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NCT Number: NCT07590128

Combined Physical Therapy and Hold-Relax Technique for Adolescent Osgood-Schlatter Knee Pain

This pilot study evaluates the preliminary effectiveness of a combined rehabilitation program incorporating hold-relax (H-R) stretching techniques and progressive therapeutic exercises on knee pain and range of motion (ROM) in adolescent athletes diagnosed with Osgood-Schlatter disease. Utilizing a retrospective, single-group pre-post design on a cohort of six athletic participants, this study aims to generate preliminary clinical evidence and assess feasibility to inform future larger-scale randomized controlled trials. Participants underwent a structured, multi-week rehabilitation protocol, with primary clinical outcomes assessed before and after the intervention period using validated measures of pain intensity and knee joint mobility.

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Key information

Conditions

Osgood-Schlatter Disease Bone Diseases Musculoskeletal Diseases Osteochondrosis

Age range

14 year–18 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Batna 2 University

Batna City, Batna, 05078, Algeria

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Clinical diagnosis of Osgood-Schlatter disease
  • Presence of anterior knee pain localized at the tibial tuberosity
  • Regular participation in sports involving running and jumping
  • No participation in structured rehabilitation programs within the previous 3 months

Exclusion criteria

  • History of knee surgery or major trauma
  • Presence of other knee pathologies (e.g., ligament or meniscal injuries)
  • Neurological or systemic disorders affecting movement

Treatment and study plan

Hold-Relax Proprioceptive Neuromuscular Facilitation (PNF)

Behavioral

A target-specific, manual stretching technique administered by a physical therapist to address muscular tightness in the lower extremity. The protocol focuses on the bilateral quadriceps and hamstring muscle groups to reduce the cumulative tensile traction forces exerted on the tibial tuberosity.

For each target muscle group, the procedure is performed as follows:

Passive Stretch: The physical therapist moves the joint to the limit of comfortable range of motion (ROM) where mild muscle tightness is felt.

Isometric Contraction: The participant performs an active, sub-maximal isometric contraction (approximately 50% of maximum voluntary contraction) against the therapist's manual resistance for 6 to 10 seconds, ensuring no actual joint movement occurs.

Relaxation and Deeper Passive Stretch: The participant is instructed to relax completely, and the therapist immediately moves the limb passively into a newly gained, deeper range of motion, holding the stati

Progressive Rehabilitation Program

Behavioral

A structured, step-by-step active exercise program designed to build lower-limb load tolerance, correct biomechanical compensations, and stabilize the knee joint complex. The rehabilitation progresses systematically through targeted phases based on individual pain levels and movement quality:Phase 1 (Pain Mitigation and Muscle Activation): Focuses on isometric quadriceps setting, straight leg raises (SLR), gluteal bridging, and ankle/hip mobility exercises to avoid direct loading of the patellar tendon while minimizing disuse atrophy.Phase 2 (Strength and Load Tolerance): Introduces closed-kinetic chain exercises with controlled ranges of motion, including shallow wall sits, leg presses, bilateral squats, and progressive calf raises.Phase 3 (Eccentric and Functional Progression): Focuses on eccentric quadriceps strengthening (e.g., controlled step-downs) and sport-specific functional retraining to prepare the adolescent athlete's patellar tendon and tibial tubercle to absorb high groun

Primary outcomes

  1. Change from Baseline in Knee Pain Intensity on the Visual Analog Scale (VAS)

    Time frame: Baseline (Day 1, pre-intervention) and post-intervention (Week 10, immediately following completion of the last rehabilitation session).

    Knee pain during athletic activity is assessed using a 10-centimeter Visual Analog Scale (VAS). The scale is a horizontal line where 0 centimeters indicates "no pain" and 10 centimeters indicates "the worst possible pain."

    The outcome is calculated as the change in the pain score (post-intervention score minus baseline score). A negative change indicates an improvement (reduction) in knee pain.

Secondary outcomes

  1. Change from Baseline in Active Knee Flexion Range of Motion

    Time frame: Baseline (Day 1, pre-intervention) and post-intervention (Week 10, immediately following completion of the last rehabilitation session).

    Active knee joint flexion range of motion measured in degrees of joint angle using a standard universal goniometer. The participant lies in a supine position and actively bends the knee as far as possible.

    The outcome is calculated as the change in degrees from baseline to post-intervention. An increase in degrees indicates an improved range of motion.

Sponsors and collaborators

Lead sponsor

Benha University

Other

Registry information

Official study title

Exploratory Effects of a Combined Hold-Relax Technique and Progressive Rehabilitation Program on Knee Pain in Adolescent Athletes With Osgood-Schlatter Disease: A Pilot Study

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
May 15, 2026
Registry last updated
May 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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