Compressive Myofascial Release of the Vastus Lateralis on Lateral Patellar Tracking in Patellofemoral Pain Syndrome

NCT06875804 | Recruiting

• 1 other identifier: REC/RCR & AHS/24/0149
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

Patellofemoral Pain Syndrome is a prevalent condition characterized by anterior knee pain, often exacerbated by activities such as squatting, running, and stair climbing. This condition is frequently associated with improper patellar tracking, particularly lateral displacement, which can be influenced by various factors including muscular imbalances and tightness. The vastus lateralis muscle, part of the quadriceps group, is often implicated in contributing to lateral patellar tracking due to its attachment and alignment. Compressive myofascial release (CMFR) is a therapeutic technique aimed at reducing muscle tightness and restoring optimal muscle function. This study will explore the effects compressive myofascial release on the vastus lateralis in improving patellar tracking in patients diagnosed with Patellofemoral Pain Syndrome.The methodology of this study involves a randomized controlled trial with a sample of patients diagnosed with Patellofemoral Pain Syndrome. Non-probability convenience sampling technique will be used and participants will be recruited in groups after randomization. Participants(n=26) will be divided into two groups: the intervention group (n=13) receiving compressive myofascial release on the vastus lateralis, and a control group receiving(n=13) a routine treatment. The intervention will be administered over a period of four weeks, with sessions occurring three times weekly. Patellar tracking will be assessed using q-angle analysis both pre- and post-intervention. Additionally, subjective measures of pain and functional ability will be evaluated using the Numeric pain rating scale (NPRS) and the Kujala Patellofemoral Score. Data analysis will focus on comparing the changes in lateral patellar displacement and patient-reported outcomes between the two groups to determine the efficacy of compressive myofascial release in correcting lateral patellar tracking and alleviating symptoms of Patellofemoral Pain Syndrome. SPSS version 25 will be used for data analysis

Conditions

Patellofemoral Pain Syndrome

Keywords

Patellofemoral Pain Syndrome; Myofascial Release; Vastus Lateralis; Patellar Tracking; Knee joint; Pain; Range of motion

Outcome Measures

Primary Outcomes (4)

• Numerical Pain Rating Scale (NPRS)

  It is a standardized self-report device consisting of a horizontal line used to estimate the subjective level of pain intensity. It is a 10 points numerical scale, corresponding to the degree of pain.

  4 weeks

• Q angle

  Quadriceps angle (Q-angle) has been used as a diagnostic measurement to assess factors which appear to increase the risk of the development of acute and/or chronic patellofemoral injury and pain in bipedal individuals. The Q-angle is the angle between the line of pull of the quadriceps (anterior superior iliac spine to mid-patella) and a line connecting the center of patella with tibial tuberosity. Normal Q-angle for males is 10-13 degrees and 15-17 degrees for females.

  4 weeks

• Goniometry

  A goniometer is the most common instrument used to measure range of motion. If a patient has altered range of motion in a particular joint, the therapist can use a goniometer to assess what the range of motion is at the initial assessment, and then make sure the intervention is working by using the goniometer in subsequent sessions to assess the effectiveness of the intervention. Goniometric measurements should be performed with functional AROM and PROM. The typical documentation for the knee motion is: 10-0-135 degrees beginning with hyperextension, moving through neutral 0 and into flexion.

  4 weeks

• Kujala score

  The "Kujala Score" is the eponymous name for the Anterior Knee Pain Scale (AKPS). It is a patient-reported outcome survey and diagnostic tool that aims to assess the severity of symptoms and physical limitations in patients with patellofemoral pain syndrome (PFPS). It was initially derived due to the diagnostic inconsistency among other tools that were used with PFPS patients. The Kujala Patellofemoral Scale is a valid and reliable questionnaire to evaluate functioning in patients with PFPS. The scores range from a maximum of 100 to a minimum of 0, with lower scores indicating greater pain and disability.

  4 weeks

Study Arms (2)

Group A: Baseline physical therapy treatment

ACTIVE COMPARATOR

baseline physical therapy treatment

Other: baseline physical therapy treatment

Group B: Compressive myofascial release of vastus lateralis.

EXPERIMENTAL

baseline physical therapy treatment along with compressive myofascial release of vastus lateralis

Other: Compressive myofascial release of vastus lateralis.

