Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome

NCT05665452 | Completed

• 1 other identifier: P.T.REC/012/004020
• Study Type: interventional
• Target: 59
• Locations: 1 country
• Sites: 1

Brief Summary

Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises. Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.

Conditions

Patellofemoral Pain Syndrome

Keywords

patellofemoral pain syndrome; strength; stretch; mobilization; release; deep friction message; retinacula

Outcome Measures

Primary Outcomes (2)

• Changes in pain that felt during ascending, descending, squatting and prolonged sitting

  Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.

  It will be assessed one week before and after treatment

• Changes in functional disability

  Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.

  It will be assessed one week before and after treatment

Secondary Outcomes (8)

• Changes in hip abductors strength

  It will be assessed one week before and after treatment

• Changes in hip external rotators strength

  It will be assessed one week before and after treatment

• changes in quadriceps strength

  It will be assessed one week before and after treatment

• changes in functional performance

  It will be assessed one week before and after treatment

• changes in hamstring flexibility

  It will be assessed one week before and after treatment

Study Arms (2)

Group (1)

ACTIVE COMPARATOR

patients will receive stretch and strength exercises

Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strength

Group (2)

EXPERIMENTAL

patients will receive stretch, strength, patellar mobilization, retinacula release and deep friction message

Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strength

Interventions

Patellar mobilization, retinacula release, deep friction message, stretch and strength PROCEDURE

All exercises will be performed for 30 to 45 minutes per session, 3 times per week for 4 weeks (12 sessions). Group (1): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). Group (2): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). manual therapy consists from iliotibial band release, deep friction message for lateral retinacula and medial patella mobilization.

Group (1); Group (2)

Eligibility Criteria

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

You may qualify if:

• Age ranging between 18 and 35 years
• Tenderness of medial and lateral borders of patella
• Retropatellar pain
• Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks
• Positive patellar compression test
• Pain intensity is more than 3 at visual analogue scale
• Had a history of insidious onset
• Had anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squatting

You may not qualify if:

• Previous patellar realignment surgery or patellar fracture
• Had a history of traumatic patellar dislocation
• Had a history of previous knee surgery
• Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis
• Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction
• Taking corticosteroids or nonsteroidal anti-inflammatory medication
• Inability to attend treatment program to the end of sessions

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Cairo University

Giza, Egypt

Location

Related Publications (1)

• Abdo N, Youssef EF, Ibrahim MM. Efficacy of adding manual therapy to hip and knee exercises in patients with patellofemoral pain syndrome: a double-blinded randomized controlled clinical trial. Sci Rep. 2025 Sep 23;15(1):32655. doi: 10.1038/s41598-025-17453-9.

  PMID: 40987761 DERIVED

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Nadia A Mohamed, Msc

  Assistant lecturer at orthopedic department of faculty of physical therapy

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant lecturer at orthopedic department of faculty of physical therapy

Study Record Dates

• First Submitted: October 26, 2022
• First Posted: December 27, 2022
• Study Start: January 15, 2023
• Primary Completion: December 11, 2023
• Study Completion: March 18, 2024
• Last Updated: August 21, 2024

Record last verified: 2024-08

Locations

EG (1)