Clinical trial NCT06197958: Comparison of Concentric-eccentric Exercises in Patellofemoral Pain Syndrome
Official title: Comparison of Concentric-eccentric Exercises in Patellofemoral Pain Syndrome
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Patello Femoral Syndrome
Patellofemoral Pain
Knee Pain Chronic
Keywords: concentric excercise
eccentric excercise
Iliotibial Band
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-01-09
Enrollment: 24
Sex: ALL
Minimum age (years): 18
Maximum age (years): 36
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: randomized clinical trail
Primary purpose: OTHER

Brief summary: Patellofemoral pain syndrome is due to dysfunctional dynamic knee valgus resulting from decrease in strength of hip abductors or abnormal rear-foot eversion with pes pronatus valgus. It is also associated with vastus medialis/vastus lateralis disbalance, hamstring tightness or iliotibial tract tightness.

Detailed description: Patellofemoral pain syndrome is due to dysfunctional dynamic knee valgus resulting from decrease in strength of hip abductors or abnormal rear-foot eversion with pes pronatus valgus. It is also associated with vastus medialis/vastus lateralis disbalance, hamstring tightness or iliotibial tract tightness. The pain is felt around or behind the patella. The causes are multifactorial. A decline in ability to perform physical activity is seen. The aim of this study will be to compare the effects of concentric and eccentric exercises on pain, strength and ROM in patellofemoral pain syndrome.A randomized clinical trial will be performed at Barki Advance Physiotherapy Center Multan through convenience sampling technique on 24 patients which will be allocated through random sampling through sealed opaque enveloped into group A and group B. Group A will receive eccentric exercises like walking down stairs, lowering a weight during shoulder press, the downward motion of squatting, the downward motion of a push-up, lowering the body during a crunch, lowering the body during a pull-up 3 sets with 10 RM (repetition maximum) for six week training. The group B will receive concentric exercises like walking upstairs, pushing up in a bench press, the beginning portion of a deadlift when you lift the barbell off the ground, sitting up in a sit up, pushing up from a lowered push-up and standing up in a back squat 3 sets with 10 RM. Screening tools include patellar grind test with positive Clark's sign and VAS (visual analogue scale) for pain rating. Outcomes will be measured through knee resisted test and MMT grading for knee extensor/flexor strength and goniometer for ROM. Data will be analyzed using SPSS software version 25. After assessing normality, it will be decided either parametric or non parametric test will be used within a group or between two groups. Effectiveness of concentric and eccentric exercises will be analyzed by comparison in individuals with patellofemoral pain syndrome.

Eligibility criteria: Inclusion Criteria:

* Players between the age 18 to 36 years.
* Both male and female gender.
* Patients who have Patellar grind test positive.
* The presence of retropatellar or peripatellar pain.
* Reproduction of retropatellar or peripatellar pain with squatting, stair climbing, prolonged sitting, or other functional activities loading the PFJ in a flexed position.

Exclusion Criteria:

* Individuals with a history of recent trauma or surgery of lower limb (16), administration of steroid injection in the past 6 months.
* Recent administration of platelet-rich plasma containing growth factors, diagnosis of rheumatoid arthritis, myositis ossificans, diagnosis of other muscular disorder.
* Patients who had taken physical therapy of any sort in the past six months will be excluded from the study.
* Furthermore, individuals with any history of occupation-related pain will be ruled out

Primary outcomes:
measure: patellofemoral pain
timeFrame: pre and 6 weeks post interventional
measure: range of motion
timeFrame: pre and 6 weeks post interventional
measure: knee extensor/flexor strength
timeFrame: pre and 6 weeks post interventional
Secondary outcomes:
Other outcomes:
Locations:
city: Multān
country: Pakistan
facility: barki advance physiotherapy center Multan
state: Punjab
Study officials:
affiliation: study principal investigator
name: moiz kamal, DPT
role: PRINCIPAL_INVESTIGATOR
References:
citation: Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM, McConnell J, Vicenzino B, Bazett-Jones DM, Esculier JF, Morrissey D, Callaghan MJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016 Jul;50(14):839-43. doi: 10.1136/bjsports-2016-096384. Epub 2016 Jun 24. No abstract available.
citation: Glaviano NR, Kew M, Hart JM, Saliba S. DEMOGRAPHIC AND EPIDEMIOLOGICAL TRENDS IN PATELLOFEMORAL PAIN. Int J Sports Phys Ther. 2015 Jun;10(3):281-90.
citation: Petersen W, Ellermann A, Gosele-Koppenburg A, Best R, Rembitzki IV, Bruggemann GP, Liebau C. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2264-74. doi: 10.1007/s00167-013-2759-6. Epub 2013 Nov 13.
citation: Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, Rathleff MS, Smith TO, Logan P. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS One. 2018 Jan 11;13(1):e0190892. doi: 10.1371/journal.pone.0190892. eCollection 2018.