Effect of Adding Blood Flow Restriction to Strengthening Exercise in Patients With Patellofemoral Pain Syndrome
- Conditions
- PFPSStrengthening ExercisesBFRQuadriceps StrengthDynamic BalanceJoint Position Sense
- Interventions
- Other: strengthening exerciseOther: BFR
- Registration Number
- NCT06565754
- Lead Sponsor
- Cairo University
- Brief Summary
To study the effect of adding BFRT to strengthening exercises and compare it with strengthening exercises alone in improving, muscular strength, pain, function, joint position sense, and dynamic balance test (star excursion test). in patients with PFPS.
- Detailed Description
Background: Patellofemoral Pain Syndrome (PFPS) is a common condition characterized by anterior knee pain, particularly affecting individuals aged 15-30. It often involves lower limb muscle weakness, particularly in the quadriceps, which can exacerbate symptoms and affect functional performance. Blood Flow Restriction Training (BFRT) has shown promise in enhancing muscle strength and functional outcomes with reduced intensity compared to traditional high-intensity training.
Purpose: This study aims to compare the efficacy of combining BFRT with traditional strengthening exercises versus using strengthening exercises alone in improving muscular strength, pain, function, joint position sense, and dynamic balance in patients with PFPS.
Methods: A triple-blinded, randomized controlled trial was conducted at the Almenshawy General Hospital, Tanta, Egypt. Fifty patients with unilateral non-traumatic PFPS, aged 18-35, were randomly assigned to either a strengthening exercises group (SE Group) or a BFRT plus strengthening exercises group (BFRT Group). Both groups underwent a 6-week intervention with three sessions per week. Outcomes assessed included quadriceps and hip abductors strength, pain severity (Visual Analog Scale), functional status (Kujala Patellofemoral Score), joint position sense (measured by digital inclinometer), and dynamic balance (Star Excursion Balance Test).
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 50
- Patient referred from Orthopedic surgeon with diagnosis of patellofemoral pain syndrome PFPS.
- Both genders.
- BMI ranges from 18.5 to 29.9.
- Age ranges between 18 and 40 years experienced non-traumatic PFPS onset of anterior knee pain for greater than 2 weeks.
- Pain with any two activities, including running, jumping, squatting, kneeling, stair ascent/descent or prolonged sitting.
- Coexisting pathology around the knee, including patellar subluxation or dislocation.
- Other sources of anterior knee pain (bursa, fat pad).
- Previous knee surgery.
- Suspicion of patellar tendinopathy, with strong consideration of pain localised to the patellar tendon.
- Any cardiovascular disease.
- Uncontrolled hypertension.
- Any lower limb trauma.
- Hip and ankle pathology.
- BMI more than 30%.
- Pregnancy.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description strengthening exercises group (SE Group) strengthening exercise all patients will receive : 1. Isometric quadriceps exercise - 3 sets of 20 repetitions (5 s). 2. Straight leg raise (SLR) with 3 sets - 20 repetitions. 3. Short arc knee extension exercise - 3 sets of 20 repetitions. 4. Hip abduction from side lying - 3 sets of 20 repetitions. BFRT plus strengthening exercises group (BFRT Group) strengthening exercise all patients will receive the below exercises using BFR cuff : 1. Isometric quadriceps exercise - 3 sets of 20 repetitions (5 s). 2. Straight leg raise (SLR) with 3 sets - 20 repetitions. 3. Short arc knee extension exercise - 3 sets of 20 repetitions. 4. Hip abduction from side lying - 3 sets of 20 repetitions. BFRT plus strengthening exercises group (BFRT Group) BFR all patients will receive the below exercises using BFR cuff : 1. Isometric quadriceps exercise - 3 sets of 20 repetitions (5 s). 2. Straight leg raise (SLR) with 3 sets - 20 repetitions. 3. Short arc knee extension exercise - 3 sets of 20 repetitions. 4. Hip abduction from side lying - 3 sets of 20 repetitions.
- Primary Outcome Measures
Name Time Method quadriceps and hip abductors strength 6 weeks Hand-Held Dynamometer (HHD). The Lafayette® HHD is a valid and reliable instrument of low cost and easy handling compared to the isokinetic dynamometer for assessment of muscle strength
- Secondary Outcome Measures
Name Time Method functional status (Kujala Patellofemoral Score) 6 weeks The 13 items on the scale are used to assess subjective symptoms and functional restrictions. A score can have a minimum of 0 points or a maximum of 100 points.
dynamic balance (Star Excursion Balance Test 6 weeks Four strips of adhesive tape will need to be cut to a length of 6-8 feet each. Two pieces will be used to form a '+', with the other two being placed over top to form an 'x' so that a star shape is formed. It is important that all lines are separated from each other by a 45° angle. The goal of the Star Excursion Balance Test (SEBT) is to maintain single leg stance on one leg while reaching as far as possible with the contralateral leg.
pain severity using Visual Analog Scale (VAS) 6 weeks The Visual Analog Scale is determined by measuring in millimeters from the left end of the line to the patient's mark. Participants will ask to determine the point at which pain represents the severity of pain maximum is 10 while lowest level of pain is zero
joint position sense (measured by digital inclinometer) 6 weeks Digital Inclinometer for joint position sense assessment. Device (Digital Protractor, 82201b-00, INSPEC, China) The inclinometer is a valid and reliable method to assess the knee proprioception through JPS in open kinetic chain
Trial Locations
- Locations (1)
Cairo University
🇪🇬Giza, Egypt