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NCT Number: NCT06875804

Compressive Myofascial Release of the Vastus Lateralis on Lateral Patellar Tracking in Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome is a prevalent condition characterized by anterior knee pain, often exacerbated by activities such as squatting, running, and stair climbing. This condition is frequently associated with improper patellar tracking, particularly lateral displacement, which can be influenced by various factors including muscular imbalances and tightness. The vastus lateralis muscle, part of the quadriceps group, is often implicated in contributing to lateral patellar tracking due to its attachment and alignment. Compressive myofascial release (CMFR) is a therapeutic technique aimed at reducing muscle tightness and restoring optimal muscle function. This study will explore the effects compressive myofascial release on the vastus lateralis in improving patellar tracking in patients diagnosed with Patellofemoral Pain Syndrome.The methodology of this study involves a randomized controlled trial with a sample of patients diagnosed with Patellofemoral Pain Syndrome. Non-probability convenience sampling technique will be used and participants will be recruited in groups after randomization. Participants(n=26) will be divided into two groups: the intervention group (n=13) receiving compressive myofascial release on the vastus lateralis, and a control group receiving(n=13) a routine treatment. The intervention will be administered over a period of four weeks, with sessions occurring three times weekly. Patellar tracking will be assessed using q-angle analysis both pre- and post-intervention. Additionally, subjective measures of pain and functional ability will be evaluated using the Numeric pain rating scale (NPRS) and the Kujala Patellofemoral Score. Data analysis will focus on comparing the changes in lateral patellar displacement and patient-reported outcomes between the two groups to determine the efficacy of compressive myofascial release in correcting lateral patellar tracking and alleviating symptoms of Patellofemoral Pain Syndrome. SPSS version 25 will be used for data analysis

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Key information

Conditions

Patellofemoral Pain Syndrome Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

20 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Social Security Hospital

Lahore, Punjab Province, 54000, Pakistan

Location status: Recruiting

Location contact

Ghulam Fatima, PhD*

CONTACT

[email protected]

03034073057

Muhammad Burhan, MS*

PRINCIPAL_INVESTIGATOR

About this study

Patellofemoral pain syndrome (PFPS) is one of the most common health-related complaints in today's societies. PFPS refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance and instability. About 50% of the non-specific knee pain is diagnosed as PFPS. PFPS frequently becomes chronic, and patients cannot do physical activity. Individuals with PFPS typically report pain that is either located in the peri-patellar or retro-patellar region during active movements involving knee movement.

Myofascial pain syndrome (MPS) has been attributed as the main cause and primary source of musculoskeletal pain in 30-85% of the patients attending physical therapy clinics. Myofascial pain syndrome often presents in the forms of pain, muscle spasm or TrP. TrP has been described as a hyperirritability spot located in a taut band of muscle; or a small pea or rope-like nodular or crepitant (crackling, grating) area within the muscle, which is painful to palpation or compression and refers pain, tenderness, or an autonomic response to a remote area. It is stated that "jump response" is elicited when pressure is applied to a Trp. TrP may result from mechanical overload, trauma, overuse, postural faults, or psychological stress. Based on their primary functions, muscles are categorized as "phasic" or "postural" muscles. In response to dysfunction or overuse, the phasic muscles tend to be inhibited or weakened; while the postural muscles tend to develop higher tone and ultimately shorten. A muscle imbalance between the dynamic and postural muscles may lead to MTP in the musculoskeletal system.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age group between 20 to 40 years
  • Male and female gender
  • Diagnosed cases of Patellofemoral syndrome
  • Participants with positive J sign and Clarke's test
  • Pain provoked during knee loading physical activity, such as jumping, running, squatting, or going up or down stairs in last 3 months
  • Presence of excessive lateral patellar tracking on axial view radiographs

