EFFECT OF HIGH INTENSITY LASER IN PATELLOFEMORAL PAIN SYNDROME

Study Overview
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Brief Summary
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The aim of this study is to investigate the effectiveness of high-intensity laser therapy on pain and lower extremity function in the treatment of patellofemoral pain syndrome.

Detailed Description
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Participants between the ages of 25-45 who were diagnosed with Unilateral patellofemoral pain syndrome by the doctor will be included in the study. Also positive Clarke's test and patellar compression tests will be determined as inclusion criteria. The 45 participants will be randomly divided into three groups. Both groups will receive 2 weeks (5 sessions per week) of therapy. First group patients underwent High Intensity Laser Therapy (HILT) and exercises. Second group patients will be treated by transcutaneous electrical nerve stimulation(TENS), ultrasound (US) and exercise for 10 sessions. Also In the third group patients will be treated with ultrasound (US),interferential current stimulation and exercise. All groups receive the same exercise exercise protocol including muscle strengthening and flexibility training for 12 weeks. The outcomes will be pain intensity measured by visual analog scale (VAS) , knee flexion range of motion (FROM), timed up and go test (TUG),muscle strength measured with handheld dynamometer, Pressure Pain Threshold with an algometry and functionality of knee measured by the Lower extremity functional scale and Kujala patellofemoral questionnaire. Statistical analyzes will be performed to compare amounts at baseline, immediately after treatment, and after 12 weeks.

Official Title
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EFFECT OF HIGH INTENSITY LASER THERAPY ON PAIN AND LOWER EXTREMITY FUNCTION IN PATELLOFEMORAL PAIN SYNDROME

Conditions
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Physical Therapy, Orthopedic Disorder

Intervention / Treatment
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* Other: High Intensity Laser Therapy Group
* Other: Ultrasound and Transcutaneous Electrical Nerve Stimulation Group
* Other: Ultrasound and Interferential Current Stimulation Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unilateral patellofemoral pain syndrome diagnosed by a doctor 25-45 years old pain from prolonged sitting, climbing and descending stairs, running,knee bend more than 3 months positive patellar compression and clarke's tests. Exclusion Criteria: Previous knee pain, trauma, surgery and other joint diseases, Knee ligament, bursa, meniscus and synovial fold injury or dysfunction Osteoarthritis in the knee joint, Neurological problems that may affect walking Pregnancy No chronic disease Malignancy, Presence of infection

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 45 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: High Intensity Laser Therapy Group<br>Patients underwent High Intensity Laser Therapy (HILT) and exercise for 10 sessions | Other: High Intensity Laser Therapy Group<br>* High Intensity Laser Therapy (HILT) and exercises will be used.<br>|
| Experimental: Ultrasound and Transcutaneous Electrical Nerve Stimulation Group<br>Patients will be treated by transcutaneous electrical nerve stimulation(TENS), ultrasound (US) and exercise for 10 sessions | Other: Ultrasound and Transcutaneous Electrical Nerve Stimulation Group<br>* Transcutaneous electrical nerve stimulation(TENS), ultrasound (US) will be applied.<br>|
| Experimental: Ultrasound and Interferential Current Stimulation Group<br>Patients will be treated with ultrasound (US) ,interferential current stimulation and exercise for 10 sessions | Other: Ultrasound and Interferential Current Stimulation Group<br>* Ultrasound (US) ,interferential current stimulation and exercise will be used.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain status | Pain intensity was evaluated with visual analog scale (VAS) in two conditions during activity and resting time. This method, which is developed to determine the intensity of pain to indicate by numbers. It begins with the absence of pain (0) on numerical scale and ends the level of unbearable pain | 5 minutes | 
| Range of motion assesment | Universal goniometer will used to measure the joint position and joint range of motion measurements based on Kendall and American Association of Orthopedic Surgeons. The participant will in the sitting position and asked to perform active cervical region flexion, extension, right and left rotation, right and left lateral flexion of the neck movements and performed degrees will recorded | 10minutes | 
| Functionality | The patients will asked to start from a sitting position in a chair, to get up at the command given, to walk the predetermined distance of 3 meters as fast as they could, and to return to their seats. The time from the time they got up from the chair and sat down again will recorded with a stopwatch. Measurements will be repeated 3 times and the average will be recorded in seconds (sec). | 5 minutes | 
| Muscle stength assesment | A myometer will be used to measure the strength of the hamstring and quadriceps muscle groups of all participants. Myometer is an evaluation method that objectively evaluates muscle strength and gives more sensitive results than manual muscle testing. | 10 minutes | 
| Pain threshold assessment | Pressure pain threshold measurement will be measured with an algometer device. Algometers are a device that can be used to define pressure and pressure pain threshold. | 10 minutes | 
| Severity and function of patellofemoral pain | It will be evaluated with the 'Kujala patellofemoral score' system. These scoring system values range from 100 (normal, pain-free, fully functional knee) to 0 (severe knee pain and dysfunction). | 5 minutes | 
| Function of lower extremity | A lower extremity function test will be used to measure lower extremity functionality. It is a test used to measure the functional status of the lower extremities. | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Patellofemoral pain, High intensity laser therapy