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The Additional Effect of Hallux Valgus Correction on Runners With First Ray Instability and Patellofemoral Pain Syndrome

Not Applicable
Completed
Conditions
Patellofemoral Pain Syndrome
Hallux Valgus
Interventions
Other: Proximal training
Other: combined training
Registration Number
NCT03468491
Lead Sponsor
National Yang Ming Chiao Tung University
Brief Summary

The study purpose is to investigate the effectiveness of a program combining biomechanical taping with lower extremity neuromuscular exercises for runners with patellofemoral pain syndrome (PFPS) and hallux valgus

Detailed Description

This will be a single-blind, experimental study with two treatment groups. A total of 30 college athletes with PFPS and hallux valgus and majoring in long distance running or soccer, or recreational runners in Taipei metropolitan area will be recruited. A set of clinical examination will be conducted to rule out abnormal knee structures, pathologies, or injuries apart from PFPS. The lower extremity alignment as well as hip and knee kinematics during a step down test will be tracked using Noraxon's myoMOTION system. Muscle activation of the muscles controlling the hip and knee movements during the step down test will be recorded using TELEmyo DTS of Noraxon. Hallux valgus angle will be measured with surface markers on photographs. Knee pain level will be rated in a visual analog scale. The investigators will analyze the data with Statistical Product and Service Solutions (SPSS) for Windows. Repeated-measure ANOVAs will be used to examine group-by-time interaction on all the outcome variables. All significance level will be set at 0.05.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • High physical activity level (running at least 5 times/week and at least 2 hours/time)
  • Presenting anterior/retropatellar knee pain in the past 6 months
  • At least two of the following activities provocated symptom: Prolonged sitting, ascending and/or descending stairs, squatting, kneeling, running, limping
  • Not having any pathologies of knee joint (ligament tear, menisci injury, patellofemoral joint dislocation, tendinitis, bursitis...etc.)
  • With hallux valgus angle>15°
  • With 1st metatarsophalangeal joint instability
  • 20~40 y/o
Exclusion Criteria
  • Lower extremities osteoarthritis
  • Systematic diseases such as rheumatoid arthritis, systemic lupus erythematosus, DM...etc.
  • Lower extremities fracture history
  • Surgical history of lower extremities
  • Neurological pathology that would interfere with gait
  • Hallux could not be corrected to neutral through passive correction
  • Low back pain and/or sacroiliac joint dysfunction in the past six months
  • Excessive femoral anteversion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Proximal training groupProximal trainingFor participants of the proximal training group, only a set of lower extremity neuromuscular exercise will be provided. This set of exercises is designed to be the same as for participants of combined training group.
Combined training groupcombined trainingBiomechanical taping will first being applied to the participants of the combined training group. They will be asked to perform following exercises in this session afterwards. As the treatment session goes on, a set of foot intrinsic muscle strengthening exercise and lower extremity neuromuscular exercise will be provided.
Primary Outcome Measures
NameTimeMethod
Displacement of femur in step-down testchanges from baseline and after 6 weeks of intervention

displacement recorded in cm/BMI

EMG amplitude of knee extensorchanges from baseline and after 6 weeks of intervention

amplitude recorded in %MVC

changes of the muscle activation time between vastus medialis oblique and vastus lateralischanges from baseline and after 6 weeks of intervention

changes of the muscle activation time recorded in second

Changes of pain-free running distancechanges from baseline and after 6 weeks of intervention

The changes of pain-free running distance will be recorded in kilometers.

Displacement of tibia in step-down testchanges from baseline and after 6 weeks of intervention

displacement recorded in cm/BMI

Knee pain levelchanges from baseline and after 6 weeks of intervention

The level of knee pain during daily activities will be quantified with visual analogue scale.

EMG amplitude of hip external rotatorchanges from baseline and after 6 weeks of intervention

amplitude recorded in %MVC

EMG amplitude of knee flexorchanges from baseline and after 6 weeks of intervention

amplitude recorded in %MVC

Secondary Outcome Measures
NameTimeMethod
Tibiofemoral angle in relaxed standingchanges from baseline and after 6 weeks of intervention

recorded in degree

Hallux valgus angle in relaxed standingchanges from baseline and after 6 weeks of intervention

recorded in degree

Hip rotation angle in relaxed standingchanges from baseline and after 6 weeks of intervention

recorded in degree

Arch height indexchanges from baseline and after 6 weeks of intervention

arch height in one leg standing, recording in the ratio of arch height and truncated foot length

Navicular dropchanges from baseline and after 6 weeks of intervention

navicular position changes between sitting and relaxed standing, recording in cm

Knee rotation angle in relaxed standingchanges from baseline and after 6 weeks of intervention

recorded in degree

Trial Locations

Locations (1)

National Yng Ming University

🇨🇳

Taipei City, 北投區, Taiwan

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