Shock Wave Therapy Versus Neuromuscular Training in Women With Patellofemoral Pain

Not Applicable

• Conditions: Knee Pain Chronic; Patellofemoral Pain Syndrome
• Interventions: Other: Neuromuscular Training; Other: Extracorporeal Shock Wave Therapy (ESWT)

• Registration Number: NCT03324204
• Lead Sponsor: Medical University of Silesia

Brief Summary

The aim of the trial is to compare the efficacy of extracorporeal shock wave therapy (ESWT) versus neuromuscular training (TR) in reducing pain in women with patellofemoral pain (PFP). Women with PFP will be randomly divided into two therapeutic groups: ESWT and TR. The ESWT group will undergo extracorporeal shock wave therapy to the iliotibial band and tensor fascia latae. The TR group will be treated with neuromuscular training. The women's gait will be analysed and the strength of hip abductors and internal rotators will be measured. Additionally, the women's pain and health status will be assessed with the visual analogue scale and the Lysholm Scale. Outcomes will be registered at baseline, and then at five weeks and at three months post-therapy

Detailed Description

Not available

Study Timeline

• Study Start: 2014-08-01
• Study First Submitted: 2017-07-18
• Status Verified: 2017-10
• Study First Submitted QC: 2017-10-24
• Last Update Submitted: 2017-10-24
• Study First Posted: 2017-10-27
• Last Update Posted: 2017-10-27
• Primary Completion: 2018-06-01
• Study Completion: 2019-01-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: Female
• Target Recruitment: 100

Inclusion Criteria

Knee pain for more than three months greater than three on the visual analogue scale (VAS) during at least two out of four typical activities:

1. ascending or descending the stairs,
2. prolonged sitting with flexed knee,
3. running or jumping,
4. squatting or kneeling.

Exclusion Criteria

1. Orthopaedic diagnosis other than PFP.
2. Patients with neurological disorders, history of injury or operations within the symptomatic leg, rheumatoid disease, or pregnancy were also excluded from the study.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Neuromuscular Training	Neuromuscular Training	Each session lasted 30 minutes and consisted of three sets of exercises with 20-30 repetitions. Emphasis is placed on proper knee alignment during exercise. Most of the women exhibit excessive medial rotation and adduction of the femur, resulting in knee valgus. The women will be instructed how to correct their abnormalities using mirrors as visual feedback. All exercises will be completed without pain. If the exercises are too easy, the level of difficulty will be increased individually in accordance with the rehabilitation protocol
Shock Wave Therapy	Extracorporeal Shock Wave Therapy (ESWT)	The ESWT group will will meet the therapist twice in the first week, and once a week after it. ESWT will be applied to the iliotibial band and tensor fascia latae with the following parameters: pressure - 4.5 bar, emission frequency -8 Hz, number of pulses per dose -2,500 per session.

Primary Outcome Measures

Name	Time	Method
Visual Analog Scale is used to assess the subjective Pain.	Outcome measures are obtained at three months after intervention	The participants are asked to make a mark on a 10 cm line that corresponds to the perceived maximal pain, peripatellar or retropatellar, they experienced during any activity or position (0 = no pain, 10 = the worst pain possible)

Secondary Outcome Measures

Name	Time	Method
Gait analysis using the Zebris FDM-TDL instrumented treadmill with pressure sensors.	Outcome measures are obtained at three months after intervention	The women walk on the treadmill barefoot for three minutes in order to become accustomed to the speed belt. After that time, the angles of the joints are measured for 30 seconds. Internal rotation is demarcated at the highest peak in midstance when the contralateral limb is in the terminal stance (toe-off phase). Hip adduction is determined at the highest peak in midstance
The self-reported health status is measured using the Lysholm Questionaire (LQ)	Outcome measures are obtained at three months after intervention	The participants are asked to complete the eight-item questionnaire, scored on a 0-100 weighted scale
Muscle strength is tested using the Micro Fet Handheld Dynamometer.	Outcome measures are obtained at three months after intervention	Muscle strength of lateral rotators, abductors of the hip is tested. Three repetitions of muscle strength testing are performed with two 30-second intervals. The participants a of re asked to press against the Dynamometer with the maximum effort for 5-7 seconds.

Trial Locations

Locations (1)

Department of Kinesitherapy and Special Methods, SHS in Katowice, Medical University of Silesia, Katowice, Poland; 🇵🇱 Katowice, Śląskie, Poland