Muscle Training With and Without Vascular Occlusion of Women With Patellofemoral Pain Syndrome: A Random Clinical Trial

Not Applicable

Completed

• Conditions: Patellofemoral Pain Syndrome; Vascular Occlusion
• Interventions: Other: Conventional muscle strengthening; Other: Muscle strengthening with vascular occlusion

• Registration Number: NCT04478422
• Lead Sponsor: Christiane Macedo

Brief Summary

Introduction: The treatment of Patellofemoral Pain Syndrome (PFPS) uses the strengthening of the knee and hip muscles. Studies propose the use of partial vascular occlusion (OVP) of the quadriceps muscle to increase muscle strength and endurance, without joint overload or discomfort to the patient. However, there is no consensus on the use in individuals with PFPS. Objective: To establish the effect of quadriceps muscle strengthening with OVP and low resistance to exercise on pain, functionality, postural control and muscle recruitment in women with patellofemoral dysfunction. Methods: Women with PFPS (n = 20) will respond to pain and functionality scales. The postural control and muscle recruitment of the quadriceps will also be evaluated in dynamic activities of single-legged squat and up / down stairs using a force platform and surface electromyography. After the initial assessment, the participants will be randomized into two groups: conventional quadriceps strengthening with greater resistance loads to exercise and quadriceps strengthening with OVP and low loads. And they will perform a six-week treatment protocol with exercises to strengthen the quadriceps. At the end of the intervention protocols, all of them will be reassessed immediately, after four and eight weeks. Expected Results: It is expected that the group submitted to exercises with OVP and lower load will present the same results of postural control and muscle recruitment compared to the conventional strengthening group. These results will indicate the possibility of using exercises and loads with less joint impairment.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-07-10
• Study First Submitted QC: 2020-07-15
• Study First Posted: 2020-07-20
• Study Start: 2021-02-01
• Primary Completion: 2021-05-31
• Study Completion: 2023-09-30
• Status Verified: 2023-12
• Last Update Submitted: 2023-12-05
• Last Update Posted: 2023-12-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 24

Inclusion Criteria

Insidious onset of symptoms unrelated to trauma, pain for at least three months; pain greater than three (3/10) in at least three of the functional activities (squatting for a long time, going up or down stairs, kneeling, running, remaining in a sitting position for a long time), maximum 86 points on the Anterior Knee Pain Scale (AKPS).

Exclusion Criteria

Signs and symptoms of other coexisting knee pathologies (arthrosis, prostheses, meniscal and ligament injuries), pain in other joints of the lower limb; lumbar spine pain, neurological, rheumatological, vascular and metabolic diseases; pregnancy; history of lower limb surgery; corticosteroid injection in the knee applied in the last three months, physiotherapy for knee rehabilitation in the last six months.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Conventional muscle strengthening	Conventional muscle strengthening	Conventional quadriceps strengthening exercises will be performed in isometric, concentric and eccentric phases, without occlusion to blood flow.
Muscle strengthening with vascular occlusion	Muscle strengthening with vascular occlusion	Quadriceps strengthening exercises will be performed in isometric, concentric and eccentric phases, with partial occlusion to blood flow. The occlusion equipment will be positioned over the proximal portion of the lower limb to be treated, just below the gluteal fold and inguinal ligament (Tennent et al. 2017). The pressure must be maintained during all series of exercises (approximately 5 minutes) (Bryk et al. 2016; Ferraz et al. 2018; Giles et al. 2017).

Primary Outcome Measures

Name	Time	Method
Change in Pain in the knee by scale score	pre-intervention, immediately after, after four weeks	Through Visual Analog Scale (VAS). The score ranges from 0 to 10, the higher the score, the greater the pain.
Change in functional capacity by scale score	pre-intervention, immediately after, after four weeks	Using the Lysholm questionnaires. The score ranges from 0 to 100, the higher the score, the better the functional capacity.

Secondary Outcome Measures

Name	Time	Method
Change in Postural control by pressure center variables	pre-intervention, immediately after, after four weeks	Evaluation of postural control using a force platform will be evaluated during one-legged squat activity and up and down stairs.
Change in Muscle activition by electromyography variables	pre-intervention, immediately after, after four weeks	Muscle activition by surface electromyography of the quadriceps will be evaluated during one-legged squat activity and up and down stairs.
Change in quadriceps muscle strength	pre-intervention, immediately after, after four weeks	Change in quadriceps muscle strength by portable dynamometry

Trial Locations

Locations (1)

State University of Londrina; 🇧🇷 Londrina, PR, Brazil