Rate of Torque Development in Adolescents With Osgood-Schlatter

Study Overview
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Brief Summary
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Osgood-Schlatter is a growth-related condition involving multiple different types of tissue in the tendon-bone interface at the tibial tubercle. Osgood-Schlatter affects one in ten adolescents causing persistent pain and reduced ability to maintain physical activities. Changes in rate of torque development is associated with decreased neuromuscular functioning and pain chronicity, thereby affecting athletic performances and general physical activities. However, changes in rate of torque development has not been investigate in patients with Osgood-Schlatter and could help characterize the condition and guide management. The aim of the study is to investigate early and peak rate of torque development during maximal voluntary isometric knee extension and knee flexion in adolescents with Osgood-Schlatter, compared to a matched group of asymptomatic adolescents (controls), in a cross-sectional study. The study will include 13 adolescent participants with Osgood-Schlatter and a group of 13 pain free controls matched on sex, age, and sports participation on the group level. Testing will include rate of torque measurements of knee extension and flexion for each limb with a fixated handheld dynamometer during a single test-session lasting approximately two hours. The examiner responsible for strength-testing will be blinded to case-status. Along with anthropometric data, participants will perform the anterior knee pain provocation test to assess pain-response to sustained knee loading, a countermovement jump test to assess power and jump height, and provide patient-reported measures of condition severity, pain, disability, and quality of life. Data collection will start March 2023 and is expected to finish by May 2023.

Official Title
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Rate of Torque Development in Adolescents With Osgood-Schlatter: A Cross-sectional Case-control Study

Conditions
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Osgood-Schlatter Disease

Intervention / Treatment
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* Other: Rate of torque development testing of knee flexors and knee extensors using a fixated handheld dynamometer (MicroFet 2, Hoggan, Scientific L.L.C., Salt Lake City, USA), sampling rate of 100hz)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients must be 9-16 years of age Presence of pain for 12 weeks or more Pain at tibial tubercle during loading activities Palpable pain at the tibial tuberosity Exclusion Criteria: Previous knee or hip surgery Other main diagnose of anterior knee pain (patellofemoral pain, Sinding-Larsen Johansson disease, Jumpers knee, etc.) Hip and/or back pain interfering with activities of daily living or physical activities Suspicion of other main diagnose such as meniscal tears and or ligamental tears Unable to communicate verbally or orally in Danish

Ages Eligible for Study
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Minimum Age: 9 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Case-group<br>13 adolescents, 9-16 years, with Osgood-Schlatter Disease. | Other: Rate of torque development testing of knee flexors and knee extensors using a fixated handheld dynamometer (MicroFet 2, Hoggan, Scientific L.L.C., Salt Lake City, USA), sampling rate of 100hz)<br>* Participants and their parents/guardian receives information about the test procedures. Written informed consent is obtained before clinical examination and testing. Clinical testing is performed, anthropometric values are obtained and patient reported outcome measure is filled out, before the tests are performed. Cases will receive treatment for their condition and controls a movie ticket as compensation.<br>|
| Control-group<br>13 healthy adolescents, 9-16 years, without any knee pain, matched on age, sex and type of sport on the group-level. | Other: Rate of torque development testing of knee flexors and knee extensors using a fixated handheld dynamometer (MicroFet 2, Hoggan, Scientific L.L.C., Salt Lake City, USA), sampling rate of 100hz)<br>* Participants and their parents/guardian receives information about the test procedures. Written informed consent is obtained before clinical examination and testing. Clinical testing is performed, anthropometric values are obtained and patient reported outcome measure is filled out, before the tests are performed. Cases will receive treatment for their condition and controls a movie ticket as compensation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of torque development (Nm/s/kg) at 0-200 ms during maximal isometric knee extension | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 60 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 
| Rate of torque development (Nm/s/kg) at 0-100 ms during maximal isometric knee extension | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 60 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 
| Peak rate of torque development (Nm/s/kg) during maximal isometric knee extension | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 60 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 
| Time to peak force, during maximal isometric knee extension | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 60 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 
| Rate of torque development (Nm/s/kg) at 0-200 ms during maximal isometric knee flexion | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 20 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 
| Rate of torque development (Nm/s/kg) at 0-100 ms during maximal isometric knee flexion | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 20 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 
| Peak rate of torque development (Nm/s/kg) during maximal isometric knee flexion | Test performed seated on an examination bed with a belt-fixated handheld dynamometer (MicroFet 2, Hoggan Scientific, USA) at 20 degrees of knee flexion during a 5 second maximal exertion. | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain during strength testing (NRS 10) | Numerical Pain Rating scale, 0-10 with 0 being no pain and 10 being worst imaginable. | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adolescents, Rate of torque development, Osgood-Schlatter, Neuromuscular, Inhibition