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NCT Number: NCT07013617

Effect of Specific Versus General Hamstring Stretch on Clinical Outcomes in Patellofemoral Pain Syndrome (PFPS)

This randomized, Single-blind, parallel-group trial will compare the effects of three hamstring stretching interventions-general hamstring Muscle Energy Technique (MET), medial hamstring MET, and lateral hamstring MET-each combined with standardized TENS and progressive hip/knee strengthening, on hamstring flexibility (knee-extension ROM), anterior knee pain (Arabic Kujala score), pain intensity visual analogue scale (VAS), and lower-limb strength (hand-held dynamometer) in adults with patellofemoral pain syndrome (PFPS).

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Key information

Conditions

Hamstring Shortness Hamstring Flexibility Joint Diseases Musculoskeletal Diseases Patellofemoral Pain (PFPS) Patellofemoral Pain Syndrome

Age range

18 year–37 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Patients with chronic PFPS will be randomized (1:1:1) into:

General MET group: standard non-specific hamstring MET stretch

Medial MET group: targeted medial-hamstring MET stretch

Lateral MET group: targeted lateral-hamstring MET stretch

All groups receive:

TENS: 20 min asymmetric biphasic square-pulse, 120 μs pulse width, 180 Hz, electrodes around patella (5-7 cm apart)

Strengthening: 3×/week for 4 weeks; hip/knee exercises, start 3×10 reps → 3×20, progress with weights or resistance bands.

Outcomes are measured pre-intervention and at 4 weeks. Analysis by mixed-design MANOVA (α < 0.05).

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Anterior or retropatellar knee pain lasting at least three months
  • Pain reproduced by at least two functional tasks: squatting, kneeling, prolonged sitting, stair climbing, hopping or running
  • Pain intensity of ≥3 on a Visual Analog Scale
  • positive active knee extension test (inability to achieve greater than 160° of knee extension with the hip at 90° of flexion)
  • Body mass index (BMI) < 30 Kg/m² and > 18Kg/m²

Exclusion criteria

  • Previous knee surgery
  • History of knee pathologies, such as meniscal injury' ligament injury, or knee osteoarthritis
  • Psychological, cardiovascular' or neurological disorders
  • Dizziness or fainting while doing exercises, pregnancy, or any contraindications to exercise
  • Physical therapy treatment in the last 3 months

Treatment and study plan

Transcutaneous Electrical Nerve Stimulation Device

Device

Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.

Other names: TENS

Strength exercises for lower limb

Other

Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.

Hamstring Stretch Muscle Energy Technique(MET) (General )

Other

The participant will be supine and the leg will be taken into hip flexion until a tightness is felt then patient will be asked to push down with his lower leg and hold the contraction for 10 seconds then relax for 2 to 3 seconds then the therapist will take the patient's leg into further flexion for 30 seconds this will be repeated for 3 times each session .

Other names: Non-Specific hamstring stretch MET

Medial Hamstring Muscle energy technique(MET) stretch

Other

The Participant will be supine' then the therapist will take his leg in flexion, abduction and external rotation at the same time until he feels tightness then he will ask the patient to push his leg down and in or toward him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more abduction 'external rotation and flexion for 30 seconds, this will be repeated for 3 times each session

Other names: specific medial hamstring MET stretch

Lateral hamstring Muscle Energy Technique(MET)Stretch

Other

The Participant will be supine' then the therapist will take his leg in flexion, adduction and internal rotation at the same time until he feels a tightness then he will ask the patient to push his leg down and out or away from him him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more adduction 'internal rotation and flexion for 30 seconds, this will be repeated for 3 times each session

Other names: Specific lateral hamstring MET stretch

Primary outcomes

  1. hamstring flexibility (knee extension range of motion )

    Time frame: 4 weeks

    measuring knee extension range of motion(hamstring flexibility) by active knee extension test using kinovea software

  2. Arabic Kujala Anterior knee pain score

    Time frame: 4 weeks

    Arabic Kujala Anterior knee pain score is used to measure pain and functional activities in anterior knee pain patients consisting of 13 questions, the Patient will be asked to mark the most suitable answer for him. Each answer has points up to 5 or 10, and the total score is 100.

    The higher the score, the better for the patient.

Secondary outcomes

  1. pain intensity by visual analogue scale (VAS)

    Time frame: 4 weeks

    from 0 to 10 centimeter line patient will detect on it the usual pain felt and the worst pain during the day

  2. lower limb strength using handheld dynamometer

    Time frame: 4 weeks

    using handheld dynamometer to assessment the strength of hip abductor, extensors, external rotators and knee extensors

Study contacts

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

Ahmed Omar Abdelnaeem, lecturer

CONTACT

[email protected]

201140736820

Amna Ibrahim Shemila, BSc

CONTACT

[email protected]

201157072513

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Official study title

Effect Of Hamstring Stretch On Clinical Outcomes In Patellofemoral Pain Syndrome

Acronym: PFPS

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jun 10, 2025
Registry last updated
Jun 15, 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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