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NCT Number: NCT06681961

Effects of a Squatting With Hip Adduction in Patients With Patellofemoral Pain Syndrome

An imbalance in the activation and onset time of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles may be one of the primary causes of PFPS. Several studies have discussed various exercise methods believed to selectively contract the (VMO) muscle for treating patellofemoral pain syndrome. VMO activity is higher during static closed-chain tasks combined with hip adduction, indicating that performing hip adduction exercises may selectively strengthen the VMO muscle.

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Key information

Conditions

PFPS Joint Diseases Musculoskeletal Diseases Patellofemoral Pain Syndrome

Age range

20 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

China Medical University

Taichung, 406040, Taiwan

About this study

Patellofemoral pain syndrome (PFPS) poses challenges in motor control and pain management, especially regarding balanced muscle activation of the vastus medialis oblique (VMO) and vastus lateralis (VL). This study introduces a home-based PFPS rehabilitation approach involving a squat exercise program with hip adduction, examining its effects on motor control and clinical outcomes. Thirty PFPS participants were randomly assigned to conventional squatting (SQU) or squatting with hip adduction (SQU-HA) groups. Participants performed exercises five days a week for 8 weeks, with pre- and post-assessments capturing clinical measures and motor control indicators using electromyography (EMG). This home-based program, integrating hip adduction into squats, enhances motor control, reduces knee stress, and improves daily function, ensuring continued care post-pandemic.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Age 20-50 years.
  • Pain around the patella at least two of the following activities¬-standing up after prolonged sitting, going up and down the stairs, running, jumping, squatting, kneeling, and high-angle knee flexion for a long time.
  • Knee joint pain for ≥3 months.
  • Pain level of ≥ 30 mm on a 100-mm visual analog scale (VAS).

Exclusion criteria

  • Had a history of patellar subluxation, dislocation, or knee surgery.
  • Had central or peripheral neurological pathology.
  • Had an obvious knee joint deformity or lower extremity malalignment.
  • Experienced severe knee joint pain (VAS) score > 80 mm), or received nonsteroidal anti-inflammatory drugs, injections, or physical therapy within the past 3 months.

Treatment and study plan

squatting with hip adduction (SQU-HA) group

Other

The intervention comprised three sets of 15 repetitions with resting 5-min between sets, followed by IT band stretching for five repetitions. Each participant performed the respective exercise 5 days a week, with 2 days of rest, for 8 weeks.

Other names: squatting (SQU) group

Primary outcomes

  1. Amplitudes of muscle activation (unit: %MVC)

    Time frame: pre-intervention and after 8-week intervention

    represented the mean RMSs for each muscle which was normalized by the maximal voluntary contractions (MVC).

  2. VMO/VL ratio

    Time frame: pre-intervention and after 8-week intervention

    represents the amplitude ratio of VMO relative to VL.

  3. Onset time (unit: msec)

    Time frame: pre-intervention and after 8-week intervention

    at 200 ms before the beginning of the trial, as the baseline, the onset of EMG activation was identified as the point at which the EMG amplitude was more than three standard deviations from the baseline level for at least 25 ms.

  4. VMO - VL (unit: msec)

    Time frame: pre-intervention and after 8-week intervention

    represented the onset time differences of VMO relative to VL, with a positive (negative) value indicating a delayed (early) onset time of VMO relative to VL.

  5. Q angle (unit: degree)

    Time frame: pre-intervention and after 8-week intervention

    The angle was calculated with the intersection formed by two lines crossing the center of the patella. The first line went from the ASIS to the center of the patella and the second from the anterior tuberosity of the tibia to the center of the patella.

  6. The visual analogue scale (VAS) (unit: mm)

    Time frame: pre-intervention and after 8-week intervention

    VAS was used to assess pain severity. The participants were asked to mark their pain levels on a 100-mm ruler (ranging from 0 = "no pain" to 100 = "unbearable pain") before and after the exercise program.

  7. patellofemoral pain severity scale (PSS) (unit: score)

    Time frame: pre-intervention and after 8-week intervention

    PSS was used to measure PFPS associated with functional activities over the past week. The scale comprises 10 items, including climbing/descending stairs, squatting, walking, jogging, running/sprinting, participating in a sport, sitting with knees bent (for 20 min), kneeling, resting, and following an activity. The maximum score was 100 points. The participants rated their pain on a 100-mm VAS, ranging from 0 = "no pain" to 100 = "unbearable pain".

Sponsors and collaborators

Lead sponsor

China Medical University Hospital

Other

Registry information

Official study title

The Therapeutic Effects of a Dynamics Closed Kinetic Chain Exercise Combination With Hip Adduction in Patients With Patellofemoral Pain Syndrome

Important dates

Study start
2017
Primary completion
2018
Study completion
2019
First posted
Nov 12, 2024
Registry last updated
Nov 12, 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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