Therapeutic Effect of Two Muscle Strengthening Programs in Patients With Patellofemoral Pain Syndrome From Bogota, Colombia. Experimental Study, Clinical Controlled Trial
Phase: NA
Conditions: Patellofemoral Pain Syndrome
Sponsor: Universidad Nacional de Colombia

LUISA FERNANDA PRIETO GARCÍA 
NCT04011436 
Therapeutic Effect of Two Muscle Strengthening Programs in Patients with Patellofemoral Pain Syndrome 
 
 
 
 
 
 
 
 
 
Therapeutic Effect of Two Muscle 
Strengthening Programs in Patients with 
Patellofemoral Pain Syndrome from Bogota, 
Colombia.  
 
Experimental Study, Clinical Controlled Trial. 
 
 
 
 
 
 
 
NCT: 04011436 
Date of creation: July 1, 2018. 
 
 
 
 
 
 
 
 
 
 

LUISA FERNANDA PRIETO GARCÍA 
NCT04011436 
Therapeutic Effect of Two Muscle Strengthening Programs in Patients with Patellofemoral Pain Syndrome 
 
 
INTERVENTION PROTOCOL 
 
From the following scheme (Scheme 3), each training session of the muscle strengthening 
program was structured for each of the intervention groups, which was based on the 
principles of training and the Earl and Hoch protocol described in the theoretical framework. 
 
 
Scheme 3: A y B Strengthening Program 
 
 
 
 
 
After the adjustments described in the pilot test, the strengthening program was applied to 
the forty patients who were previously randomized to the intervention protocols for groups 
A and B. 
 
Each of the exercise sessions lasted approximately 45 to 60 minutes, of which, the first 8 to 
10 minutes were dedicated to the initial warm-up exercises, the same for program A and B, 
which gave way to the phase central to the session, that is to say the strengthening exercises: 
group B took about five minutes less to complete it, because they performed an exercise 
less than group A in each of the three phases set out in the program; This phase of 
strengthening lasted approximately 20 to 30 minutes of the total session. 

LUISA FERNANDA PRIETO GARCÍA 
NCT04011436 
Therapeutic Effect of Two Muscle Strengthening Programs in Patients with Patellofemoral Pain Syndrome 
 
 
 
Each session was divided into four parts, of which the second part (central strengthening 
phase) included between 24 and 28 exercises in total, group A and B respectively. In addition 
to this, the anatomical conditioning phase was carried out in two weeks, in which 5 to 6 
strengthening exercises were prescribed depending on the treatment group, but for both 
groups the volume was two sets of 10 repetitions, with approximately 30 seconds rest 
between sets and between exercises, with an execution speed of 1/1 (concentric / eccentric 
contraction ratio) that allowed patients to adapt to adequate movement control and therefore, 
joint protection. 
After the conditioning phase, from the third to the sixth week of intervention, the 
strengthening or resistance strength gain phase was performed, in which 6 to 7 exercises were 
performed; that is, the training was progressed with the addition of an exercise and also with 
the increase of series and repetitions as follows: from the third to the fifth week the volume 
was 2 sets of 15 repetitions, with a 20 seconds rest and a 2/2 contraction speed, which allowed 
greater control of the movement by decreasing the speed of execution of the movement; In 
the sixth week the participants went from performing two sets of 15 repetitions to performing 
3 sets of 15 repetitions, with a decrease in rest between sets and exercises of 10 seconds and 
a decrease in contraction speed (ratio 3/3) that implied greater neuromuscular control over 
the exercise performed and therefore significant increases in muscle strength. 
During the last two weeks of treatment, both groups increased the number of exercises (7 
exercises group B and 8 exercises group A) and some of the exercises changed to exercises 
of greater difficulty, but with a decrease in the volume of training in the seventh week (two 
sets of 10 repetitions for session 21 and two sets of 15 repetitions for sessions 22 and 23) and 
this increase in the eighth and final week of training (three sets of 15 repetitions). The reason 
for these changes was based on the principles of progression and overload, as well as on 
ensuring the correct execution of the exercises without compensation from other muscle 
groups, especially the lumbar muscles, and also to avoid premature fatigue observed in the 
pilot test. 

LUISA FERNANDA PRIETO GARCÍA 
NCT04011436 
Therapeutic Effect of Two Muscle Strengthening Programs in Patients with Patellofemoral Pain Syndrome 
 
The warm-up included 13 exercises, performed in an average time of 8 to 10 minutes and in 
the same way during the eight weeks of intervention, while, in the fourth part of the session, 
final stretching or return to calm, the participants performed 8 exercises during the first 6 
weeks of intervention and 10 exercises in the last two weeks. Each exercise was performed 
for 30 seconds, which took approximately 8 to 10 minutes to complete them. Finally, the 
neuromuscular component (static balance training with one-foot balance exercises) was 
performed after muscle strengthening exercises. It was based on 8 exercises, which changed 
every two weeks with a duration between 30 to 45 seconds each, and between one to two 
repetitions per exercise depending on the week of intervention. The three phases mentioned 
above were exactly the same for both treatment groups. 
 
 
All participants participated in groups of four people per session, three exercise sessions per 
week for eight weeks in total, at the IPS-CAFAM (Institución Prestadora de Salud de la Caja 
de Compensación Familiar) Rehabilitation Center, for a total of twenty-four sessions, which 
were supervised by a Physiotherapist, who was responsible not only to verify the quality in 
the performance of each of the exercises, but to teach during the first two weeks of 
intervention (anatomical conditioning phase) the fundamental bases of adequate breathing 
and feed them back during all the intervention protocol, as well as guaranteeing a correct 
posture in performing the training and thus avoiding the appearance of low back pain as a 
result     of     a     poor      training      technique,      as      well      as      the      increase      in 
intra- abdominal pressure generated by the “pushing” when it is not known to breathe 
properly during strength training. 
The hydration of each participant was also crucial during each training session. Similarly and 
prior to the start of the protocol, all patients were instructed and suggested the importance of 
wearing appropriate footwear for training (sports sneakers, sportswear - during the first two 
weeks they were suggested to wear shorts to observe the position of the knees during the 
exercises and later the use of liquefied pants up to the ankle to avoid rubbing the elastic bands 
with the skin-; likewise, they were instructed to bring water bottle, towel to dry the sweat and 
not to use elements that could injure them during the exercise, such as bracelets or necklaces. 

LUISA FERNANDA PRIETO GARCÍA 
NCT04011436 
Therapeutic Effect of Two Muscle Strengthening Programs in Patients with Patellofemoral Pain Syndrome 
 
However, it is important to mention that it was agreed with about 15% of the patients residing 
in sites far from the place where the program was carried out, at least two of the three sessions 
in the rehabilitation center, and the third session at home, taking into account that it was 
important to supervise the performance of the exercises by the Physiotherapist in charge of 
the intervention program. To do this, the participants attached the necessary evidence in the 
form of photos and videos to support their commitment in carrying out the exercises. This 
aspect was controlled throughout the time by the physiotherapist.