The Effects of Open Chain Versus Closed Chain Strengthening on Dynamic Valgus During a Step Down Test

NCT06348836 | Recruiting

• 1 other identifier: 2123624-1/2
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to compare the effects of different exercises programs in individuals with abnormal knee motion. The main question it aims to answer are:

• In individuals with abnormal knee motion and without knee pain, does a weight-bearing exercise program reduce abnormal knee motion during a step-down test better than a non weight-bearing exercise program? Participants will
• Perform a stepdown test while undergoing motion analysis and electromyograph (EMG) recording.
• Participants will then be placed either into a weight-bearing or non weight-bearing exercise group. Exercises will be performed 3 times per week for 6 weeks.
• Further motion analysis and EMG data will be collected to test for differences. Researchers will compare individual results before and after exercise, and between-group results before and after exercise to see if one exercise program helps improved abnormal knee motion more than the other.

Conditions

Dynamic Knee Valgus

Keywords

knee valgus; hip weakness

Outcome Measures

Primary Outcomes (3)

• Electromyographic activity of gluteus medius muscle during step-down test

  Muscle activity of gluteus medius during max contraction and during step-down test

  6 weeks

• Electromyographic activity of quadriceps muscle during step-down test

  Muscle activity of quadriceps muscle during max contraction and during step-down test

  6 weeks

• Electromyographic activity of hamstring muscles during step-down test

  Muscle activity of hamstring muscles during max contraction and during step-down test

  6 weeks

Secondary Outcomes (1)

• Amount of dynamic knee valgus during step-down test measured with motion analysis

  6 weeks

Study Arms (2)

Closed-Chain exercise

ACTIVE COMPARATOR

4 exercises: 1)Single leg bridge, 2)side plank (with testing side down), 3) single leg squat, 4) banded squat Exercises to be performed with 3 sets of 10 repetitions each. Frequency will be 2 times per week for 6 weeks.

Other: Exercise

Open-Chain exercise

ACTIVE COMPARATOR

4 exercises: 1) Side plank (with testing side up), 2) clamshells, 3) front plank with hip extension, 4)wall slide Exercises to be performed with 3 sets of 10 repetitions each. Frequency will be 2 times per week for 6 weeks.

Other: Exercise

Interventions

Exercise OTHER

Description of exercises are noted in the arms/groups descriptions

Also known as: Closed-chain exercise, Open-chain exercise

Closed-Chain exercise; Open-Chain exercise

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Dynamic knee valgus with observed step down test

You may not qualify if:

• Presently experiencing lower extremity pain
• Lower extremity surgery within the past 1 year

Sponsors & Collaborators

• Alvernia University: lead

Study Sites (1)

Alvernia University

Reading, Pennsylvania, 19607, United States

RECRUITING

Related Publications (16)

• Devereaux MD, Lachmann SM. Patello-femoral arthralgia in athletes attending a Sports Injury Clinic. Br J Sports Med. 1984 Mar;18(1):18-21. doi: 10.1136/bjsm.18.1.18.

  PMID: 6722419 BACKGROUND

• Bunt CW, Jonas CE, Chang JG. Knee Pain in Adults and Adolescents: The Initial Evaluation. Am Fam Physician. 2018 Nov 1;98(9):576-585.

  PMID: 30325638 BACKGROUND

• Fukuda TY, Rossetto FM, Magalhaes E, Bryk FF, Lucareli PR, de Almeida Aparecida Carvalho N. Short-term effects of hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial. J Orthop Sports Phys Ther. 2010 Nov;40(11):736-42. doi: 10.2519/jospt.2010.3246.

  PMID: 21041965 BACKGROUND

• Bolgla LA, Boling MC, Mace KL, DiStefano MJ, Fithian DC, Powers CM. National Athletic Trainers' Association Position Statement: Management of Individuals With Patellofemoral Pain. J Athl Train. 2018 Sep;53(9):820-836. doi: 10.4085/1062-6050-231-15.

  PMID: 30372640 BACKGROUND

• Dutton RA, Khadavi MJ, Fredericson M. Patellofemoral Pain. Phys Med Rehabil Clin N Am. 2016 Feb;27(1):31-52. doi: 10.1016/j.pmr.2015.08.002.

