Patellofemoral Pain Syndrome Clinical Trial
— PhD_BrunoOfficial title:
Addition Effect of the Calf Stretching and Ankle Mobilization to Quadriceps and Gluteus Strengthening on Knee Pain and Function in Women With Patellofemoral Pain: a Randomized Controlled Trial
Patellofemoral pain (PFP) is the most common overuse injury of the lower limb, its prevalence is around 20% in general population, and women are more likely to develop PFP compared to men. PFP may develop as a result of increased pressure and joint stress due to an reduction in contact area in the patellofemoral joint. The excessive dynamic knee valgus is an important contributor to patella misalignment and for the increasing of laterally directed forces on the patella, and restriction in ankle dorsiflexion range of motion (ROM) has been previously associated with excessive dynamic knee valgus. Although the evidence shows that strengthening exercises for the quadriceps and gluteus promote improvement of knee pain and function, there is a lack of studies that investigate if targeted interventions for improvement ankle dorsiflexion may promote additional benefits in knee pain and function when performed in combination with strengthening exercises. Thus, the aimed of this study is analyze the addition effect of calf stretching and ankle mobilization to quadriceps and gluteus strengthening on knee pain and function in women with PFP who display ankle dorsiflexion restriction.
Status | Not yet recruiting |
Enrollment | 68 |
Est. completion date | December 2025 |
Est. primary completion date | December 2024 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years to 35 Years |
Eligibility | Inclusion Criteria: - Presence of anterior knee pain for at least 3 months, unrelated to any traumatic knee event and reproducible by performing at least two of the following activities: sitting for a long time, squatting, kneeling, ascending or descending stairs, walking or running long distances, and performing jump-landing tasks; - Anterior knee pain in the previous week with an intensity of at least 3 points on numeric pain rating scale (NPRS); - Score in the Anterior Knee Pain Scale less than or equal to 86 points, and; - Limited ankle dorsiflexion range of motion in closed kinetic chain, identified by a weight-bearing lunge test in which the distance between foot and wall being less than or equal to 10 cm. Exclusion Criteria: - History of surgery or fracture in the lumbar spine, hip, knee, ankle, or foot; - Referred pain from the lumbar spine, hip, ankle, or foot; - History of patellar subluxation; - Presence of knee swelling; - Presence of meniscal, ligament or tendon injury, and; - Osgood-Schlatter or Siding-Larsen-Johansson syndrome. |
Country | Name | City | State |
---|---|---|---|
Brazil | Bruno Augusto Lima Coelho | Fortaleza | Ceará |
Lead Sponsor | Collaborator |
---|---|
Universidade Federal do Ceara |
Brazil,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Numeric Pain Rating Scale | Pain will be assessed by use of an 11-point Numeric Pain Scale, where 0 correspond to no pain and 10 correspond to worst imaginable pain. | At the end of the six weeks of treatment | |
Primary | Anterior Knee Pain Scale | The subjective functional capacity of the participant will be recorded with the translated and validated Portuguese-language version of the Anterior Knee Pain Scale (AKPS). The scores for this scale, 0 to 100, represent the lowest to the highest levels of functional capacity, respectively. | At the end of the six weeks of treatment | |
Secondary | Numeric Pain Rating Scale | Pain will be assessed by use of an 11-point Numeric Pain Scale, where 0 correspond to no pain and 10 correspond to worst imaginable pain. | At 3 and 6 months follow-up | |
Secondary | Anterior Knee Pain Scale | The subjective functional capacity of the participant will be recorded with the translated and validated Portuguese-language version of the Anterior Knee Pain Scale (AKPS). The scores for this scale, 0 to 100, represent the lowest to the highest levels of functional capacity, respectively. | At 3 and 6 months follow-up | |
Secondary | Weight-Bearing Lunge Test | The ankle dorsiflexion range of motion in closed kinetic chain will be measured by the distance between foot and wall in the weight-bearing lunge test. | At the end of the six weeks of treatment | |
Secondary | Dynamic knee valgus | The dynamic knee valgus will be assessed by 2D kinematic through measurement of frontal plane projection angle of the knee during the forward step-down test. | At the end of the six weeks of treatment | |
Secondary | Isometric strength of the quadriceps | The quadriceps isometric strength will be assessed using a handheld dynamometer (Nicholas Manual Muscle Test, Lafayette Instrument Company, Lafayette, Indiana, USA). The evaluation will be performed with the participant in a sitting position, straight trunk and knee at 90ยบ of flexion. | At the end of the six weeks of treatment. | |
Secondary | Isometric strength of the hip posterolateral complex | The hip posterolateral complex isometric strength will be assessed using a handheld dynamometer (Nicholas Manual Muscle Test, Lafayette Instrument Company, Lafayette, Indiana, USA) during the Hip Stability Isometric Test (HipSIT). | At the end of the six weeks of treatment. | |
Secondary | Global Effect Perception Scale for Treatment | The participant's perception of treatment will be assessed by use of an 11-point Global Effect Perception Scale , where +5 correspond to perception of great improvement and -5 correspond to perception of great worsening. | At the end of the six weeks of treatment. |
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