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

Not Applicable

Not yet recruiting

• Conditions: Hamstring Shortness; Patellofemoral Pain Syndrome; Hamstring Flexibility; Patellofemoral Pain (PFPS)

• Registration Number: NCT07013617
• Lead Sponsor: Cairo University

Brief Summary

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).

Detailed Description

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).

Study Timeline

• Status Verified: 2025-06
• Study First Submitted: 2025-06-02
• Study First Submitted QC: 2025-06-02
• Study First Posted: 2025-06-10
• Last Update Submitted: 2025-06-11
• Study Start: 2025-06-14
• Last Update Posted: 2025-06-15
• Primary Completion: 2025-10
• Study Completion: 2025-11

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
hamstring flexibility (knee extension range of motion )	4 weeks	measuring knee extension range of motion(hamstring flexibility) by active knee extension test using kinovea software
Arabic Kujala Anterior knee pain score	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 Outcome Measures

Name	Time	Method
pain intensity by visual analogue scale (VAS)	4 weeks	from 0 to 10 centimeter line patient will detect on it the usual pain felt and the worst pain during the day
lower limb strength using handheld dynamometer	4 weeks	using handheld dynamometer to assessment the strength of hip abductor, extensors, external rotators and knee extensors

Trial Locations

Locations (1)

faculty of physical therapy Cairo university; 🇪🇬 Giza, Egypt