Close Kinetic Chain Exercise With Kinesio Taping in the Management of Patellofemoral Pain Syndrome

Study Overview
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Brief Summary
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The investigators will include patients attending outpatient clinic in the area of Orthopedics and Traumatology of our hospital with a diagnosis of unilateral Patellofemoral Pain Syndrome. Two groups would be made, the control group will receive treatment with acetaminophen and physical therapy rehabilitation, closed chain exercises and stretches at home intended for the strengthening of quadriceps, abductors and internal rotators of the hip for the duration of six weeks. The experimental treatment group will receive the above plus the application of the technique NUCAP Medical Upper Knee Spider ® Kinesio taping on the affected knee. Both groups will be evaluated by an external consultation. They will be assessed by the Tegner Activity Scale, the Kujala score of the WOMAC and visual analog scale (VAS) for pain assessment; these scales will be applied at the beginning, third and sixth week

Detailed Description
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The investigators will include patients attending outpatient clinic in the area of Orthopedics and Traumatology of our hospital with a diagnosis of unilateral Patellofemoral Pain Syndrome. Inclusion criteria are: age between fifteen and thirty-five years, presenting unilateral Patellofemoral pain syndrome with six months of evolution, presenting anterior or retro knee pain that presents itself when undergoing two or more of the following activities: squatting, running, kneeling, jumping, or climbing stairs; physically active patients, with at least thirty minutes of physical activity at least three times per week. Exclusion criteria include patients with previous knee surgeries, chronic pain with more than one year of evolution, pregnancy or suspected pregnancy, application of intra-articular steroids in the three months prior to their evaluation, patients with meniscal injuries, ligament or intra-articular knee structures, degenerative diseases such as diabetes, rheumatoid arthritis, Osteoarthritis of the knee, hip or ankle, history of dislocation or subluxation of patella, Osgood Schlatter syndrome and patellar tendinitis or quadriceps. The investigators will divide patients into two groups. The control group will receive treatment with acetaminophen and physical therapy rehabilitation, closed chain exercises and stretches at home intended for the strengthening of quadriceps, abductors and internal rotators of the hip for the duration of six weeks. The experimental treatment group will receive the above plus the application of the technique NUCAP Medical Upper Knee Spider ® Kinesio taping on the affected knee. Both groups will be evaluated by an external consultation. They will be assessed by the Tegner Activity Scale, the Kujala score of the WOMAC and visual analog scale (VAS) for pain assessment; these scales will be applied at the beginning, third and sixth week. The patients in the experimental group will be quoted each week to change the tape. The control group will be quoted at the beginning, at three weeks and after six weeks. During the first appointment we will take patients anthropometric measurements (weight, height, BMI) as well as general information. Radiographic studies (anteroposterior and lateral knee, plus the projection Merchant) will be sought to rule out other diseases and see the degree of contact of the patella on the patellofemoral joint. All patients will receive an explanation about their illness, and a booklet with the required exercises as well as their frequency. For patients to be included in the group of Spider ® Taping, Kinesio Tape pre-cut strips that were placed inferior to the head with no pressure applied, then two bands are placed at the ends of the tape and crossed on the edges of the patella and ending at the thigh to finish applying moderate tension to place them, then two strips were placed at each end of the edges of the first and second tape without applying pressure. The tapes can last up to five days on the extremities while maintaining their purpose, patients included in this group will be summoned each week to remove the tapes and place new ones.

Official Title
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Close Kinetic Chain Exercise With Kinesio Taping in the Management of Patellofemoral Pain Syndrome.

Conditions
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Patellofemoral Pain Syndrome

Intervention / Treatment
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* Drug: Acetaminophen 500mg
* Device: Kinesio taping


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Age between fifteen and thirty-five years, Presenting unilateral PFPS with six months of evolution, Presenting anterior or retro knee pain that presents itself when undergoing two or more of the following activities: (squatting, running,kneeling, jumping,climbing stairs,physically active patients, with at least thirty minutes of physical activity at least three times per week.) Exclusion criteria: Patients with previous knee surgeries, Chronic pain with more than one year of evolution, Pregnancy or suspected pregnancy Application of intra-articular steroids in the three months prior to their evaluation Patients with meniscal injuries Ligament or intra-articular knee structures Degenerative diseases such as diabetes Rheumatoid arthritis Osteoarthritis of the knee, hip or ankle History of dislocation or subluxation of patella Osgood Schlatter syndrome Patellar tendinitis or quadriceps.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Acetaminophen 500mg<br>The control group will receive treatment with acetaminophen 500mg and physical therapy rehabilitation | Drug: Acetaminophen 500mg<br>* 500 mg, tablets every 8 hours<br>* Other names: Tempra® 500mg;|
| Experimental: Kinesio taping<br>The experimental treatment group will receive acetaminophen 500mg and physical therapy rehabilitation, plus the application of the technique NUCAP Medical Upper Knee Spider ® Kinesio taping | Device: Kinesio taping<br>* Taping will be changed every week.<br>* Other names: SpiderTech ® Kinesio taping;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Closed kinetic chain exercise with kinesio taping pain relief measured in the Kujala score | The Kujala patellofemoral score is a functional evaluation instrument to evaluate knee problems related to the patellofemoral system.It is a 13-item knee-specific self-report questionnaire. It documents response to six activities thought to be associated specifically with anterior knee pain syndrome (walking, running, jumping, climbing stairs, squatting, and sitting for prolonged periods with knees bent), as well as symptoms such as limp, inability to weight bear through the affected limb, swelling, abnormal patellar movement, muscle atrophy and limitation of knee flexion. | Baseline,3 weeks, 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Closed kinetic chain exercise with kinesio taping pain relief measured in the Tegner Activity Scale. | The Tegner activity scale was designed as a score of activity level to complement other functional scores for patients with ligamentous injuries. The instrument scores a person's activity level between 0 and 10 where 0 is 'on sick leave/disability' and 10 is 'participation in competitive sports such as soccer at a national or international elite level | Baseline, 3 weeks, 6 weeks |