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Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome

Primary Purpose

Patellofemoral Pain Syndrome

Status
Recruiting
Phase
Not Applicable
Locations
Egypt
Study Type
Interventional
Intervention
Patellar mobilization, retinacula release, deep friction message, stretch and strength
Sponsored by
Cairo University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Patellofemoral Pain Syndrome focused on measuring patellofemoral pain syndrome, strength, stretch, mobilization, release, deep friction message, retinacula

Eligibility Criteria

18 Years - 35 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Age ranging between 18 and 35 years Tenderness of medial and lateral borders of patella Retropatellar pain Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks Positive patellar compression test Pain intensity is more than 3 at visual analogue scale Had a history of insidious onset Had anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squatting Exclusion Criteria: Previous patellar realignment surgery or patellar fracture Had a history of traumatic patellar dislocation Had a history of previous knee surgery Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction Taking corticosteroids or nonsteroidal anti-inflammatory medication Inability to attend treatment program to the end of sessions

Sites / Locations

  • Cairo UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Group (1)

Group (2)

Arm Description

patients will receive stretch and strength exercises

patients will receive stretch, strength, patellar mobilization, retinacula release and deep friction message

Outcomes

Primary Outcome Measures

Changes in pain that felt during ascending, descending, squatting and prolonged sitting
Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.
Changes in functional disability
Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.

Secondary Outcome Measures

Changes in hip abductors strength
It will be assessed using handheld dynamometer
Changes in hip external rotators strength
It will be assessed using handheld dynamometer
changes in quadriceps strength
It will be assessed using handheld dynamometer
changes in functional performance
It will be assessed using step down test
changes in hamstring flexibility
It will be assessed using 90-90 test
changes in gastrocnemius flexibility
It will be assessed using ankle dorsiflexion range of motion
changes in knee valgus
It will be assessed using Q angle
changes in foot pronation
It will be assessed using navicular drop test

Full Information

First Posted
October 26, 2022
Last Updated
February 2, 2023
Sponsor
Cairo University
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1. Study Identification

Unique Protocol Identification Number
NCT05665452
Brief Title
Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome
Official Title
Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 15, 2023 (Actual)
Primary Completion Date
August 15, 2023 (Anticipated)
Study Completion Date
September 15, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Cairo University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises. Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.
Detailed Description
this is interventional study in which patients will receive stretching and strengthening exercises in control group. in addition, experimental group will receive the same exercises of control group in addition to patellar mobilization, retinacula release and deep friction message.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Patellofemoral Pain Syndrome
Keywords
patellofemoral pain syndrome, strength, stretch, mobilization, release, deep friction message, retinacula

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group (1)
Arm Type
Active Comparator
Arm Description
patients will receive stretch and strength exercises
Arm Title
Group (2)
Arm Type
Experimental
Arm Description
patients will receive stretch, strength, patellar mobilization, retinacula release and deep friction message
Intervention Type
Procedure
Intervention Name(s)
Patellar mobilization, retinacula release, deep friction message, stretch and strength
Intervention Description
All exercises will be performed for 30 to 45 minutes per session, 3 times per week for 4 weeks (12 sessions). Group (1): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). Group (2): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). manual therapy consists from iliotibial band release, deep friction message for lateral retinacula and medial patella mobilization.
Primary Outcome Measure Information:
Title
Changes in pain that felt during ascending, descending, squatting and prolonged sitting
Description
Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.
Time Frame
It will be assessed one week before and after treatment
Title
Changes in functional disability
Description
Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.
Time Frame
It will be assessed one week before and after treatment
Secondary Outcome Measure Information:
Title
Changes in hip abductors strength
Description
It will be assessed using handheld dynamometer
Time Frame
It will be assessed one week before and after treatment
Title
Changes in hip external rotators strength
Description
It will be assessed using handheld dynamometer
Time Frame
It will be assessed one week before and after treatment
Title
changes in quadriceps strength
Description
It will be assessed using handheld dynamometer
Time Frame
It will be assessed one week before and after treatment
Title
changes in functional performance
Description
It will be assessed using step down test
Time Frame
It will be assessed one week before and after treatment
Title
changes in hamstring flexibility
Description
It will be assessed using 90-90 test
Time Frame
It will be assessed one week before and after treatment
Title
changes in gastrocnemius flexibility
Description
It will be assessed using ankle dorsiflexion range of motion
Time Frame
It will be assessed one week before and after treatment
Title
changes in knee valgus
Description
It will be assessed using Q angle
Time Frame
It will be assessed one week before and after treatment
Title
changes in foot pronation
Description
It will be assessed using navicular drop test
Time Frame
It will be assessed one week before and after treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ranging between 18 and 35 years Tenderness of medial and lateral borders of patella Retropatellar pain Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks Positive patellar compression test Pain intensity is more than 3 at visual analogue scale Had a history of insidious onset Had anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squatting Exclusion Criteria: Previous patellar realignment surgery or patellar fracture Had a history of traumatic patellar dislocation Had a history of previous knee surgery Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction Taking corticosteroids or nonsteroidal anti-inflammatory medication Inability to attend treatment program to the end of sessions
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nadia A Mohamed, Msc
Phone
01141581284
Email
nadiaabdo895@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Nadia A Mohamed, Msc
Phone
01068088440
Email
drnadia2015a@cu.edu.eg
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nadia A Mohamed, Msc
Organizational Affiliation
Assistant lecturer at orthopedic department of faculty of physical therapy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cairo University
City
Giza
Country
Egypt
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nadia A Mohamed, Msc
Phone
01141581284
Email
nadiaabdo895@gmail.com
First Name & Middle Initial & Last Name & Degree
Nadia A Mohamed, Msc
Phone
01068088440
Email
drnadia2015a@cu.edu.eg

12. IPD Sharing Statement

Learn more about this trial

Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome

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