Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome

Not Applicable

Completed

• Conditions: Patellofemoral Pain Syndrome
• Interventions: Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strength

• Registration Number: NCT05665452
• Lead Sponsor: Cairo University

Brief Summary

Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises.

Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.

Detailed Description

this is interventional study in which patients will receive stretching and strengthening exercises in control group. in addition, experimental group will receive the same exercises of control group in addition to patellar mobilization, retinacula release and deep friction message.

Study Timeline

• Study First Submitted: 2022-10-26
• Study First Submitted QC: 2022-12-22
• Study First Posted: 2022-12-27
• Study Start: 2023-01-15
• Primary Completion: 2023-12-11
• Study Completion: 2024-03-18
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-19
• Last Update Posted: 2024-08-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 59

Inclusion Criteria

1. Age ranging between 18 and 35 years
2. Tenderness of medial and lateral borders of patella
3. Retropatellar pain
4. Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks
5. Positive patellar compression test
6. Pain intensity is more than 3 at visual analogue scale
7. Had a history of insidious onset
8. Had anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squatting

Exclusion Criteria

1. Previous patellar realignment surgery or patellar fracture
2. Had a history of traumatic patellar dislocation
3. Had a history of previous knee surgery
4. Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis
5. Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction
6. Taking corticosteroids or nonsteroidal anti-inflammatory medication
7. Inability to attend treatment program to the end of sessions

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group (2)	Patellar mobilization, retinacula release, deep friction message, stretch and strength	patients will receive stretch, strength, patellar mobilization, retinacula release and deep friction message
Group (1)	Patellar mobilization, retinacula release, deep friction message, stretch and strength	patients will receive stretch and strength exercises

Primary Outcome Measures

Name	Time	Method
Changes in functional disability	It will be assessed one week before and after treatment	Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.
Changes in pain that felt during ascending, descending, squatting and prolonged sitting	It will be assessed one week before and after treatment	Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.

Secondary Outcome Measures

Name	Time	Method
Changes in hip external rotators strength	It will be assessed one week before and after treatment	It will be assessed using handheld dynamometer
changes in quadriceps strength	It will be assessed one week before and after treatment	It will be assessed using handheld dynamometer
changes in functional performance	It will be assessed one week before and after treatment	It will be assessed using step down test
changes in gastrocnemius flexibility	It will be assessed one week before and after treatment	It will be assessed using ankle dorsiflexion range of motion
changes in foot pronation	It will be assessed one week before and after treatment	It will be assessed using navicular drop test
changes in hamstring flexibility	It will be assessed one week before and after treatment	It will be assessed using 90-90 test
Changes in hip abductors strength	It will be assessed one week before and after treatment	It will be assessed using handheld dynamometer
changes in knee valgus	It will be assessed one week before and after treatment	It will be assessed using Q angle

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Giza, Egypt