  PMID: 26616176 BACKGROUND

• Hollman JH, Ginos BE, Kozuchowski J, Vaughn AS, Krause DA, Youdas JW. Relationships between knee valgus, hip-muscle strength, and hip-muscle recruitment during a single-limb step-down. J Sport Rehabil. 2009 Feb;18(1):104-17. doi: 10.1123/jsr.18.1.104.

  PMID: 19321910 BACKGROUND

• Stickler L, Finley M, Gulgin H. Relationship between hip and core strength and frontal plane alignment during a single leg squat. Phys Ther Sport. 2015 Feb;16(1):66-71. doi: 10.1016/j.ptsp.2014.05.002. Epub 2014 Jun 3.

  PMID: 25070759 BACKGROUND

• Scholtes SA, Salsich GB. A DYNAMIC VALGUS INDEX THAT COMBINES HIP AND KNEE ANGLES: ASSESSMENT OF UTILITY IN FEMALES WITH PATELLOFEMORAL PAIN. Int J Sports Phys Ther. 2017 Jun;12(3):333-340.

  PMID: 28593087 BACKGROUND

• Chowdhury RH, Reaz MB, Ali MA, Bakar AA, Chellappan K, Chang TG. Surface electromyography signal processing and classification techniques. Sensors (Basel). 2013 Sep 17;13(9):12431-66. doi: 10.3390/s130912431.

  PMID: 24048337 BACKGROUND

• Harris-Hayes M, Steger-May K, Koh C, Royer NK, Graci V, Salsich GB. Classification of lower extremity movement patterns based on visual assessment: reliability and correlation with 2-dimensional video analysis. J Athl Train. 2014 May-Jun;49(3):304-10. doi: 10.4085/1062-6050-49.2.21.

  PMID: 24955621 BACKGROUND

• Simon M, Parizek C, Earl-Boehm JE, Bazett-Jones DM. Quantitative and qualitative assessment of frontal plane knee motion in males and females: A reliability and validity study. Knee. 2018 Dec;25(6):1057-1064. doi: 10.1016/j.knee.2018.09.008. Epub 2018 Nov 8.

  PMID: 30414788 BACKGROUND

• Kunene SH, Taukobong NP, Ramklass S. Rehabilitation approaches to anterior knee pain among runners: A scoping review. S Afr J Physiother. 2020 Jan 27;76(1):1342. doi: 10.4102/sajp.v76i1.1342. eCollection 2020.

  PMID: 32161824 BACKGROUND

• Ismail MM, Gamaleldein MH, Hassa KA. Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial. Eur J Phys Rehabil Med. 2013 Oct;49(5):687-98. Epub 2013 Jul 2.

  PMID: 23820880 BACKGROUND

• Moore D, Semciw AI, Pizzari T. A SYSTEMATIC REVIEW AND META-ANALYSIS OF COMMON THERAPEUTIC EXERCISES THAT GENERATE HIGHEST MUSCLE ACTIVITY IN THE GLUTEUS MEDIUS AND GLUTEUS MINIMUS SEGMENTS. Int J Sports Phys Ther. 2020 Dec;15(6):856-881. doi: 10.26603/ijspt20200856.

  PMID: 33344003 BACKGROUND

• Boren K, Conrey C, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises. Int J Sports Phys Ther. 2011 Sep;6(3):206-23.

  PMID: 22034614 BACKGROUND

• Willy RW, Davis IS. The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. J Orthop Sports Phys Ther. 2011 Sep;41(9):625-32. doi: 10.2519/jospt.2011.3470. Epub 2011 Jul 12.

  PMID: 21765220 BACKGROUND

MeSH Terms

Interventions

Exercise

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• James M O'Donohue, DPT

  Alvernia University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

James M O'Donohue, DPT

CONTACT

6103341162; james.odonohue@alvernia.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Physical Therapy

Model Details: Participants will be randomly assigned to either a closed-chain (weightbearing) exercise group or an open-chain (non-weightbearing) exercise group

Study Record Dates

• First Submitted: March 30, 2024
• First Posted: April 5, 2024
• Study Start: March 22, 2024
• Primary Completion: February 28, 2025
• Study Completion: February 28, 2025
• Last Updated: April 5, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)