Effects of a Squatting With Hip Adduction in Patients With Patellofemoral Pain Syndrome

NCT06681961 | Completed

• 1 other identifier: CMUH106-REC1-014
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

An imbalance in the activation and onset time of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles may be one of the primary causes of PFPS. Several studies have discussed various exercise methods believed to selectively contract the (VMO) muscle for treating patellofemoral pain syndrome. VMO activity is higher during static closed-chain tasks combined with hip adduction, indicating that performing hip adduction exercises may selectively strengthen the VMO muscle.

Conditions

PFPS

Keywords

Patellofemoral pain syndrome; Vastus medialis obliquus; Squatting; Hip adduction

Outcome Measures

Primary Outcomes (7)

• Amplitudes of muscle activation (unit: %MVC)

  represented the mean RMSs for each muscle which was normalized by the maximal voluntary contractions (MVC).

  pre-intervention and after 8-week intervention

• VMO/VL ratio

  represents the amplitude ratio of VMO relative to VL.

  pre-intervention and after 8-week intervention

• Onset time (unit: msec)

  at 200 ms before the beginning of the trial, as the baseline, the onset of EMG activation was identified as the point at which the EMG amplitude was more than three standard deviations from the baseline level for at least 25 ms.

  pre-intervention and after 8-week intervention

• VMO - VL (unit: msec)

  represented the onset time differences of VMO relative to VL, with a positive (negative) value indicating a delayed (early) onset time of VMO relative to VL.

  pre-intervention and after 8-week intervention

• Q angle (unit: degree)

  The angle was calculated with the intersection formed by two lines crossing the center of the patella. The first line went from the ASIS to the center of the patella and the second from the anterior tuberosity of the tibia to the center of the patella.

  pre-intervention and after 8-week intervention

• The visual analogue scale (VAS) (unit: mm)

  VAS was used to assess pain severity. The participants were asked to mark their pain levels on a 100-mm ruler (ranging from 0 = "no pain" to 100 = "unbearable pain") before and after the exercise program.

  pre-intervention and after 8-week intervention

• patellofemoral pain severity scale (PSS) (unit: score)

  PSS was used to measure PFPS associated with functional activities over the past week. The scale comprises 10 items, including climbing/descending stairs, squatting, walking, jogging, running/sprinting, participating in a sport, sitting with knees bent (for 20 min), kneeling, resting, and following an activity. The maximum score was 100 points. The participants rated their pain on a 100-mm VAS, ranging from 0 = "no pain" to 100 = "unbearable pain".

  pre-intervention and after 8-week intervention

Study Arms (2)

squatting with hip adduction (SQU-HA) group

EXPERIMENTAL

The participants stood equally on both legs on the floor with their feet shoulder-width apart and angled outward at 20°-30°. After a warm-up, the participants performed 45° squats with squeezing a Swiss ball of 18-cm diameter at a slow speed of 2 s for flexion and extension from the standing posture by using a commercial metronome. The squatting with knee flexion from 0° to 45° was the safest for people with PFPS.

Other: squatting with hip adduction (SQU-HA) group

squatting (SQU) group

OTHER

The participants stood equally on both legs on the floor with their feet shoulder-width apart and angled outward at 20°-30°. After a warm-up, the participants performed 45° squats at a slow speed of 2 s for flexion and extension from the standing posture by using a commercial metronome. The squatting with knee flexion from 0° to 45° was the safest for people with PFPS.

Other: squatting with hip adduction (SQU-HA) group

Interventions

squatting with hip adduction (SQU-HA) group OTHER

The intervention comprised three sets of 15 repetitions with resting 5-min between sets, followed by IT band stretching for five repetitions. Each participant performed the respective exercise 5 days a week, with 2 days of rest, for 8 weeks.

Also known as: squatting (SQU) group

squatting (SQU) group; squatting with hip adduction (SQU-HA) group

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age 20-50 years.
• Pain around the patella at least two of the following activities¬-standing up after prolonged sitting, going up and down the stairs, running, jumping, squatting, kneeling, and high-angle knee flexion for a long time.
• Knee joint pain for ≥3 months.
• Pain level of ≥ 30 mm on a 100-mm visual analog scale (VAS).

You may not qualify if:

• Had a history of patellar subluxation, dislocation, or knee surgery.
• Had central or peripheral neurological pathology.
• Had an obvious knee joint deformity or lower extremity malalignment.
• Experienced severe knee joint pain (VAS) score \> 80 mm), or received nonsteroidal anti-inflammatory drugs, injections, or physical therapy within the past 3 months.

Sponsors & Collaborators

• China Medical University Hospital: lead

Study Sites (1)

China Medical University

Taichung, 406040, Taiwan

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Interventions

Population Groups

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Demography; Population Characteristics

Study Officials

• Wei-Hsien Hong, PhD

  China Medical University, Taiwan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This was a prospective, randomized-controlled trial.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: China Medical University

Model Details: Thirty PFPS participants were randomly assigned to conventional squatting (SQU) (n=15) or squatting with hip adduction (SQU-HA) (n=15) groups. Participants were blinded to the interventions used in the other group.

Study Record Dates

• First Submitted: November 4, 2024
• First Posted: November 12, 2024
• Study Start: November 27, 2017
• Primary Completion: November 30, 2018
• Study Completion: January 5, 2019
• Last Updated: November 12, 2024

Record last verified: 2024-11

Locations

TW (1)