Taping and Patellar Maltraction in PFPS Patients

NCT04692727 | Unknown DMC

• 1 other identifier: 2018/76
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Patellofemoral Pain Syndrome(PFPS) treatment is basically conservative, but there is no general consensus on the most appropriate therapeutic approach. The aim of this study was to examine the misalignment of the patellofemoral joint with MRI and compare the effectiveness of McConnell patellar taping and femoral lateral rotational taping techniques applied to exercise function on pain, patellar maltraction, functional status, balance and quality of life in patients with PFPS.

Conditions

Patellofemoral Pain Syndrome

Keywords

PFPS; Magnetic Resonance Imaging; McConnell; femoral rotation; taping; malalignment

Outcome Measures

Primary Outcomes (4)

• Change in Bisect offset index (BOI)

  A reference line is drawn through the posterior of the femoral condyles in the axial plan. A line is drawn from the widest diameter of the patella. A perpendicular third line drawn from the deepest point of the trochlear groove divides the widest diameter of the patella into 2 parts (α, β). Bisect offset is defined as the ratio of the lateral part of the patella to the patellar width and is calculated by the formula \[α / (α + β) x100\]. Being above 57° is a risk factor for pain and patellofemoral joint degeneration.

  Change from baseline BOI at 6 weeks

• Change in Patellar tilt angle (PTA)

  The patellar tilt angle is the angle between the posterior line of the femoral condyles and the widest mediolateral line of the patella. Below 15 degrees is considered normal.

  Change from baseline PTA at 6 weeks

• Change in Lateral patellofemoral angle (LPFA)

  It is the angle between the line connecting the top points of the femoral condyles and the line drawn along the lateral facet of the patella. In general, the patellofemoral angle is more than 8 ° and is open laterally. Medial patency monitoring or an angle less than 8 ° is considered an abnormal slope.

  Change from baseline LPFA at 6 weeks

• Change in Lateral patellar displacement (LPD)

  In the axial plan, a line connecting the top of the medial and lateral condyles and a vertical line is drawn from this at the top of the medial femoral condyle. The distance between this perpendicular line and the medial edge of the patella is measured. This distance should not be more than 1 mm in normal knees.

  Change from baseline LPD at 6 weeks

Secondary Outcomes (11)

• Visual analog scale (VAS)

  Just before the treatment and at the end of 6-week treatment.

• Y balance test (YBT)

  Just before the treatment and at the end of 6-week treatment.

• Kujala Patellofemoral Score (KPS)

  Just before the treatment and at the end of 6-week treatment.

• Q angle

  Just before the treatment and at the end of 6-week treatment.

• Nottingham Health Profile (NHP)

  Just before the treatment and at the end of 6-week treatment.

Study Arms (3)

Exercise grup

ACTIVE COMPARATOR

An exercise program that includes stretching, strengthening and balance exercises accompanied by physiotherapist in the clinic will be applied to all individuals participating in the study for 6 weeks, 2 times a week (12 sessions). Each session will take approximately 40 minutes and patients will be asked to repeat the exercises at least 2 sets a day at home when they are not in the clinic (other 5 days a week). The home program will be followed by the exercise daily form.

Other: Exercise program

McConnell patellar taping grup

EXPERIMENTAL

McConnell patellar taping technique will be applied using a rigid tape in addition to the exercise program applied to the exercise group. The tape will remain in the body for a maximum of 48 hours and will be renewed by the same physiotherapist in each session.

Other: Exercise program; Other: McConnel patellar taping technique

Femoral rotational taping grup

EXPERIMENTAL

Femoral lateral rotation taping technique will be applied using a rigid tape in addition to the exercise program applied to the exercise group.The tape will remain in the body for a maximum of 48 hours and will be renewed by the same physiotherapist in each session.

Other: Exercise program; Other: Femoral rotational taping technique

Interventions

Exercise program OTHER

* Hamstring, quadriceps, gastrocnemius, iliopsoas, iliotibial band (ITB), lateral and medial retinaculum stretching exercises * Isometric exercises of vastus medialis, gluteus medius and external rotators * Isotonic exercises of vastus medialis, gluteus medius and external rotators * Closed kinetic chain exercises * Balance and coordination exercises * Core stabilization exercises

Exercise grup; Femoral rotational taping grup; McConnell patellar taping grup

McConnel patellar taping technique OTHER

Individuals are placed in a supine position with their knees extended and the quadriceps relaxed. A 5 cm wide hypoallergenic band is applied transversely over the patella without affecting the position of the patella. Then, it is started at the lateral edge of the patella with a rigid tape. The tape is terminated at the medial femoral condyle after a medial pull and / or medial tilt to the patella.

