Association Between Ankle Dorsiflexion and Frontal Projection Angle in PFPS

Completed

• Conditions: Patellofemoral Pain Syndrome
• Interventions: Other: frontal projection angle, ankle dorsiflexion

• Registration Number: NCT03897569
• Lead Sponsor: Cairo University

Brief Summary

The study will investigate an association between ankle dorsiflexion and altered frontal knee kinematics during step down test in patients with PFPS.

Detailed Description

Altered frontal and transverse plane hip kinematics during single leg weight-bearing tasks are thought to be important contributors to patellofemoral pain (PFP). The closed chain nature of single leg tasks means that hip kinematics can be influenced by more distal mechanics, such as foot pronation.

One of the often-studied distal movements theorized to cause PFPS is pronation of the subtalar joint. Pronation is a tri-planar movement that includes dorsiflexion, eversion, and abduction of the foot. Many studies have examined eversion characteristics of PFPS patients, but the dorsiflexion aspect of the movement has been shown to be a possible risk factor, restricting dorsiflexion was shown to increase medial knee displacement in young healthy adults. Conversely, when available dorsiflexion ROM is increased, medial knee displacement is thought to decrease.

Patients with PFPS were observed to have a decreased DFROM (dorsiflexion range of motion) as compared to normal individuals, though this topic has not thoroughly been investigated.

Study Timeline

• Study First Submitted: 2019-03-27
• Study First Submitted QC: 2019-03-29
• Study Start: 2019-03-30
• Study First Posted: 2019-04-01
• Status Verified: 2019-07
• Primary Completion: 2019-07-01
• Study Completion: 2019-07-01
• Last Update Submitted: 2019-07-28
• Last Update Posted: 2019-07-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 46

Inclusion Criteria

1. Anterior or retropatellar knee pain from at least 2 of the following Activities : (1) prolonged sitting; (2) stair climbing; (3) squatting; (4) running; (5) kneeling; and (6) hopping/jumping.
2. Insidious onset of symptoms unrelated to a traumatic incident and persistent for at least 6weeks.
3. VAS equal to or greater than 3.
4. Age of the subject 18-35 years to limit the possibility that PFPS over age 35 may have been complicated by arthritic changes, and also the subjects should have closed epiphyseal growth plates.
5. BMI under 30 kg/m2, both gender

For the control group, subjects were recruited to this study if they had:

1. No previous history or diagnosis of knee pathology.
2. No pain with any of the above-mentioned provocative activities.
3. No history of lower limb or spinal pathology.

Exclusion Criteria

1. A history of any of the following condition: meniscal or other intraarticular pathologic conditions; cruciate or collateral ligament involvement.
2. A history of traumatic patellar subluxation or dislocation.
3. Previous surgery in the lower extremities within the 12 months prior to participation in the study.
4. Any balance impairments are secondary to a vestibular or neurological disorder or secondary to the use of medication.
5. Any lower limb bony/congenital deformity

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
patellofemoral pain syndrome	frontal projection angle, ankle dorsiflexion	twenty subjects with anterior or retropatellar knee pain from at least 2 of the following Activities : (1) prolonged sitting; (2) stair climbing; (3) squatting; (4) running; (5) kneeling; and (6) hopping/jumping.
control	frontal projection angle, ankle dorsiflexion	twenty-six asymptomatic subject will be recruited for this study and should have no pain or other relevant clinical symptoms in the lower quadrant

Primary Outcome Measures

Name	Time	Method
Frontal knee kinematic	20 minutes	The knee kinematic will be measured by using digital video camera using single leg squat during functional step down test

Secondary Outcome Measures

Name	Time	Method
Ankle mobility	20 minutes	Ankle dorsiflexion ROM will be assessed by bubble inclinometer during weight-bearing and non-weight-bearing positions.

Trial Locations

Locations (1)

Faculty of Physical therapy, Cairo University; 🇪🇬 Cairo, Egypt