Neuromuscular Training Compared to Progressive Resistance Training for Patients With Anterior Knee Pain

NCT06110455 | Unknown

• 1 other identifier: NMT PRT Thess
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The primary aim of this randomized control trial is to investigate patients' with anterior knee pain if a neuromuscular training program (NMT) has better results in pain and functionality, than an ordinary progressive resistance training program (PRT). Pain will be measured via a visual analog scale for pain (VAS) and functionality via questionnaires such as Kujala and the Greek version of the Modified Baecke Questionnaire (mBQ) and functional tests such as the Anterior Lunge test, Step up/down, squat, balance and reach test. The secondary aims are to investigate the:

1. 1.Hip and knee muscles strength, which will be measured with the Kinvent K-Push dynamometer. Strength will be measured before and after the rehabilitation programs (at baseline and after 8 weeks of intervention).
2. 2.Balance, will also be measured to see the effects of the NMT program.
3. 3.Kinesiophobia, which will be measured with the Tampa Scale
4. 4.Dynamic Knee Valgus, via the Single Leg Landing and Single Leg Squat tests

Conditions

Anterior Knee Pain Syndrome

Outcome Measures

Primary Outcomes (2)

• Pain Intensity

  Pain will be assessed by a numeric Visual Analogue Scale (VAS), where patients will be asked how much their pain level is. Maximum Score Will be a 10, which is the worst pain they ever felt and minimum score will be 0, which is no pain. Higher scores indicate more pain.

  Measured at baseline and at the end of the program (week 8)

• Functionality

  Functionality will be assessed by the greek translated version of the Kujala Questionnaire, which is dedicated to assess the functionality of patients with Anterior Knee Pain. The questionnaire is consisted of 13 questions, the maximum score is 100 and minimum score is 0. The lower the score, the less functional the person is.

  Measured at baseline and at the end of the program (week 8)

Secondary Outcomes (4)

• Stability/Balance

  Measured at baseline and at the end of the program (week 8)

• Strength

  Measured at baseline and at the end of the program (week 8)

• Kinesiophobia

  Measured at baseline and at the end of the program (week 8)

• Dynamic Knee Valgus

  Measured at baseline and at the end of the program (week 8)

Study Arms (2)

Neuromuscular Exercise Training (NMT)

EXPERIMENTAL

The 8-week exercise intervention program consists of group sessions of Neuromuscular training supervised by a physical therapist 3 times per week. Patients will be taught and familiarized with the proper way to do the exercises on a separate day prior to the start of their actual rehabilitation program. Each session consists of a 5 minute submaximal warm-up followed by 25 minutes of NMT. Every 2 weeks, there will be a progression that will be achieved by increasing the difficulty level of each exercise. We will take under consideration the individuality each patient has on how much progression is needed every two weeks and it will be done by maintaining a proper quality of performance, minimal exertion and control of the movement. Participants will be given special equipment including sliders and elastic tubing

Other: Neuromuscular Training exercises

Progressive Resistance Training (PRT)

EXPERIMENTAL

The 8-week exercise intervention program consists of group sessions of progressive resistance training supervised by a physical therapist 3 times per week. Patients will be taught and familiarized with the proper way to do the exercises on a separate day prior to the start of their actual rehabilitation program. Each session consists of a 5 minute submaximal warm-up followed by 25 minutes of PRT, targeting hip and knee muscles, such as hip abductors, knee flexors and extensors. The exercise intensity will be monitored by the physical therapist, as determined by the patients' ability to complete 3 sets of 8-12 repetitions for a given exercise and a Borg Rating of Perceived Exertion (RPE) of 6-8. Every 2 weeks, progression will be achieved by changing the resistance based on VAS and RPE, with an elastic tubing

Other: Hip and Knee Muscular Strength exercises

Interventions

Neuromuscular Training exercises OTHER

The 8 week exercise intervention consists of 25 minute group sessions of Neuromuscular training supervised by a physical therapist.

Neuromuscular Exercise Training (NMT)

Hip and Knee Muscular Strength exercises OTHER

The 8 week exercise intervention consists of 25 minute group sessions of progressive resistance training, supervised by a physical therapist.

Progressive Resistance Training (PRT)

Eligibility Criteria

• Age: 18 Years - 40 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Pain ≥ 3 months
• Pain VAS now ≥ 3
• y/o
• No pain relief medicine 2 weeks prior to the program
• Kujala 50-80
• Pain during squat, knee bending, palpation, isometric contraction on 60°, long sitting, jumping, step up/down, running.
• Theatre sign
• Positive functional tests: grind test, 45 sec anterior knee provocation, McConnel

You may not qualify if:

• Patellar dislocation
• Lower extremity surgery
• Ligament instability
• Rheumatoid Arthritis
• Osteoarthritis
• Tendinopathy
• Meniscus tear
• Ligamentous knee injury or laxity
• Bursitis
• Sinding Larsen Johansson Syndrome
• Previous pathology
• Low back surgery
• Metabolic diseases
• NSAIDs for extended period of time
• Cardiorespiratory diseases

Sponsors & Collaborators

• University of Thessaly: lead

Study Sites (1)

University of Thessaly

Lamia, Central Greece, GR-35132, Greece

RECRUITING

Related Publications (3)

• Hott A, Brox JI, Pripp AH, Juel NG, Paulsen G, Liavaag S. Effectiveness of Isolated Hip Exercise, Knee Exercise, or Free Physical Activity for Patellofemoral Pain: A Randomized Controlled Trial. Am J Sports Med. 2019 May;47(6):1312-1322. doi: 10.1177/0363546519830644. Epub 2019 Apr 8.

  PMID: 30958707 BACKGROUND

• Willy RW, Hoglund LT, Barton CJ, Bolgla LA, Scalzitti DA, Logerstedt DS, Lynch AD, Snyder-Mackler L, McDonough CM. Patellofemoral Pain. J Orthop Sports Phys Ther. 2019 Sep;49(9):CPG1-CPG95. doi: 10.2519/jospt.2019.0302.

  PMID: 31475628 BACKGROUND

• Bennell KL, Egerton T, Wrigley TV, Hodges PW, Hunt M, Roos EM, Kyriakides M, Metcalf B, Forbes A, Ageberg E, Hinman RS. Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol. BMC Musculoskelet Disord. 2011 Dec 5;12:276. doi: 10.1186/1471-2474-12-276.

  PMID: 22141334 RESULT

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Interventions

Papaverine

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Benzylisoquinolines; Alkaloids; Heterocyclic Compounds; Opiate Alkaloids; Isoquinolines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring

Central Study Contacts

Nick Chatziavraam

CONTACT

6974653813; nikoschatziavraam2392@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Official Title: Head of Human Performance and Rehabilitation Laboratory of the Physiotherapy Department

Study Record Dates

• First Submitted: October 18, 2023
• First Posted: October 31, 2023
• Study Start: February 2, 2023
• Primary Completion: December 15, 2023
• Study Completion: May 15, 2024
• Last Updated: October 31, 2023

Record last verified: 2023-10

Locations

GR (1)