Pilates-based Core Strengthening on Patellofemoral Pain Syndrome

Study Overview
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Brief Summary
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Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal pain conditions that tend to become a chronic problem. PFPS is common among young adolescents, particularly in physically active individuals aged 12 to 17 years old with more prevalence among females, as it affects females 1.5 - 3 times when compared to males.

Detailed Description
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Adolescents with PFPS usually complain of retro-patellar pain (behind the kneecap) or peripatellar pain (around the kneecap) and crepitation in the knee joint, and also there is discomfort while sitting with a flexed knee for a long time. Symptoms are usually exacerbated by activities that increase the load on patellofemoral joints such as weight-bearing activities, squatting, walking up or downstairs, and running. PFPS takes place whenever the muscles around the knee fail to keep the kneecap properly aligned, leading to abnormal lateral tracking of the patella.Overuse such as running and jumping sports, the trauma of kneecaps such as fracture, dislocation, or knee surgery may also predispose to PFPS.

Official Title
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Incorporation of Pilates-based Core Strengthening Exercises Into the Rehabilitation Protocol for Adolescents With Patellofemoral Pain Syndrome: a Randomized Clinical Trial

Conditions
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Patellofemoral Pain Syndrome

Intervention / Treatment
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* Other: Pilates exercises
* Other: Traditional physical therapy program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pain felt anterior to knee joint. Pain felt retro-patellar. Pain felt during rest and increased with activities like prolonged sitting, squatting, running, and stair climbing. Insidious onset lasting for more than 6 weeks. Without any traumatic incidence. Not participating in a physical therapy program for the past three months. Exclusion Criteria: If they had a meniscal tear. Cruciate/collateral ligaments involvement. Knee osteoarthritis. Rheumatoid arthritis. A history of knee or hip surgery. Patellar dislocation/subluxation. Traction apophysitis encompassing the patellofemoral complex. Any pathology in the patellar tendon. Spinal referred pain.

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 17 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: study group<br>Patients in the study group received Pilates exercises (25 minutes/ session). There are different types of equipment to be used in Pilates exercises to achieve different purposes; mat, Pilates band or elastic bands, and Pilate's ball were used. | Other: Pilates exercises<br>* Side kick internal/ external rotation with Pilate's band<br>* Other names: Pilates band;|
| Experimental: control group<br>Participants in control group received the traditional physical therapy program program (60 minutes/session, three sessions /week for three months). | Other: Traditional physical therapy program<br>* strength, flexibility<br>* Other names: strengthening exercises;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain assessment | assessed by using a visual analog scale, 10-cm VAS scale, with 0 indicating no pain and 10 for worst pain sensation | at baseline | 
| Pain assessment | assessed by using a visual analog scale,10-cm VAS scale, with 0 indicating no pain and 10 for worst pain sensation | after 12 weeks | 
| Muscle strength assessment | assessed using a calibrated handheld dynamometer | at baseline | 
| Muscle strength assessment | assessed using a calibrated handheld dynamometer | after 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional status | evaluated using the Arabic version of the Anterior Knee pain Questionnaire, The score ranges from 0 to 100, with 0 indicating complete functional limitation and 100 indicating no pain and no functional limitation. | at baseline | 
| Functional status | evaluated using the Arabic version of the Anterior Knee pain Questionnaire, The score ranges from 0 to 100, with 0 indicating complete functional limitation and 100 indicating no pain and no functional limitation. | after 12 weeks | 
| health-related quality of life | assessed by using the self-report Pediatric Quality of Life Inventory, it includes 23 items distributed among 4 domains [physical (8 items), emotional (5 items), social (5 items), and school functions (3 items)]. Each item is rated on a 5- points scale (0 means never, and 4 means almost always). Items are transformed linearly to 0-100 scale (0 = 100, 1 = 75, 2 = 50, 3 = 25, and 4 = 0). | at baseline | 
| health-related quality of life | assessed by using the self-report Pediatric Quality of Life Inventory, it includes 23 items distributed among 4 domains [physical (8 items), emotional (5 items), social (5 items), and school functions (3 items)]. Each item is rated on a 5- points scale (0 means never, and 4 means almost always). Items are transformed linearly to 0-100 scale (0 = 100, 1 = 75, 2 = 50, 3 = 25, and 4 = 0). | after 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patellofemoral pain syndrome, Pilates exercises, functional status