A Comparison of Two Exercise Programs on Knee Motor Control

Study Overview
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Brief Summary
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Pain at the front of the knee is a common condition treated by physical therapists. Treatment may consist of generalised strengthening exercises directed at the quadriceps muscle or specific retraining aimed at restoring motor control at the knee. This study compared these two exercise programs in a group of people who were painfree at the time to evaluate their effect on motor control. It was hypothesised that only the motor retraining program would influence motor control at the knee.

Official Title
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The Effect of Specific Versus Generalised Quadriceps Exercise on Neural Control of the Vasti

Conditions
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Knee Pain, Patellofemoral Pain

Intervention / Treatment
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* Behavioral: Motor control retraining program
* Behavioral: Quadriceps strengthening program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged between 16-40 years, with the upper age limit to reduce the likelihood of osteoarthritic changes in the patellofemoral joint a self-reported history of anterior or retropatellar knee pain with insidious onset of symptoms and with at least one episode of pain in the past 12 months where pain was aggravated by at least two of the following: prolonged sitting, stairs, squat, running, kneeling and hopping/jumping currently asymptomatic for at least 8 weeks prior to assessment delay in the onset of VMO EMG relative to that of VL of greater than 10 ms during either the ascent or descent of a stair stepping task Exclusion Criteria: current knee pain history of knee surgery or other knee injury in previous 12 months physiotherapy treatment for knee pain in the past 12 months history of patellar dislocation/subluxation clinical evidence of meniscal lesion, ligamentous instability, traction apophysitis around the patellofemoral complex, patellar tendon pathology, chondral damage, osteoarthritis and spinal referred pain current lower limb pathology affecting their ability to satisfactorily complete the testing or exercise protocol current use of non-steroidal anti-inflammatory or corticosteroid drugs inability to communicate and comprehend written or verbal instructions in English

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Motor control retraining program | Behavioral: Motor control retraining program<br>* Specific retraining of VMO activation in a low-load situation,and progressed to integrate more functional positions. Use of dual channel biofeedback was incorporated<br>Behavioral: Quadriceps strengthening program<br>* 4 exercises focused on quadriceps strengthening commencing at a resistance of 60% 1 repetition maximum. Each exercise was performed for 3 sets of 10 repetitions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| latency between the onset of VMO electromyographic activity relative to that of VL during stair ascent and stair descent measured using surface electrodes |  | 6 weeks with 8 week followup | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Concentric and eccentric quadriceps muscle strength as assessed by isokinetic dynamometry |  | 6 weeks with 8 week followup | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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exercise, knee pain, rehabilitation