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NCT Number: NCT06565754

Effect of Adding Blood Flow Restriction to Strengthening Exercise in Patients With Patellofemoral Pain Syndrome

To study the effect of adding BFRT to strengthening exercises and compare it with strengthening exercises alone in improving, muscular strength, pain, function, joint position sense, and dynamic balance test (star excursion test). in patients with PFPS.

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Key information

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cairo University

Giza, 12613, Egypt

Location contact

abdelgalil A shaaban, PhD

CONTACT

[email protected]

+201146937036

abdelgalil A shaaban, PhD

PRINCIPAL_INVESTIGATOR

ahmed M khalil, PhD

PRINCIPAL_INVESTIGATOR

ahmed S helal, PhD

PRINCIPAL_INVESTIGATOR

enas F youssef, Professor

CONTACT

[email protected]

+201127867507

About this study

Background: Patellofemoral Pain Syndrome (PFPS) is a common condition characterized by anterior knee pain, particularly affecting individuals aged 15-30. It often involves lower limb muscle weakness, particularly in the quadriceps, which can exacerbate symptoms and affect functional performance. Blood Flow Restriction Training (BFRT) has shown promise in enhancing muscle strength and functional outcomes with reduced intensity compared to traditional high-intensity training.

Purpose: This study aims to compare the efficacy of combining BFRT with traditional strengthening exercises versus using strengthening exercises alone in improving muscular strength, pain, function, joint position sense, and dynamic balance in patients with PFPS.

Methods: A triple-blinded, randomized controlled trial was conducted at the Almenshawy General Hospital, Tanta, Egypt. Fifty patients with unilateral non-traumatic PFPS, aged 18-35, were randomly assigned to either a strengthening exercises group (SE Group) or a BFRT plus strengthening exercises group (BFRT Group). Both groups underwent a 6-week intervention with three sessions per week. Outcomes assessed included quadriceps and hip abductors strength, pain severity (Visual Analog Scale), functional status (Kujala Patellofemoral Score), joint position sense (measured by digital inclinometer), and dynamic balance (Star Excursion Balance Test).

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Patient referred from Orthopedic surgeon with diagnosis of patellofemoral pain syndrome PFPS.
  • Both genders.
  • BMI ranges from 18.5 to 29.9.
  • Age ranges between 18 and 40 years experienced non-traumatic PFPS onset of anterior knee pain for greater than 2 weeks.
  • Pain with any two activities, including running, jumping, squatting, kneeling, stair ascent/descent or prolonged sitting.

Exclusion criteria

  • Coexisting pathology around the knee, including patellar subluxation or dislocation.
  • Other sources of anterior knee pain (bursa, fat pad).
  • Previous knee surgery.
  • Suspicion of patellar tendinopathy, with strong consideration of pain localised to the patellar tendon.
  • Any cardiovascular disease.
  • Uncontrolled hypertension.
  • Any lower limb trauma.
  • Hip and ankle pathology.
  • BMI more than 30%.
  • Pregnancy.

Treatment and study plan

BFR

Other

Blood flow restriction training is an accessory to a variety of different exercise modes (e.g., resistance exercise, walking, cycling) has recently become a popular research topic. It involves the application of pressurized cuffs to the proximal portion of each lower extremity or upper extremity. It enhance blood pooling in the capillary beds of the limb muscles distal to the tourniquet or cuff.

The 3rd Generation SmartCuffs® pump (SmartCuffs® 3.0 PRO) is Personalized Pressure feature which allows for a fast, hassle-free personalized pressure calculation. With the built-in pressure sensor and on-board computer, it is calculate arterial occlusion pressure and set the optimal pressure for patient's body. There is no need for an external doppler probe or hand pump. This unit will do everything for patient. Smart Cuffs 3rd generation is FDA Approved Listed Class 1 device.

The automatized tourniquet (Smart Tools) contains a ring-shaped single- chamber

Strengthening exercise

Other

Quadriceps strengthening exercises are part of the treatment of PFPS, but the heavy resistance exercises may aggravate knee pain. Blood flow restriction training (BFRT) provides a low-load quadriceps strengthening method to treat PFPS (Giles et al., 2017).

Primary outcomes

  1. quadriceps and hip abductors strength

    Time frame: 6 weeks

    Hand-Held Dynamometer (HHD). The Lafayette® HHD is a valid and reliable instrument of low cost and easy handling compared to the isokinetic dynamometer for assessment of muscle strength

Secondary outcomes

  1. pain severity using Visual Analog Scale (VAS)

    Time frame: 6 weeks

    The Visual Analog Scale is determined by measuring in millimeters from the left end of the line to the patient's mark. Participants will ask to determine the point at which pain represents the severity of pain maximum is 10 while lowest level of pain is zero

  2. functional status (Kujala Patellofemoral Score)

    Time frame: 6 weeks

    The 13 items on the scale are used to assess subjective symptoms and functional restrictions. A score can have a minimum of 0 points or a maximum of 100 points.

  3. joint position sense (measured by digital inclinometer)

    Time frame: 6 weeks

    Digital Inclinometer for joint position sense assessment. Device (Digital Protractor, 82201b-00, INSPEC, China) The inclinometer is a valid and reliable method to assess the knee proprioception through JPS in open kinetic chain

  4. dynamic balance (Star Excursion Balance Test

    Time frame: 6 weeks

    Four strips of adhesive tape will need to be cut to a length of 6-8 feet each. Two pieces will be used to form a '+', with the other two being placed over top to form an 'x' so that a star shape is formed. It is important that all lines are separated from each other by a 45° angle. The goal of the Star Excursion Balance Test (SEBT) is to maintain single leg stance on one leg while reaching as far as possible with the contralateral leg.

Study contacts

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

ABDELRAHMAN M HEWID, MSc

CONTACT

[email protected]

9294358403 ext. 9294358403

ahmed M khalil, PhD

CONTACT

[email protected]

9294358403

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Acronym: BFR

Important dates

Study start
2024
Primary completion
2025
Study completion
2026
First posted
Aug 22, 2024
Registry last updated
Aug 22, 2024

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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