Activation of Hip Muscles in Runners With Patellofemoral Syndrome
Condition: Patellofemoral Pain Syndrome
MeSH terms: Patellofemoral Pain Syndrome; Syndrome
Study type: Interventional

Summary: 
      Introduction: Hip motor control deficit and neuromuscular disorders of the gluteus medius
      influence the mechanics of patellofemoral joints through increased dynamic knee valgus and
      can lead to Patellofemoral Pain Syndrome (PFPS). Mechanoreceptors can be stimulated by an
      elastic tape, which sends desired tactile cues via afferent improving the functional support
      of the musculoskeletal system.

      Objective: To analyze the response to hip stabilizer muscle activation in street runners with
      PFPS through the application of elastic tape therapy.

      Methods: The investigators evaluated street runners between the ages of 18 and 45, who run at
      least 5km/week and had been suffering from pain for at least 3 months. The volunteers had
      been assessed in relation to their measurements, experience of pain and training routine,
      their medius muscle (GM) and biceps femoris muscle (BF) had also been tested with surface
      electromyography through pre-determined performance tests. The participants of both groups
      wore a bandage for 6 weeks (1 per week). However for the participants of the placebo group
      the investigators applied a different anatomical path without tension, eliminating all the
      therapeutic elements. The volunteers were reassessed following the trial.

      Hypothesis: Expected to observe that elastic tape therapy do result in any improvement in the
      activation of hip muscles and improvement of pain in street runners with patellofemoral pain
      syndrome.
    

Detailed description: 
      Will be recruited individuals 18-45 years of age, of at least running frequency 5 km/week and
      history of pain in the knee for at least three months in two or more of the following listed
      activities: up or down stairs, squatting, kneeling , jump, long time sitting or pain on
      palpation of the lateral side / medial patella.

      Will be included individuals without cardiovascular diseases, which have not undergone
      surgery of the lower limbs in the last two years without back pain and without injury to the
      hip or knee. They will be excluded from those presenting allergy to the use of elastic
      bandage or who can not remain with the use of it during the stipulated period. Participants
      will sign an informed consent and informed, prior to the start of collections.

      Data collection was developed with a electromyography (EMG) for muscle data and questionnaire
      with participants by a blinded examiner initially will be held. The questionnaire consists of
      the Visual Analogue Scale (VAS). For EMG of the gluteus medius (GM) and biceps femoris (BF),
      the electrodes are positioned according to the protocols of Surface Electromyography for the
      Non-Invasive Assessment of Muscles (SENIAM), with the reference electrode located in anterior
      tibial tuberosity. The application site will be prepared with abrasion and cleansing the skin
      with 70% alcohol and trichotomy. The maneuver of maximum voluntary isometric contraction
      (MVIC) will be trained and previously performed the collection, with five seconds support for
      normalization of data to the gluteus medius and biceps. Among the MVICs every muscle will
      hold a minute's rest. The muscle activity recorded during the exercises will be expressed in
      percentage of MVIC. After maneuvers MVIC, individuals will rest for five minutes and then
      immediately to start the acquisition of electromyographic data during functional tests.

      For this, individuals previously will be guided and trained to realize them. During testing,
      barefoot athletes will be positioned on one foot on the leg with more intense pain
      complaints, contralateral leg approximately 70 ° of knee flexion, relaxed upper body next to
      the body, torso upright and keeping focused look a marking affixed to the wall at eye level.
      In the first test, prompted a squat (AG) of approximately 45 ° of knee flexion, with one
      foot; in the second test, the same squat will be held, but followed by maximum external
      rotation (ROT-AG) in the hip support. The cadence of the movement will be standardized and
      guided by the appraiser to be started and completed in 10 seconds. Functional tests are
      designed to simulate the action of the hip muscles in the race support phase and motor
      control of the lower limb.

      After electromyographic reviews, be held to randomization to the control group and treatment
      through and opaque sealed envelopes, by a blinded evaluator. Individuals of both groups will
      be submitted to the application of the bandage on the leg with pain complaints. For this, a
      qualified professional trained for the bandage application in relation to anatomical
      landmarks and elastic tension of the application, without the knowledge, so as to physiology
      or function thereof. Will be used two techniques in the intervention group. For the placebo
      group, the application of the bandage will follow a different anatomical path without
      tension, eliminating all therapeutic process elements.

      The groups will be followed for six weeks and will be guided them to keep their daily
      routine. Each week, individuals remain five days with the application of the bandage, and two
      days without, to avoid possible adverse effects of excessive and constant use of it. After
      this, a new bandage will be applied by the same trained professional, following the protocols
      already mentioned. After six weeks, the volunteers return for reevaluation.
    

Intervention name(s): Therapy taping; Placebo taping
Intervention type(s): Other; Other
Intervention description(s): Therapy taping follows an anatomical pattern from the femur until tibia for correction of dynamic valgus with therapy taping.; Placebo taping follows a different anatomical path without tension, eliminating all therapeutic process elements
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: patellofemoral pain syndrome; therapy taping; knee; physical therapy; runners