patellofemoral joint loading variables.

Scand J Med Sci Sports 2020 Nov 27;30(11):2215-2221. Epub 2020 Jul 27.

Department of Physiotherapy, School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Brazil.

Background: Altered patellofemoral joint (PFJ) loading and elevated kinesiophobia are commonly reported in people with patellofemoral pain (PFP). However, the relative relationship of these physical-psychological variables with pain and disability in people with PFP is unknown.

Aim: To explore the relationship of PFJ loading during stair ascent and kinesiophobia, with self-reported pain and disability in women with PFP.

Methods: Fifty-seven women with PFP completed the Tampa Scale for Kinesiophobia, a Visual Analog Scale (0-100 mm) for pain during stair ascent, and the Anterior Knee Pain Scale (disability). Stair ascent mechanics were assessed via three-dimensional motion analysis while participants ascended an instrumented seven-step staircase. Peak PFJ contact force and stress, and PFJ contact force and stress loading rates were estimated using a musculoskeletal model. The relationships of PFJ kinetics during stair ascent and kinesiophobia, with the Anterior Knee Pain Scale (disability) and pain during stair ascent, were evaluated with Spearman rank correlation. Variables (kinetics and kinesiophobia) significantly correlating with the dependent variables (pain and disability) were inserted in linear regression models.

Results: Kinesiophobia was moderately associated with self-reported pain (rho = 0.37) and disability (rho = -0.58) in women with PFP. No PFJ loading variables were found to be associated with self-reported pain or disability (P > .05). Kinesiophobia explained 14% of the variance of participants' pain while ascending stairs and 33% of the variance of participant's self-reported disability.

Conclusion: Addressing kinesiophobia during treatment of women with PFP may be important to reduce self-reported pain and disability.
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http://dx.doi.org/10.1111/sms.13767DOI Listing
November 2020

Knee and Hip Isometric Force Steadiness Are Impaired in Women With Patellofemoral Pain.

J Strength Cond Res 2019 Jul 22. Epub 2019 Jul 22.

Laboratory of Biomechanics and Motor Control (LABCOM), Physiotherapy Department, School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.

Ferreira, AS, de Oliveira Silva, D, Ferrari, D, Magalhães, FH, Pappas, E, Briani, RV, Pazzinatto, MF, and de Azevedo, FM. Knee and hip isometric force steadiness are impaired in women with patellofemoral pain. J Strength Cond Res XX(X): 000-000, 2019-The purposes were as follows: to compare knee extension and hip abduction force steadiness and maximal strength between women with patellofemoral pain (PFP) and pain-free women; and to investigate whether maximal strength, self-reported pain during force-matching tasks, self-reported knee function, symptoms duration, and physical activity level are associated with knee extension and hip abduction force steadiness. Thirty women with PFP and 30 pain-free women were recruited. Knee extension and hip abduction maximal voluntary isometric contractions and submaximal isometric force-matching tasks were evaluated using an isokinetic dynamometer. Subjects were asked to match a target force corresponding to 10% of their maximal isometric voluntary contraction while force steadiness was computed as the coefficient of variation (CV) of the exerted force. Women with PFP had significant 36% lower knee extension and 33% lower hip abduction peak strength. They also had significant 70% lower knee extension force steadiness and 60% lower hip abduction force steadiness (i.e., higher CV) than pain-free women. Self-reported pain and self-reported knee function were significantly associated (r = 0.61, p < 0.001; r = -0.35, p = 0.05) and able to predict 41% of the variance of knee extensor force steadiness. Hip abductor maximum strength was significantly associated (r = -0.57; p = 0.001) and able to predict 32% of the variance of hip abductor force steadiness. These findings indicate that muscle impairments in PFP go beyond only low knee and hip muscle strength because women with PFP also present deficits in knee extension and hip abduction force steadiness. Evidence-based treatments aiming at improving force steadiness may be a promising addition to PFP rehabilitation programs.
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http://dx.doi.org/10.1519/JSC.0000000000003215DOI Listing
July 2019

Impaired Isometric, Concentric, and Eccentric Rate of Torque Development at the Hip and Knee in Patellofemoral Pain.

J Strength Cond Res 2021 Sep;35(9):2492-2497

Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), President Prudente, Sao Paulo, Brazil; and.