Exclusion criteria

  • History of knee surgery in the past year.
  • Any contraindications to myofascial release therapy, such as active infections, open wounds.
  • Presence of hip pathology or other knee conditions such as ligament tears, meniscal injuries, Osgood-Schlatter or Sinding-Larsen-Johanssen syndrome or jumpers knee
  • Participants with a history of trauma or repetitive episodes of patellar subluxation or dislocation
  • Use of intra-articular corticosteroid injections
  • Presence of auto-immune disorder (spondylolisthesis, spondylitis, Rheumatoid arthritis etc.) other than knee OA or systemic conditions such as severe cardiovascular disease

Treatment and study plan

baseline physical therapy treatment

Other

Group A focuses on pain relief, muscle relaxation, and strengthening. Hot packs and TENS are applied to the lateral thigh and knee for 20 minutes to reduce pain and muscle tension. Hip strengthening exercises include side-lying hip abduction, clam-shells, prone hip extension, bridging, and lunges. Quadriceps exercises involve straight leg raises, prone terminal knee extension, and mini-squats. Each exercise is done in 2-3 sets of 10-15 repetitions, holding stretches for 5 seconds.

Compressive myofascial release of vastus lateralis.

Other

The experimental group receives an additional session of Compressive Myofascial Release (CMFR) for the Vastus Lateralis to address lateral patellar tracking in PFPS patients. The patient lies on their side, and the therapist identifies tight areas, applying firm pressure for 20-30 seconds. Deeper pressure is held for 30-60 seconds, followed by 1-2 minutes of cross-fiber friction. The session includes muscle shaking for 30 seconds and stretching the Vastus Lateralis by extending the hip and flexing the knee for 30-60 seconds, repeated 2-3 times. Patient response is documented for progress tracking.

Primary outcomes

  1. Numerical Pain Rating Scale (NPRS)

    Time frame: 4 weeks

    It is a standardized self-report device consisting of a horizontal line used to estimate the subjective level of pain intensity. It is a 10 points numerical scale, corresponding to the degree of pain.

  2. Q angle

    Time frame: 4 weeks

    Quadriceps angle (Q-angle) has been used as a diagnostic measurement to assess factors which appear to increase the risk of the development of acute and/or chronic patellofemoral injury and pain in bipedal individuals. The Q-angle is the angle between the line of pull of the quadriceps (anterior superior iliac spine to mid-patella) and a line connecting the center of patella with tibial tuberosity. Normal Q-angle for males is 10-13 degrees and 15-17 degrees for females.

  3. Goniometry

    Time frame: 4 weeks

    A goniometer is the most common instrument used to measure range of motion. If a patient has altered range of motion in a particular joint, the therapist can use a goniometer to assess what the range of motion is at the initial assessment, and then make sure the intervention is working by using the goniometer in subsequent sessions to assess the effectiveness of the intervention. Goniometric measurements should be performed with functional AROM and PROM. The typical documentation for the knee motion is: 10-0-135 degrees beginning with hyperextension, moving through neutral 0 and into flexion.

  4. Kujala score

    Time frame: 4 weeks

    The "Kujala Score" is the eponymous name for the Anterior Knee Pain Scale (AKPS). It is a patient-reported outcome survey and diagnostic tool that aims to assess the severity of symptoms and physical limitations in patients with patellofemoral pain syndrome (PFPS). It was initially derived due to the diagnostic inconsistency among other tools that were used with PFPS patients. The Kujala Patellofemoral Scale is a valid and reliable questionnaire to evaluate functioning in patients with PFPS. The scores range from a maximum of 100 to a minimum of 0, with lower scores indicating greater pain and disability.

Study contacts

Contact information is provided by the study sponsor or research team.

Imran Amjad, PHD*

CONTACT

[email protected]

03324390125

Imran Amjad, PHD*

CONTACT

[email protected]

051-5481826

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Effects of Compressive Myofascial Release of the Vastus Lateralis on Lateral Patellar Tracking in Patients With Patellofemoral Pain Syndrome

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Mar 13, 2025
Registry last updated
Mar 13, 2025

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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