Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Patellofemoral Pain Syndrome

Study Overview
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Brief Summary
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This study compared the effects of patellar taping and electromyographic-biofeedback (EMG-BF) guided isometric quadriceps strengthening at different knee angles in patello-femoral pain syndrome (PFPS).

Detailed Description
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A total of 60 adult male athletes aged 18 to 45 years were recruited. Subjects will be included with the history of knee pain during activities such as descending and ascending stairs, squatting, and running, had positive J sign (lateral tilt of patella), and a sign of patellar malalignment on the radiograph. Individuals with a history of fracture around the knee, patella dislocation, knee deformity (e.g., genu varum), flexion contracture, ligaments/meniscal injuries, and osteoarthritis of the knee will be excluded from the study. The protocol was submitted to and approved by the ethical sub-committee of the College of applied medical science, Majmaah, Saudi Arabia (Ethics number: MUREC-Nov./COM-2O20/11-2). Participants were requested to sign a written informed consent form approved by the institution ethics committee. Participants were randomly assigned to Group A (experimental group): electromyography biofeedback (EMG-BF) guided maximum voluntary isometric contraction exercise with patellar taping; Group B (control group): sham EMG-BF guided maximum voluntary isometric contraction without patellar taping. The outcome measure for this study will be the mean changes in maximum voluntary isometric contraction (MVIC) of the quadriceps muscle at different angles, pain intensity, single-leg triple hop test (SLTH), and functional status up to 6 weeks.

Official Title
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Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes With Patellofemoral Pain Syndrome

Conditions
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Patellofemoral Disorder, Anterior Knee Pain Syndrome

Intervention / Treatment
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* Other: Electromyographic-biofeedback guided (EMG-BF) isometric quadriceps strengthening with patellar taping five days a week for six weeks.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Knee pain during activities such as descending and ascending stairs, squatting, and running, Positive J sign (lateral tilt of patella), Sign of patellar malalignment on the radiograph Exclusion Criteria: Fracture around the knee, Patella dislocation, Knee deformity (e.g., genu varum), Knee flexion contracture, Ligaments/meniscal injuries, and Osteoarthritis of the knee.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Experimental: Participants in this group will receive electromyography biofeedback (EMG-BF) guided strength training along with patellar taping at 30, 60, and 90-degree angles. No Intervention: Control: Participants in this group will receive Sham EMG-BF guided strength training without patellar taping at 30, 60, and 90-degree angles.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental group<br>Experimental: Participants in this group will receive electromyography biofeedback (EMG-BF) guided strength training along with patellar taping | Other: Electromyographic-biofeedback guided (EMG-BF) isometric quadriceps strengthening with patellar taping five days a week for six weeks.<br>* Patellar Taping, electromyography biofeedback (EMG-BF), Strength Training<br>* Other names: Control group will receive Sham EMG-BF guided isometric quadriceps strengthening without patellar taping five days a week for six weeks.;|
| Sham Comparator: Control group<br>No Intervention: Control: Participants in this group will receive Sham EMG-BF guided strength training without patellar taping | Other: Electromyographic-biofeedback guided (EMG-BF) isometric quadriceps strengthening with patellar taping five days a week for six weeks.<br>* Patellar Taping, electromyography biofeedback (EMG-BF), Strength Training<br>* Other names: Control group will receive Sham EMG-BF guided isometric quadriceps strengthening without patellar taping five days a week for six weeks.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean changes in pain intensity | The 10-cm visual analogue scale (VAS) will be used for the assessment of pain intensity. Each participant will be instructed to report their current intensity of pain on a 10-cm scale between two anchors 0 (indicates no pain) and 10 (indicates maximum pain). | 6 weeks | 
| Mean changes in knee function | Knee function will be assessed using the validated Anterior Knee Pain scale. It comprised of 13 questions designed to evaluate difficulties related to PFPS such as presence of a limp, walking ability, need for support, squatting, stair climbing, jumping, running, pain, abnormal painful kneecap movement, prolonged sitting with knees flexed, atrophy of the thigh, swelling, and flexion deficiency. Total scores range between 0 and 100. A higher score suggests lower symptoms and better functional capacity. | 6 weeks | 
| Mean changes in quadriceps muscle strength | Maximum voluntary isometric strength of quadriceps femoris muscle will be measured using an isokinetic dynamometer. Participants will be made in a sitting position and secured using the stabilization straps with the knee joint in 30,60,90 degrees of flexion, as this position has resulted in the most significant torque output. They will be verbally encouraged to carry out three maximal voluntary isometric contractions of quadriceps with 5-sec rest. The best of the three maximum peak torque will be used for the analysis. | 6 weeks | 
| Mean changes in balance performance | The SLTH test measured the distance participants travelled from the starting point to where the back of their heel touched the ground. They conducted three trials with a 3-minute rest period in between. The maximum distance covered score of the three, i.e., the best, was used as the baseline score. | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pain; Strength; Function; PFPS; Athletes; SLTHT