Lumbar Thrust-mobilization Effects on Hip Strength and Anterior Knee Pain

Not Applicable

• Conditions: Anterior Knee Pain Syndrome
• Interventions: Other: Lumbar-thrust mobilization; Other: Sham thrust-mobilization

• Registration Number: NCT04119310
• Lead Sponsor: Messiah College

Brief Summary

The purpose of this study is to investigate changes in lateral hip muscle strength as well as self-reported pain during the performance of three functional tests in patients with anterior knee pain following a lumbopelvic thrust-mobilization.

Hypothesis(es):

Lumbar thrust-mobilization will lead to increased lateral hip strength and decreased anterior knee pain during 3 functional activities (single leg step down, functional squat, drop jump).

Detailed Description

The participant will complete a medical history form and undergo a brief physical exam of the lumbar spine and knees to include: lumbar range of motion and mobility testing, knee range of motion, palpation, and knee mobility testing. The participant will complete a hip strength test utilizing the Biodex System 4 Pro®. The participant will then perform three activities (single leg step down, squat, and drop jump from a 2 foot platform) and provide a self-reported knee pain measure with each activity. A sealed envelope indicating the intervention to be received will be given to the participant. An investigator blinded to the pre and post-measures will open the envelope indicating the intervention to be performed. The participant will be blinded to which intervention group they are categorized to. Th e participant will be positioned on a high-low treatment table to receive the assigned intervention. The participant will be positioned to receive either intervention 1 (thrust mobilization) or 2 (sham mobilization). The participant will either receive the thrust-mobilization or sham mobilization up to 2 times on the left and right side. An immediate re-test of hip strength will be conducted followed by performing the same three functional activities (single leg step down, squat, and drop jump from a 2 foot platform) while providing a self-reported pain measure after each activity. Follow-up measures at 15 minutes post-intervention and the final measure at 30 minutes post-intervention will be performed.

Study Timeline

• Status Verified: 2019-10
• Study First Submitted: 2019-10-01
• Study First Submitted QC: 2019-10-07
• Last Update Submitted: 2019-10-07
• Study First Posted: 2019-10-08
• Last Update Posted: 2019-10-08
• Study Start: 2019-11-01
• Primary Completion: 2020-05-31
• Study Completion: 2020-05-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 128

Inclusion Criteria

• Healthy males and females between the ages of 18 and 25 with non-traumatic anterior knee pain
• Able read and write in English
• Clearly understand the informed consent form

Exclusion Criteria

• Low back pain
• Pregnant or may be pregnant
• Previously diagnosed with spondylolisthesis,
• Previously diagnosed with a herniated disc,
• Signs and symptoms of nerve root compression
• History of spine surgery
• History of knee surgery
• History of cancer
• History of compression fracture
• History of osteoporosis
• History of osteopenia
• History of a systemic disease
• History of a connective tissue disease
• History of a neurological disease
• Pain with pre-manipulative hold
• Positive findings on medical history form, or physical exam
• Presence of anxiety during the procedure

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Lumbar thrust-mobilization	Lumbar-thrust mobilization	The investigator will perform a lumbar thrust-mobilization with the subject in right and then left sidelying position
Sham-mobilization	Sham thrust-mobilization	No lumbar-thrust mobilization will be performed. Subject will receive simple passive inter-vertebral range of motion.

Primary Outcome Measures

Name	Time	Method
Change in lateral hip strength	Pre-intervention, immediately following intervention, 15 min post-intervention & 30 min post-intervention	lateral isometric hip strength will be measured with Biodex system 4
Change in pain with double leg squat	Pre-intervention, immediately following intervention, 15 min post-intervention & 30 min post-intervention	Subject will provide level of anterior knee pain via Visual Analogue Scale (VAS) while performing a double leg squat.; The VAS pain scale is a 0 to 10 scale, 0 indicates no pain, 5 indicates distressing pain, 10 indicates unbearable pain. Any whole number between 0 and 10 may be chosen. 0 is better and 10 is worse.
Change in pain with drop jump from 2 foot platform	Pre-intervention, immediately following intervention, 15 min post-intervention & 30 min post-intervention	Subject will provide level of anterior knee pain via Visual Analogue Scale (VAS) while performing a drop jump from a 2 foot platform.; The VAS pain scale is a 0 to 10 scale, 0 indicates no pain, 5 indicates distressing pain, 10 indicates unbearable pain. Any whole number between 0 and 10 may be chosen. 0 is better and 10 is worse.
Change in pain with single leg step down	Pre-intervention, immediately following intervention, 15 min post-intervention & 30 min post-intervention	Subject will provide level of anterior knee pain via Visual Analogue Scale (VAS) while performing a single leg step down.; The VAS pain scale is a 0 to 10 scale, 0 indicates no pain, 5 indicates distressing pain, 10 indicates unbearable pain. Any whole number between 0 and 10 may be chosen. 0 is better and 10 is worse.