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NCT Number: NCT05665452

Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises.

Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.

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Key information

Conditions

Patellofemoral Pain Syndrome Joint Diseases Musculoskeletal Diseases

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cairo University

Giza, Egypt

About this study

this is interventional study in which patients will receive stretching and strengthening exercises in control group. in addition, experimental group will receive the same exercises of control group in addition to patellar mobilization, retinacula release and deep friction message.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age ranging between 18 and 35 years
  • Tenderness of medial and lateral borders of patella
  • Retropatellar pain
  • Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks
  • Positive patellar compression test
  • Pain intensity is more than 3 at visual analogue scale
  • Had a history of insidious onset
  • Had anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squatting

Exclusion criteria

  • Previous patellar realignment surgery or patellar fracture
  • Had a history of traumatic patellar dislocation
  • Had a history of previous knee surgery
  • Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis
  • Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction
  • Taking corticosteroids or nonsteroidal anti-inflammatory medication
  • Inability to attend treatment program to the end of sessions

Treatment and study plan

Patellar mobilization, retinacula release, deep friction message, stretch and strength

Procedure

All exercises will be performed for 30 to 45 minutes per session, 3 times per week for 4 weeks (12 sessions). Group (1): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise).

Group (2): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). manual therapy consists from iliotibial band release, deep friction message for lateral retinacula and medial patella mobilization.

Primary outcomes

  1. Changes in pain that felt during ascending, descending, squatting and prolonged sitting

    Time frame: It will be assessed one week before and after treatment

    Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.

  2. Changes in functional disability

    Time frame: It will be assessed one week before and after treatment

    Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.

Secondary outcomes

  1. Changes in hip abductors strength

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using handheld dynamometer

  2. Changes in hip external rotators strength

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using handheld dynamometer

  3. changes in quadriceps strength

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using handheld dynamometer

  4. changes in functional performance

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using step down test

  5. changes in hamstring flexibility

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using 90-90 test

  6. changes in gastrocnemius flexibility

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using ankle dorsiflexion range of motion

  7. changes in knee valgus

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using Q angle

  8. changes in foot pronation

    Time frame: It will be assessed one week before and after treatment

    It will be assessed using navicular drop test

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Important dates

Study start
2023
Primary completion
2023
Study completion
2024
First posted
Dec 27, 2022
Registry last updated
Aug 21, 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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