Effect of Functional Strength Training of Hip Abductors in Runners With Medial Tibial Stress Syndrome

NCT05637476 | Unknown

• 1 other identifier: Medial tibial stress syndrome
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be the first project to investigate the effect of functional strength training of hip abductors on pain, function, hip, and knee kinematics including contra-lateral pelvic drop angle (hip frontal plane projection angle) and dynamic knee valgus (knee frontal plane projection angle) in runners with medial tibial stress syndrome patients.

Conditions

Medial Tibial Stress Syndrome

Keywords

Recreational runners; Frontal plane projection angle; Pelvic drop height; Kinovea software

Outcome Measures

Primary Outcomes (2)

• The Frontal Plane Projection Angle

  It is a measure of the degree of dynamic knee valgus during functional tasks. FPPA is an angle that consists of two lines. One line between the thigh and hip markers and the other line between the ankle and knee markers .So that,from a frontal view, when the knee marker is medial to a line from the ankle marker to the thigh marker,the FPPA is negative (knee valgus).While,The FPPA is positive if the knee marker is lateral to a line drawn from ankle marker to the thigh marker (knee varus).

  Change from baseline frontal plane projection angle at 8 weeks.

• The contra-lateral pelvic drop angle

  It is determined as the angle subtended by one line connecting the anterior superior iliac spine with the stance and swing limb and a second line drawn perpendicular to the stance limb anterior superior iliac spine then, the measurement will be subtracted from 90 degrees.

  Change from baseline contra-lateral pelvic drop angle at 8 weeks.

Secondary Outcomes (2)

• Pain severity

  8 weeks

• Lower extremity function

  8 weeks

Study Arms (2)

Group A (Active control group)

ACTIVE COMPARATOR

Group A (number=20): which is the control group with medial tibial stress syndrome, they will receive a selected physical therapy exercise program.

Other: A selected physical therapy exercise program

Group B (Experimental group)

EXPERIMENTAL

Group B (number=20): which is the experimental group with Medial tibial stress syndrome, they will receive the same physical therapy exercise program as group A in addition to, functional strength training of hip abductors.

Other: Functional strength training of hip abductors; Other: A selected physical therapy exercise program

Interventions

Functional strength training of hip abductors OTHER

Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises: 1. Pelvic drop. 2. Single leg -bridge. 3. Side-lying hip abduction with hip internal rotation. 4. Lateral step-up. 5. Standing hip abduction on stance or swing leg with extra resistance .

Group B (Experimental group)

A selected physical therapy exercise program OTHER

Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises: 1. Strength dorsiflexors of the ankle-using rubber band. 2. Eccentric calf exercise (calf raise) . 3. Balance and proprioceptive exercise using wobble boards. 4. Stretch planter flexors (three sets of thirty repetitions, thirty seconds rest in between, three times per week)

Also known as: Common established treatment exercises

Group A (Active control group); Group B (Experimental group)

Eligibility Criteria

• Age: 25 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female Athletes (runners) with a referred diagnosis of MTSS for at least 1 month
• Participants with bilateral affection, the most affected limb will be included in measurements.
• Body mass index range between (18.5-25 kg /m2 )

You may not qualify if:

• History of previous lower extremity surgery
• Neurological problems that will affect lower extremity function
• Recent or old fractures at lower limbs
• Cognitive impairment
• Medications (anti-inflammatory/muscle relaxant)
• Tumours

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Orthopedic out clinic of the faculty of Physical therapy, Cairo, University,and Gezira Youth Center.

Cairo, Egypt

Location

Related Publications (21)

• Robinson RL, Nee RJ. Analysis of hip strength in females seeking physical therapy treatment for unilateral patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2007 May;37(5):232-8. doi: 10.2519/jospt.2007.2439.

  PMID: 17549951 BACKGROUND

• Irawan DS, Huoth C, Sinsurin K, Kiratisin P, Vachalathiti R, Richards J. Concurrent Validity and Reliability of Two-dimensional Frontal Plane Knee Measurements during Multi-directional Cutting Maneuvers. Int J Sports Phys Ther. 2022 Feb 2;17(2):148-155. doi: 10.26603/001c.31651. eCollection 2022.

  PMID: 35136683 RESULT

• Almeida GP, Silva AP, Franca FJ, Magalhaes MO, Burke TN, Marques AP. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop. 2016 Feb 9;51(2):181-6. doi: 10.1016/j.rboe.2016.01.010. eCollection 2016 Mar-Apr.

  PMID: 27069887 RESULT

• Cashman GE. The effect of weak hip abductors or external rotators on knee valgus kinematics in healthy subjects: a systematic review. J Sport Rehabil. 2012 Aug;21(3):273-84. doi: 10.1123/jsr.21.3.273.