McConnell patellar taping grup

Femoral rotational taping technique OTHER

This technique is applied in a standing position and hip extreme external rotation. Taping is started on the vastus medialis and is pulled diagonally from the anterior of the leg to the lateral and ends on the trochanter major.

Femoral rotational taping grup

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Presence of anterior knee pain lasting more than 6 weeks
• Anterior or retropatellar knee pain is present in at least two activities (stair descending, stair climbing, squatting, running, jumping, sitting for a long time
• Presence of malalignment of patellofemoral joint in MRI examination \[Bisect offset index (BOİ) ≥57 and / or patellar tilt angle (PTA) ≥15\]

You may not qualify if:

• presence of knee trauma history and/or previous knee surgery
• presence limitation in knee joint range of motion
• presence of meniscopathy or lesion in knee ligaments
• presence of patellar subluxation or dislocation
• presence of a neuromuscular (upper or lower motor neuron lesions), cardiovascular or rheumatological disease
• pregnancy status
• presence of MRI contraindications

Sponsors & Collaborators

• Ankara Yildirim Beyazıt University: lead

Study Sites (1)

Ankara Yıldırım Beyazıt University

Ankara, 06370, Turkey (Türkiye)

Location

Related Publications (6)

• Laugharne E, Bali N, Purushothamdas S, Almallah F, Kundra R. Variability of Measurement of Patellofemoral Indices with Knee Flexion and Quadriceps Contraction: An MRI-Based Anatomical Study. Knee Surg Relat Res. 2016 Dec 1;28(4):297-301. doi: 10.5792/ksrr.16.032.

  PMID: 27894177 BACKGROUND

• Nakagawa TH, Muniz TB, Baldon Rde M, Dias Maciel C, de Menezes Reiff RB, Serrao FV. The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil. 2008 Dec;22(12):1051-60. doi: 10.1177/0269215508095357.

  PMID: 19052244 BACKGROUND

• Song CY, Huang HY, Chen SC, Lin JJ, Chang AH. Effects of femoral rotational taping on pain, lower extremity kinematics, and muscle activation in female patients with patellofemoral pain. J Sci Med Sport. 2015 Jul;18(4):388-93. doi: 10.1016/j.jsams.2014.07.009. Epub 2014 Jul 24.

  PMID: 25127530 BACKGROUND

• Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, Davis IS, Powers CM, Macri EM, Hart HF, de Oliveira Silva D, Crossley KM. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med. 2018 Sep;52(18):1170-1178. doi: 10.1136/bjsports-2018-099397. Epub 2018 Jun 20.

  PMID: 29925502 BACKGROUND

• Callaghan MJ, Guney H, Reeves ND, Bailey D, Doslikova K, Maganaris CN, Hodgson R, Felson DT. A knee brace alters patella position in patellofemoral osteoarthritis: a study using weight bearing magnetic resonance imaging. Osteoarthritis Cartilage. 2016 Dec;24(12):2055-2060. doi: 10.1016/j.joca.2016.07.003. Epub 2016 Jul 16.

  PMID: 27432215 BACKGROUND

• Callaghan MJ, Selfe J. Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev. 2012 Apr 18;2012(4):CD006717. doi: 10.1002/14651858.CD006717.pub2.

  PMID: 22513943 BACKGROUND

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Interventions

Resistance Training

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Ertuğrul Demirdel, PhD

  Ankara Yildirim Beyazıt University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The information of the individuals being treated will be hidden from the researcher who will make the MRI measurements.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Single blind randomized controlled study:Three parallel treatment groups; the control group received only exercise therapy, while the other two groups received two different taping treatments in addition to exercise therapy.

Study Record Dates

• First Submitted: December 26, 2020
• First Posted: January 5, 2021
• Study Start: December 17, 2020
• Primary Completion: June 1, 2021
• Study Completion: July 1, 2021
• Last Updated: January 5, 2021

Record last verified: 2021-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)