Ilium Mobilization in Patellofemoral Pain Syndrome Treatment

Study Overview
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Brief Summary
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Aim of the study is to investigate the effect of adding posterior ilium mobilization on knee pain, knee function, anterior pelvic tilt, dynamic knee valgus, muscle strength of extensors, abductors and external rotators of hip and knee extensors in patients with patellofemoral pain syndrome.

Official Title
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Efficacy of Adding Posterior Ilium Mobilization to Treatment of Patellofemoral Pain Syndrome

Conditions
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Patellofemoral Pain Syndrome

Intervention / Treatment
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* Other: posterior ilium mobilization
* Other: strengthening and stretching exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of the subjects between 18-35 years. BMI will be ≤ 29.5 Anterior or retro patellar knee pain for at least 6 weeks duration. Foot posture index score from +6 to +12. Anterior pelvic tilt angle more than 8 degree. Pain elicited at least by two of the following four tests; (i) Isometric muscle contraction with slight bent knee,(ii) palpation of the patellofemoral joint line, (iii) patellar compression against the femoral bone (iv) active resisted knee extension. Pain intensity more than 3 at ANPS and provoked by at least two of the following activities: running, walking, hopping, squatting, stair negotiation, kneeling, or prolonged sitting. Exclusion Criteria: Meniscal or other intraarticular pathologic conditions; cruciate or collateral ligament involvement. A history of traumatic patellar subluxation or dislocation. Previous surgery in the knee, ankle and hip joints. Knee, ankle and hip joints osteoarthritis. Taking non-steroidal anti-inflammatory drugs or corticosteroids within 24 h before the test. History of brain injury or vestibular disorder within the last 6 months. Pregnant female.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 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: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group 1<br> | Other: strengthening and stretching exercises<br>* the participants will receive strengthening exercises on the hip and knee joint beside that they will receive stretching exercises<br>|
| Experimental: Group 2<br> | Other: posterior ilium mobilization<br>* the therapist will mobilize the innominate on the affected side posteriorly<br>Other: strengthening and stretching exercises<br>* the participants will receive strengthening exercises on the hip and knee joint beside that they will receive stretching exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in pain | Arabic Numeric pain scale (ANPS) will be used to assess pain changes during walking, hopping, squatting, stair negotiation, kneeling, or prolonged sitting. | It will be assessed at baseline and after 4 weeks | 
| Changes in knee functional disability | The Arabic version of Anterior knee pain scale (AKPS) will be used to assess the knee functional disability | It will be assessed at baseline and after 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in hip abductors strength | Handheld dynamometer will be used to assess changes in muscle strength | It will be assessed at baseline and after 4 weeks | 
| Changes in hip extensors strength | Handheld dynamometer will be used to assess changes in muscle strength | It will be assessed at baseline and after 4 weeks | 
| Changes in hip external rotators strength | Handheld dynamometer will be used to assess changes in muscle strength | It will be assessed at baseline and after 4 weeks | 
| Changes in knee extensors strength | Handheld dynamometer will be used to assess changes in muscle strength | It will be assessed at baseline and after 4 weeks | 
| Changes in dynamic knee valgus | Cell phone Camera, tripod device and Kinovea Computer Program (KCP) will be used to assess knee frontal plane projection angle to detect changes in knee valgus during step down test | It will be assessed at baseline and after 4 weeks | 
| Changes in pelvic tilt angle | Palpation Meter (PALM) will be used to assess changes in pelvic tilt angle | It will be assessed at baseline and after 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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strength, patellofemoral pain syndrome, stretch, mobilization, ilium, innominate