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Clinical Prediction Rules

1. Patellar taping CPR for treating patellofemoral pain


Patients with patellofemoral pain will have a 52% to 83% chance of a successful outcome from a medial glide patellar technique if:

  •  Positive patellar tilt test
  • Tibial varum greater than 5 degrees

2. Patients with knee pain and evidence of knee OA who would benefit from a hip mobilization


92% chance of a favorable short-term response to a hip mobilization if 1/5 of the following parameters are met, 97% chance if 2/5 are met:

  • Hip or groin pain or paresthesia
  • Anterior thigh pain
  • Passive knee flexion less than 122 degrees
  • Passive hip internal rotation less than 17 degrees
  • Pain with hip distraction

3. Lumbopelvic manipulation for patients with patellofemoral pain syndrome (PFPS)


Patients with PFPS will have a positive immediate response if:

  • Side to side difference in hip internal rotation > 14 degrees**
  • Ankle dorsiflexion with knee flexed > 16 degrees
  • Navicular drop > 3mm
  • No self-reported stiffness with sitting >20 min
  • Squatting reported as most painful activity­

·      {C}**If present, chance of a successful outcome improves from 45% to 80%


4. Ottawa Knee CPR to rule in/out radiography of the knee after trauma


Meeting at least one of the following criteria suggests an x-ray referral

  • Age 55 years or older
  • Isolated tenderness of patella and/or fibular head
  • Inability to flex to 90 degrees
  • Inability to bear weight both immediately and in the emergency department (4 steps)


1. Lesher JD, Sutlive TG, Miller GA, et al. Development of a clincial prediction rule for classifying patients with patellofemoral pain syndrome who respond to patellar taping. J Orthop Sports Phys Ther. 2006;36(11):854-866.

2. Currier LL, Froelich PJ, Carow SD, et al. Development of a clinical prediction rule to identify patients with knee pain and clincial evidence of knee osteoarthritis who demonstrate a favorable short-term response to hip mobilization. Phys Ther. 2007;87(9):1106-1119. 

3. Iverson CA, Sutlive TG, Crowell MS, et al. Lumbopelvic manipulation for the treatment of patients with patellofemoral pain syndrome: development of a clinical prediction rule. J Orthop Sports Phys Ther. 2008;38(6):297-309. 

4. Tandeter HB, Shvartzman P, Stevens MA. Acute knee injuries: use of decision rules for selective radiograph ordering. Am Fam Physician. 1999;60(9):2599-2608.