Comparison of Effects of Mobilization With Movement and Kinesiotaping in Patellofemoral Pain Syndrome

Study Overview
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Brief Summary
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Patellofemoral Pain Syndrome (PFPS), also known as the anterior knee pain, is one of the most common musculoskeletal disorders. Most of the patients suffer from knee pain for long time. The aim of this study was to investigate the short-term effects of Mobilization with movement and Kinesiotaping on pain, function and balance in patient with PFPS.

Detailed Description
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Patellofemoral Pain Syndrome is one of the most common musculoskeletal problem in the world. It's incidence is also becoming higher and most people who have knee pain suffer from it for long time. In the treatment of PFPS, conservative treatment methods are preferred prior to surgical ones. When the literature was reviewed, no study in which Mobilization with movement (MWM) method was used and in which the effects of it was shown and compared with (Kinesiotaping) KT has been found so far with respect to the treatment of PFPS. Thirty-five female patients diagnosed with unilateral PFPS were randomly assigned into 2 groups. The patients in the first group (n=18) received two techniques of Mobilization with movement intervention while Kinesiotaping was applied to the other group (n=17). Both groups were treated with exercise. All patients received 4 sessions of treatment twice a week for a period of 2 weeks and followed up in accordance with a 6-week-home exercise program. Primary outcomes: pain severity, knee range of motion, hamstring flexibility, and physical performance (10-step stair climbing test, timed up and go test), Kujala Patellofemoral Pain Scoring and Y-Balance test were assessed.

Official Title
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Comparison of Short-Term Effects of Mobilization With Movement and Kinesiotaping on Pain, Function and Balance in Patellofemoral Pain Syndrome: A Randomized Control

Conditions
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Patellofemoral Pain Syndrome

Intervention / Treatment
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* Other: Mulligan's Straight leg-raise with traction
* Other: Mulligan's Mobilization with Movement
* Other: Kinesiotaping
* Other: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: having knee pain at least 3 months and more than 3 points according to visual analog scale Exclusion Criteria: no complying to the rehabilitation if patient wants to finished and want to complete study, they were excluded having meniscus, bursa, ligament, patellar tendon lesions, patellofemoral dislocation and/or recurrent subluxation, undergone lower extremity surgery

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Effects of Mulligan's Mobilization<br>The patients in this arm (n=18) received two techniques pertaining to Mulligan's Mobilization with movement approach (Mulligan's Straight Leg-Raise with Traction and Tibial Gliding) along with an exercise therapy. Patients received 4 sessions of treatment twice a week for a period of 2 weeks and followed up in accordance with a 6-week-home exercise program. Primary outcomes: pain severity, knee range of motion, hamstring flexibility, and physical performance (10-step stair climbing test, timed up and go test), Kujala Patellofemoral Pain Scoring and Y-Balance test were assessed before the treatment, 45 minutes after the initial treatment, at the end of the 4-session-treatment during 2-week period and 6 weeks later. | Other: Mulligan's Straight leg-raise with traction<br>* Mulligan's Straight leg raise technique was performed on patients with patellofemoral pain syndrome. The extremity on which the practice would be performed in supine position was grasped from the ankle level and was, then, subjected to traction longitudinally. Afterwards, the knee was lifted up passively while in extension and was kept for waiting for a few seconds at the point where tension was felt and was, then, returned to its initial position. The practice was repeated 10 times, and 3 sets of practice at 1-minute-intervals were performed.<br>Other: Mulligan's Mobilization with Movement<br>* Mulligan's Mobilization with Movement technique was performed on patients with patellofemoral pain syndrome. Each patient was tested in every direction in the course of the active knee flexion-extension movement so as to find out the best pain-free tibial gliding direction (medial-lateral part of the tibia, anterior-posterior, internal-external rotation). At the time of the active movement of the knee, the tibial gliding direction where pain was felt at the least was selected as the treatment direction of mobilization technique along with movement. The practice was performed by doing 10 repetitions for 3 sets and by providing 1-minute-resting time between the sets.<br>Other: Exercise<br>* All the patients were provided with several exercises within the scope of the home exercise program, such as hamstring muscle stretching, quadriceps isometric exercises, 4-way-strengthening with exercise elastic bands for the muscles of the hip, knee locking on foot and mini-squatting exercises. They were asked to do these exercises in 3 sets a day along with 10 repetitions for a period of 6 weeks.<br>|
| Other: Effects of Kinesiotaping<br>Patients in this arm were applied kinesiotaping on quadriceps and hamstring muscle along with an exercise therapy. Patients received 4 sessions of treatment twice a week for a period of 2 weeks and followed up in accordance with a 6-week-home exercise program. The same assessment parameters was conducted on this arm too. | Other: Kinesiotaping<br>* Kinesiotaping was applied on patient with patellofemoral pain syndrome. To maintain proprioceptive stimulation in the quadriceps (from origo towards insertio) and to alleviate the tension of hamstring muscle, a 'Y''-shaped kinesiotape was applied by using the muscle technique.<br>Other: Exercise<br>* All the patients were provided with several exercises within the scope of the home exercise program, such as hamstring muscle stretching, quadriceps isometric exercises, 4-way-strengthening with exercise elastic bands for the muscles of the hip, knee locking on foot and mini-squatting exercises. They were asked to do these exercises in 3 sets a day along with 10 repetitions for a period of 6 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knee pain measured with Visual Analog Scale | Patient's knee pain was measured with Visual Analog Scale | 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knee joint range of motion was measured Universal goniometer. | Universal goniometer was used for evaluating the knee joint range of motion. | 6 weeks | 
| Balance measured with Y- Balance Test | The dynamic balance measurements of the patients were evaluated through Y- Balance Test | 6 weeks | 
| Function was measured with 10-step-ascent & descent stair-climbing test. | To evaluate the functional performances of the patients, 10-step-ascent & descent stair-climbing test was used. | 6 weeks | 
| Function was measured Kujala patellofemoral scoring system | Patient's function was measured with Kujala patellofemoral scoring system | 6 weeks | 
| Function was measured with timed up&go test | To evaluate the functional performances of the patients, timed up&go test was used. | 6 weeks | 
| Hamstring muscle flexibility was measured Universal goniometer. | Universal goniometer was used for evaluating the hamstring muscle flexibility. | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Knee, Mobilization, Taping, Function, Balance