Abstract: Ferreira, AS, de Oliveira Silva, D, Barton, CJ, Briani, RV, Taborda, B, Pazzinatto, MF, and de Azevedo, FM. Impaired isometric, concentric, and eccentric rate of torque development at the hip and knee in patellofemoral pain. J Strength Cond Res 35(9): 2492-2497, 2021-The aims of this study were to compare maximal muscle strength and rate of torque development (RTD) of knee extensor and hip abductor during isometric, concentric, and eccentric contractions between women with and without patellofemoral pain (PFP). Thirty-eight women with PFP (PFPG) and 38 pain-free women (CG) participated in this study. Isometric, concentric, and eccentric maximal torque and RTD of knee extensor and hip abductor were assessed using an isokinetic dynamometer. Rate of torque development was calculated as the change in torque over the change in time from torque onset to 30, 60, and 90% of the maximal torque (RTD30%, RTD60%, and RTD90%) during isometric, concentric, and eccentric contractions. PFPG had lower isometric, concentric, and eccentric knee extensor maximal torque (29.9, 28.3, and 26.7%) compared with the CG. For knee extensor RTD, PFPG had slower isometric RTD30% (17.8%), RTD60% (21.5%), and RTD90% (23.4%); slower concentric RTD30% (35.7%), RTD60% (29.3%), and RTD90% (28.2%); and slower eccentric RTD30% (20.5%), RTD60% (25.2%), and RTD90% (22.5%) compared with the CG. PFPG had lower isometric, concentric, and eccentric hip abductor maximal torque (28.3, 21.8, and 17%) compared with the CG. For hip abductor RTD, PFPG had slower isometric RTD30% (32.6%), RTD60% (31.1%), and RTD90% (25.4%); slower concentric RTD90% (11.5%); and slower eccentric RTD30% (19.8%), RTD60% (26.4%), and RTD90% (24%) compared with the CG. In conclusion, women with PFP presented deficits in both maximal strength and RTD of knee extensor and hip abductor during isometric, concentric, and eccentric contractions, which highlight the potential importance of addressing different aspects of muscle function through exercise therapy.
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http://dx.doi.org/10.1519/JSC.0000000000003179DOI Listing
September 2021

Influence of kinesiophobia and pain catastrophism on objective function in women with patellofemoral pain.

Phys Ther Sport 2019 Jan 28;35:116-121. Epub 2018 Nov 28.

São Paulo State University (UNESP), School of Science and Technology, Laboratory of Biomechanics and Motor Control (LABCOM), Presidente Prudente, Brazil; La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Victoria, Australia. Electronic address:

Objectives: (i) To compare kinesiophobia, pain catastrophism and objective function between women with patellofemoral pain (PFP) and pain-free; (ii) to investigate the association of kinesiophobia and pain catastrophism with objetive function in women with PFP.

Design: Case-control.

Setting: Laboratory-based.

Participants: Fifty-five women with PFP and forty pain-free women.

Main Outcome Measures: Kinesiophobia and pain catastrophism were assessed using the Tampa Scale of Kinesiophobia and Pain Catastrophizing Scale, respectively. Forward step-down, single leg hop, and modified star balance tests were used to assess objective function. Independent t-tests were used for between-groups comparisons and Pearson correlation coefficients were used to investigate the association between the outcomes.

Results: Women with PFP had significantly worse kinesiophobia (p < 0.001; Effect size (ES) = 1.16), pain catastrophism (p < 0.001; ES = 1.57), and poorer objective function (step-down, (p < 0.001; ES = 0.99); single-leg hop (p = 0.002; ES = 0.74); modified star balance (p < 0.001; ES = 0.66) than pain-free controls. Kinesiophobia and pain catastrophism were not correlated with objective function.

Conclusion: Greater kinesiophobia, pain catastrophism and poorer objective function is evident in women with PFP, compared to pain-free controls. Kinesiophobia and pain catastrophism were not associated with objective function in women with PFP. Future research is necessary to understand how other physical and psychological factors might affect objective function.
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http://dx.doi.org/10.1016/j.ptsp.2018.11.013DOI Listing
January 2019

Different pain responses to distinct levels of physical activity in women with patellofemoral pain.

Braz J Phys Ther 2017 Mar - Apr;21(2):138-143. Epub 2017 Mar 17.

Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia (FCT), Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Presidente Prudente, SP, Brazil. Electronic address:

Background: Physical activity levels seem to play a role in patellofemoral pain (PFP); however, few studies have been conducted to confirm this hypothesis.

Objectives: To determine the reported pain levels of women with and without PFP who maintain different levels of physical activity; to determine the capability of these levels to predict pain; and to test the capability of two stair-negotiation protocols, with and without external load, to equalize pain between groups.

Method: Four groups were divided based on the women's physical activity levels: moderate activity PFP group (28), moderate activity control group (23), intense activity PFP group (22), and intense activity control group (22). All participants were asked to perform 15 repetitions of stair negotiation with and without external load on a seven-step staircase on two separate days. Pain levels were reported using a visual analog scale at five distinct moments: previous month, before stair negotiation, after stair negotiation, before patellofemoral joint (PFJ) loading protocol, and after PFJ loading protocol.

Results: The intense activity PFP group showed higher levels of pain than the moderate activity PFP group (F=11.714, p=0.000, η=0.30). The PFJ loading protocol was able to equalize and exacerbate pain in the PFP groups.

Conclusion: Intense physical activity seems to have a higher association with knee pain than moderate physical activity. A PFJ loading protocol may be an alternative to equalize pain in women with PFP during clinical assessments.
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http://dx.doi.org/10.1016/j.bjpt.2017.03.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537465PMC
October 2017
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