Interventions

baseline physical therapy treatment OTHER

Group A focuses on pain relief, muscle relaxation, and strengthening. Hot packs and TENS are applied to the lateral thigh and knee for 20 minutes to reduce pain and muscle tension. Hip strengthening exercises include side-lying hip abduction, clam-shells, prone hip extension, bridging, and lunges. Quadriceps exercises involve straight leg raises, prone terminal knee extension, and mini-squats. Each exercise is done in 2-3 sets of 10-15 repetitions, holding stretches for 5 seconds.

Group A: Baseline physical therapy treatment

Compressive myofascial release of vastus lateralis. OTHER

The experimental group receives an additional session of Compressive Myofascial Release (CMFR) for the Vastus Lateralis to address lateral patellar tracking in PFPS patients. The patient lies on their side, and the therapist identifies tight areas, applying firm pressure for 20-30 seconds. Deeper pressure is held for 30-60 seconds, followed by 1-2 minutes of cross-fiber friction. The session includes muscle shaking for 30 seconds and stretching the Vastus Lateralis by extending the hip and flexing the knee for 30-60 seconds, repeated 2-3 times. Patient response is documented for progress tracking.

Group B: Compressive myofascial release of vastus lateralis.

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age group between 20 to 40 years
• Male and female gender
• Diagnosed cases of Patellofemoral syndrome
• Participants with positive J sign and Clarke's test
• Pain provoked during knee loading physical activity, such as jumping, running, squatting, or going up or down stairs in last 3 months
• Presence of excessive lateral patellar tracking on axial view radiographs

You may not qualify if:

• History of knee surgery in the past year.
• Any contraindications to myofascial release therapy, such as active infections, open wounds.
• Presence of hip pathology or other knee conditions such as ligament tears, meniscal injuries, Osgood-Schlatter or Sinding-Larsen-Johanssen syndrome or jumpers knee
• Participants with a history of trauma or repetitive episodes of patellar subluxation or dislocation
• Use of intra-articular corticosteroid injections
• Presence of auto-immune disorder (spondylolisthesis, spondylitis, Rheumatoid arthritis etc.) other than knee OA or systemic conditions such as severe cardiovascular disease

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Social Security Hospital

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (5)

• Torrente QM, Killingback A, Robertson C, Adds PJ. The Effect of Self-Myofascial Release on the Pennation Angle of the Vastus Medialis Oblique and the Vastus Lateralis in Athletic Male Individuals: An Ultrasound Investigation. Int J Sports Phys Ther. 2022 Jun 1;17(4):636-642. doi: 10.26603/001c.35591. eCollection 2022.

  PMID: 35693863 BACKGROUND

• Stanek J, Sullivan T, Davis S. Comparison of Compressive Myofascial Release and the Graston Technique for Improving Ankle-Dorsiflexion Range of Motion. J Athl Train. 2018 Feb;53(2):160-167. doi: 10.4085/1062-6050-386-16. Epub 2018 Jan 26.

  PMID: 29373060 BACKGROUND

• Zago J, Amatuzzi F, Rondinel T, Matheus JP. Osteopathic Manipulative Treatment Versus Exercise Program in Runners With Patellofemoral Pain Syndrome: A Randomized Controlled Trial. J Sport Rehabil. 2020 Dec 17;30(4):609-618. doi: 10.1123/jsr.2020-0108.

  PMID: 33333491 BACKGROUND

• Halabchi F, Abolhasani M, Mirshahi M, Alizadeh Z. Patellofemoral pain in athletes: clinical perspectives. Open Access J Sports Med. 2017 Oct 9;8:189-203. doi: 10.2147/OAJSM.S127359. eCollection 2017.

  PMID: 29070955 BACKGROUND

• Schoots EJ, Tak IJ, Veenstra BJ, Krebbers YM, Bax JG. Ultrasound characteristics of the lateral retinaculum in 10 patients with patellofemoral pain syndrome compared to healthy controls. J Bodyw Mov Ther. 2013 Oct;17(4):523-9. doi: 10.1016/j.jbmt.2013.03.005. Epub 2013 Apr 26.

  PMID: 24139014 BACKGROUND

MeSH Terms

Conditions

Patellofemoral Pain Syndrome; Pain

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ghulam Fatima, PHD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, PHD*

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Imran Amjad, PHD*

CONTACT

051-5481826; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 10, 2025
• First Posted: March 13, 2025
• Study Start: January 2, 2025
• Primary Completion: September 2, 2025
• Study Completion: September 15, 2025
• Last Updated: March 13, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)