Optimizing Clinical Outcomes for Patients With Patellofemoral Pain Using Strength Training Rehabilitation Incorporating Power Exercises
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 88
- 试验地点
- 3
- 主要终点
- Change in knee pain.
研究概览
简要总结
The objective of this study is to compare a novel 6-week strength training rehabilitation incorporating power exercises (STRIPE) program to a standard of care (SOC) program on short-term and long-term pain, subjective function, patellofemoral pain recurrence rates, and secondary outcomes (hip abduction and extension rate of torque development and single-leg squat kinematics). We hypothesize that participants with patellofemoral pain who complete the STRIPE program will have 1) decreased pain, 2) improved subjective function, 3) reduced patellofemoral pain recurrence rates, 4a) improved hip abduction/extension rate of torque development, and 4b) decreased hip adduction and pelvic drop during a single leg squat compared to participants who complete a SOC rehabilitation program.
详细描述
The proposed study will compare strength-based exercises, which is the standard of care (SOC), that target the hip abductors, hip extensors, lumbo-pelvic, and quadriceps muscles, to a strength training program that utilized power-based exercises (Strength Training Rehabilitation Incorporating Power Exercises [STRIPE]). Individuals with patellofemoral pain, both within the military and general population, present with long-term pain, decreased subjective function, and high recurrence rates. Our primary outcomes are to determine intervention success with self-reported knee pain, measured by the visual analog scale, subjective function, measured by the anterior knee pain scale, and recurrence rates. Recent evidence suggests that two in every three individuals with patellofemoral pain report symptoms up to two years after seeking care, therefore we will assess patellofemoral pain recurrence rates for two years. Additionally, the proposed interventions target gluteal muscle function, supporting our selection of secondary outcome variables. We will assess rate of torque development, as power-based exercises are recommended to improve muscle capacity, of both the targeted gluteus medius and gluteus maximus. We will also assess frontal plane kinematics, as the gluteal muscles are responsible for controlling pelvic and hip motion during functional tasks.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participants to be between the ages of 18-40 years old.
- •Insidious onset of symptoms greater than 3 months.
- •Worst pain in the previous month of 3/10 with two of the following tasks: prolonged sitting, jumping, squatting, kneeling, running, and stair ambulation.
排除标准
- •Other forms of anterior knee pain (Osgood-Schlatter, tendon pain, bursitis, etc.).
- •History of lower extremity surgery.
- •History of patella subluxation, meniscal injury or ligamentous instability.
- •History of referred pain from the lumbar spine.
研究组 & 干预措施
Standard of Care (SOC)
The SOC rehabilitation group will complete three strength sessions a week. All participants will be provided an educational pamphlet and exercises will be divided into four components - hip abductors, hip extensors, core, and quadriceps muscles. The load magnitude for exercises will be between 60-70% of their 1 repetition max (1RM), with 3 sets of 12 repetitions and a 2-3-minute rest between sets. Time under tension will be prescribed as slow to moderate, with a 2-second concentric phase and 2-second eccentric phase for each exercise. Hip abductor, hip extensor, and core exercises will be initiated during week 1 and continued for the 6-week intervention, while quadriceps focused exercises will be introduced in weeks 3-6.
干预措施: Standard of Care Rehabilitation (SOC) (Behavioral)
Strength Training Rehabilitation Incorporating Power Exercises (STRIPE)
Those in the STRIPE group will complete two power and one strength training sessions a week. All participants will be provided an educational pamphlet and exercises will be divided into four components - hip abductors, hip extensors, core, and quadriceps muscles. The load magnitude will be greater than 60% of the 1RM, with the goal of continually loading against heavy resistance. Participants will complete 4 sets of 6 repetitions, with 3-5 minutes of rest between sets. Time under tension will be prescribed as <1 second for the concentric phase and 1 second for the eccentric phase of the exercise. The strength training sessions will adhere to same parameters as the SOC. Hip abductor, hip extensor, and core exercises will be initiated during week 1 and continued for the 6-week intervention, while quadriceps focused exercises will be introduced in weeks 3-6.
干预措施: Strength Training Rehabilitation Incorporating Power Exercises (STRIPE) (Behavioral)
结局指标
主要结局
Change in knee pain.
时间窗: Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.
Data are presented as knee pain, assessed on the visual analog scale in centimeters, resulting in a score of 0-10, with 0 representing no pain and 10 being worst pain imaginable. Group means and standard deviations will be reported.
Change in self-reported knee function.
时间窗: Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.
Data are presented as self-reported knee function, assessed by the anterior knee pain scale. The scale ranged between 0-100, with 0 indicating complete disability and 100 indicating no disability. Group means and standard deviations will be reported.
Patellofemoral pain recurrence
时间窗: 6 months post intervention, 12-months post intervention, 18-months post intervention, and 24-months post intervention
The number of patients who report symptoms of patellofemoral pain
Change in pelvic drop during a single leg squat
时间窗: Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.
Data are presented as a degree, with a higher number representing a higher amount of pelvic drop. Group means and standard deviations will be reported.
Change in hip rate of torque development
时间窗: Immediately after the intervention.
Hip abduction and extension rate of torque development will be assessed with a handheld dynamometer. Data are reported as linear, with higher scores representing a faster ability to develop hip muscle force. Group means and standard deviations will be reported.
Change in hip adduction during a single leg squat
时间窗: Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.
Data are presented as a degree, with a higher number representing a higher amount of hip adduction. Group means and standard deviations will be reported.
次要结局
- Change in psychological factors(Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.)
- Change in cognitive factors(Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.)
- Change in coping strategy(Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.)
- Change in physical activity(Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.)
- Change in self-reported knee function(Immediately after the intervention and then 6, 12, 18, and 24 months post-intervention.)
研究者
Neal Glaviano
Responsible Party
University of Connecticut