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NCT Number: NCT07298798

To Compare the Effect of Closed Kinetic Chain and Isometric Exercises in Reducing Pain and Improving Functional Disability in Patients With Patellofemoral Pain Syndrome Associated With Knee Osteoarthritis

Investigator study aims to compare the benefits of isometric exercise and closed kinetic chain exercises in strengthening programs to lessen pain along with enhance functionality in patients with PFP that are being associated with osteoarthritis and the assessment of PFP pertains to its recognition and the determination of significant therapeutic techniques. 70 Participants from the department of physiotherapy, Civil Hospital Karachi CHK and Dow University of Health Science (DIPMR) will be randomly assigned into two groups, an experimental group receiving closed kinetic chain exercise, and a control group receiving isometric exercises. The therapy will last four weeks, consisting of twelfth sessions. There will be 35 to 40 minutes in each session, Patients will be evaluated on primary outcome measure, pain intensity and functional limitation using various scales, including the numerical pain rating scale (NPRS) and Kujala/anterior knee pain scale (AKPS)

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This study is active but is not currently recruiting participants.

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Key information

Conditions

Knee Osteoarthritis Arthritis Joint Diseases Musculoskeletal Diseases Osteoarthritis Osteoarthritis, Knee Rheumatic Diseases

Age range

35 year–60 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Saddar

Karachi, Pakistan

About this study

The most prevalent issue of musculoskeletal knee joint that impact is patellofemoral pain syndrome (PFPS) particularly in young adults and the elderly, causing severe discomfort behind and around the patella, making it the primary etiology for anterior knee discomfort. Patellofemoral joint may be the first compartment affected in early knee osteoarthritis. Most exercise programs designed for treating p a t e l l o f e m o r a l p a i n ( PFP) focus on strengthening the quadriceps, primarily the vastus medialis oblique (VMO). A rehabilitation program including closed kinetic chain exercises and isometric exercises may be beneficial for patients with patellofemoral pain (PFP) to improve their functional limitations and minimize pain. Closed kinetic chain exercises improve functional movement patterns, while isometric exercises are better tolerated during pain or inflammation. The effectiveness of these approaches in individuals with patellofemoral pain (PFP) associated with knee OA is unclear, but understanding their differential impacts can guide targeted rehabilitation strategies for this complex patient population. Investigator aims to compare the benefits of isometric exercise and closed kinetic chain exercises in strengthening programs to lessen pain along with enhance functionality in patients with PFP that are being associated with osteoarthritis, Participants from the department of physiotherapy, Civil Hospital Karachi CHK and Dow University of Health Science (DIPMR) will be randomly assigned into two groups, an experimental group receiving closed kinetic chain exercise, and a control group receiving isometric exercises. The therapy will last four weeks, consisting of twelfth sessions. There will be 35 to 40 minutes in each session, Patients will be evaluated on pain intensity and functional limitation using various scales, including the numerical pain rating scale (NPRS) and Kujala/anterior knee pain scale (AKPS).

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age between (35 to 60) years.
  • Gender: female.
  • The numerical pain rating scale (NPRS) is greater than three out often i.e. 3/10 score.
  • Patient experiences anterior knee pain due to such activities like squatting, prolonged sitting, running and stair climbing.
  • Patient with unilateral or bilateral knee pain with positive radiographic imaging.
  • Patients have grade 1 and 2 knee osteoarthritis (K&L classification).

Exclusion criteria

  • Any past record of knee surgery.
  • Any past record of knee fracture.
  • Patients with any neurological disorder.
  • Cancer, malignancy or any bone tumor.
  • Comorbid like diabetes mellitus.
  • Any systemic inflammatory arthritis.

Treatment and study plan

Terminal knee extension. .VMO squat. [TheraBand]

Behavioral

Terminal knee extension, The patient stand facing the plinth with feet shoulder-width apart and a theraband looped around their knee and other plinth legs. They bend their knees to a 30-degree angle, extend their leg against the band's resistance, and hold this position for six seconds.

VMO squat, The position of patient, hip and knee will bend, weight of the body on feet and feet about shoulder width apart and turnthe feet outward about 45 degrees and position hold for 30 second.

Isometric exercises [knee roller]

Behavioral

Static Quads The patient is long sitting or supine on their back, with a foam roll or towel behind their knee.

Contract your quadriceps muscles while pressing down on the towel, maintaining this position for five seconds. Straight leg raising (SLR) The patient will be laying in supine, and before the exercise's lifting phase, a maximal isometric quadriceps contraction will be executed, followed by raising the leg to a height of 10 cm above the plinth for 10 seconds.

Primary outcomes

  1. numerical pain rating scale (NPRS)

    Time frame: 12th sessions for four weeks ,outcome measures will take place both, at the baseline when intervention start and four weeks, following the intervention

    • Numerical pain rating scale (NPRS) Pain intensity will measure using NPR scale (no need for permission), a reliable instrument retest reliability of 0.95 , 0 represents no pain and 10 represents severe suffering.

    10= indicate worse pain 5= indicate moderate pain 0 = indicate no pain.

  2. . Kujala/ Anterior knee pain scale (AKPS)

    Time frame: 12th sessions for four weeks, ,outcome measures will take place both, at the baseline when intervention start and four weeks, following the intervention

    we will use the Kujala scale to measure functional limitations, a reliable instrument retest reliability of 0.9 in patient with PFPS, total 13 self-reported questionnaire. AKPS graded 0 to 100, 100 being the highest possible score with no pain and disability. Lower scores reflect greater pain and disability.

Sponsors and collaborators

Lead sponsor

Dow University of Health Sciences

Other

Registry information

Official study title

Comparison of the Closed Kinetic Chain and Isometric Exercise in Female Patient With Patellofemoral Pain Syndrome Associated With Knee Osteoarthritis: A Randomized Control Trial

Important dates

Study start
2023
Primary completion
2026
Study completion
2027
First posted
Dec 23, 2025
Registry last updated
May 19, 2026

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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