  PMID: 22894982 RESULT

• Chuter VH, Janse de Jonge XA. Proximal and distal contributions to lower extremity injury: a review of the literature. Gait Posture. 2012 May;36(1):7-15. doi: 10.1016/j.gaitpost.2012.02.001. Epub 2012 Mar 21.

  PMID: 22440758 RESULT

• Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE. Hip strength in collegiate female athletes with patellofemoral pain. Med Sci Sports Exerc. 2007 Aug;39(8):1227-32. doi: 10.1249/mss.0b013e3180601109.

  PMID: 17762354 RESULT

• Craig DI. Medial tibial stress syndrome: evidence-based prevention. J Athl Train. 2008 May-Jun;43(3):316-8. doi: 10.4085/1062-6050-43.3.316.

  PMID: 18523568 RESULT

• Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. J Orthop Sports Phys Ther. 2008 Aug;38(8):448-56. doi: 10.2519/jospt.2008.2490. Epub 2008 Aug 1.

  PMID: 18678957 RESULT

• Ferber R, Davis IM, Williams DS 3rd. Gender differences in lower extremity mechanics during running. Clin Biomech (Bristol). 2003 May;18(4):350-7. doi: 10.1016/s0268-0033(03)00025-1.

  PMID: 12689785 RESULT

• Franklyn M, Oakes B. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World J Orthop. 2015 Sep 18;6(8):577-89. doi: 10.5312/wjo.v6.i8.577. eCollection 2015 Sep 18.

  PMID: 26396934 RESULT

• Galbraith RM, Lavallee ME. Medial tibial stress syndrome: conservative treatment options. Curr Rev Musculoskelet Med. 2009 Oct 7;2(3):127-33. doi: 10.1007/s12178-009-9055-6.

  PMID: 19809896 RESULT

• Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. doi: 10.1002/acr.20543. No abstract available.

  PMID: 22588748 RESULT

• Hreljac A, Marshall RN, Hume PA. Evaluation of lower extremity overuse injury potential in runners. Med Sci Sports Exerc. 2000 Sep;32(9):1635-41. doi: 10.1097/00005768-200009000-00018.

  PMID: 10994917 RESULT

• Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003 Nov;33(11):671-6. doi: 10.2519/jospt.2003.33.11.671.

  PMID: 14669962 RESULT

• Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004 Jun;36(6):926-34. doi: 10.1249/01.mss.0000128145.75199.c3.

  PMID: 15179160 RESULT

• Mehta SP, Fulton A, Quach C, Thistle M, Toledo C, Evans NA. Measurement Properties of the Lower Extremity Functional Scale: A Systematic Review. J Orthop Sports Phys Ther. 2016 Mar;46(3):200-16. doi: 10.2519/jospt.2016.6165. Epub 2016 Jan 26.

  PMID: 26813750 RESULT

• Menendez C, Batalla L, Prieto A, Rodriguez MA, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. Int J Environ Res Public Health. 2020 Oct 13;17(20):7457. doi: 10.3390/ijerph17207457.

  PMID: 33066291 RESULT

• Fredericson M, Bergman AG, Hoffman KL, Dillingham MS. Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. Am J Sports Med. 1995 Jul-Aug;23(4):472-81. doi: 10.1177/036354659502300418.

  PMID: 7573660 RESULT

• Willson JD, Davis IS. Utility of the frontal plane projection angle in females with patellofemoral pain. J Orthop Sports Phys Ther. 2008 Oct;38(10):606-15. doi: 10.2519/jospt.2008.2706.

  PMID: 18827327 RESULT

• Skouras AZ, Kanellopoulos AK, Stasi S, Triantafyllou A, Koulouvaris P, Papagiannis G, Papathanasiou G. Clinical Significance of the Static and Dynamic Q-angle. Cureus. 2022 May 11;14(5):e24911. doi: 10.7759/cureus.24911. eCollection 2022 May.

  PMID: 35698708 RESULT

• Lashien SA, Abdelnaeem AO, Gomaa EF. Effect of hip abductors training on pelvic drop and knee valgus in runners with medial tibial stress syndrome: a randomized controlled trial. J Orthop Surg Res. 2024 Oct 29;19(1):700. doi: 10.1186/s13018-024-05139-3.

  PMID: 39468623 DERIVED

MeSH Terms

Conditions

Medial Tibial Stress Syndrome

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Neuromuscular Diseases; Nervous System Diseases; Leg Injuries; Wounds and Injuries

Study Officials

• Ebtessam F Gomaa, Doctorate

  Cairo University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior musculoskeletal physiotherapist ,faculty of physical therapy

Study Record Dates

• First Submitted: November 13, 2022
• First Posted: December 5, 2022
• Study Start: December 1, 2022
• Primary Completion: June 30, 2024
• Study Completion: June 30, 2024
• Last Updated: January 16, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)