Comparison Between the Effects of Mulligan and Maitland Mobilization on Patellofemoral Pain Syndrome

NCT07004881 | Recruiting

• 1 other identifier: FUI/CTR/2024/74
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This study is a randomised control trial and the purpose of this study is to investigate and compare the "Effects of Maitland mobilizations and Mulligan Mobilization With Movement (MWM) in patients with Patellofemoral Pain Syndrome

Conditions

Patellofemoral Pain Syndrome

Outcome Measures

Primary Outcomes (3)

• Patellofemoral Pain

  It will be measured using numeric pain rating scale (NPRS). Subjects select a number ranging from 0-10 according to their intensity of pain where '0' indicates no pain while '10' indicates worst pain experienced.

  2 weeks

• Range of Motion

  Universal goniometer is used to measure knee flexion and extension ranges. Patient is positioned in supine with the knee straight and foot flat on the table. Therapist stabilizes the femur with one hand. Axis of goniometer is aligned with the lateral epicondyle of the femur, stationary arm is kept parallel to the femur and moving arm is aligned with long axis of tibia. The patient is then asked to flex and extend the knee to maximum range without pain, subsequently aligning moving arm of goniometer with new position of tibia. Angle of flexion/extension are then recorded from the goniometer and documented.

  Variable will be assessed at before and after treatment for the total interval of 2 weeks.

• Lower Extremity Function

  It is measured using Lower Extremity Function Scale (LEFS). The LEFS is a questionnaire used to assess an individual's ability to perform daily activities and functional tasks related to the lower extremities (hips, knees, ankles, and feet). It comprises of total 20 questions and patients rate their ability to perform each activity on a scale from 0 (unable to perform) to 4 (able to perform without difficulty). The total score ranges from 0 to 80, with higher scores indicating better functional ability. The total sore before and after interventions of both groups is calculated and compared.

  Variable will be assessed at before and after treatment for the total interval of 2 weeks.

Study Arms (2)

Mulligan Mobilization with Movement

ACTIVE COMPARATOR

Mulligan Mobilization with Movement This group will receive two techniques of mulligan i.e. Medial Patellar Glide relative to femoral trochlea and other is tibial internal rotation relative to femoral condyles. Both the techniques are repeated 10 times with total 3 sets. 3 sessions are performed in a week on alternate days. Total duration of interventions is 2 weeks. After mobilization, following exercises are to be performed all in 3 sets of 7 repetitions: 1. Side-lying hip abduction 2. Clamshell exercises 3. Quadriceps setting exercise 4. Vastus Medialis Oblique strengthening 5. Mini squats 6. Hamstring stretch 7. Iliotibial band stretch

Procedure: Group A (Active Comparator) Mulligan's Mobilization With Movement (MWM)

Maitland Mobilization

EXPERIMENTAL

Maitland Mobilization This group recieves 4 patellar mobilization tehniques given by Maitland. For all the mobilizations the patient is positioned either in supine or sitting with 30-0 degree knee flexion or full knee extension. The therapist holds patella between his/her thumb and index finger and glides it cranially (Superior Patellar glide), caudally (Inferior Patellar Glide) and medially (Medial Patellar Glide). The fourth one i.e. Patellofemoral Distraction is given by grasping the patella between two fingers and lifting it above/away from underlying femoral trochlea. All 4 of these techniques are repeated 10 times with total 3 sets. 3 sessions are performed in a week on alternate days. Total duration of interventions is 2 weeks. After mobilization; 3 sets of 7 repetitions: 1. Side-lying hip abduction 2. Clamshell exercises 3. Quadriceps setting exercise 4. Vastus Medialis Oblique strengthening 5. Mini squats 6. Hamstring stretch 7. Iliotibial band stretch

Procedure: Group B(Experimental) Maitland's Patellar Mobilizations

Interventions

Group A (Active Comparator) Mulligan's Mobilization With Movement (MWM) PROCEDURE

This group will receive two techniques of mulligan i.e. Medial Patellar Glide relative to femoral trochlea and other is tibial internal rotation relative to femoral condyles.In Medial Patellar Glide; patient is positioned supine with 40 degree knee flexion. Stabilizing hand of therapist stabilizes the posterior aspect of tibia and fibula and with mobilizing hand, the therapist gently glides the patella medially. With that, the patient is asked to actively flex and then extend the knee. In the tibial internal rotation technique; similarly the patient is positioned supine with 40 degree knee flexion. Stabilizing hand of therapist stabilizes t After mobilization; following exercises are to be performed all in 3 sets of 7 repetitions: 1. Side-lying hip abduction 2. Clamshell exercises 3. Quadriceps setting exercise 4. Vastus Medialis Oblique strengthening 5. Mini squats 6. Hamstring stretch 7. Iliotibial band stretch

Mulligan Mobilization with Movement

Group B(Experimental) Maitland's Patellar Mobilizations PROCEDURE

For all the mobilizations the patient is positioned either in supine or sitting with 30-0 degree knee flexion or full knee extension. The therapist holds patella between his/her thumb and index finger and glides it cranially (Superior Patellar glide), caudally (Inferior Patellar Glide) and medially (Medial Patellar Glide). The fourth one i.e. Patellofemoral Distraction is given by grasping the patella between two fingers and lifting it above/away from underlying femoral trochlea. All 4 of these techniques are repeated 10 times with total 3 sets. 3 sessions are performed in a week on alternate days. Total duration of interventions is 2 weeks. Both groups receive similar exercises therapy following mobilizations.

Maitland Mobilization

Eligibility Criteria

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

You may qualify if:

• Referred patients from rehabilitation, orthopedic and rheumatology department
• Both males and females of age 18-40 years
• Having pain from at least 2 months.
• Pain score ≥ 3 on NPRS.
• Pain on palpation of medial or lateral Patellar facet. (12, 13)
• Retro patellar pain in at least two of the following activities:
• Ascending , descending stairs
• Hopping / jumping
• prolonged sitting with flexed knees
• kneeling and squatting
• Patellar tilt test
• Positive tests/findings on physical examination for knee menisci, ligaments and bursa.
• Chondromalacia patellae
• Individuals with Instability of tibiofemoral joint
• lower extremity surgery

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, 44000, Pakistan

RECRUITING

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Interventions

Movement

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Central Study Contacts

Anza Moiz, DPT

CONTACT

+923350511715; anzamoiz31@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: It is a single blinded Randomized Controlled Trial, in which the data assessor will be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Randomized Control Trial

Study Record Dates

• First Submitted: May 26, 2025
• First Posted: June 4, 2025
• Study Start: July 15, 2024
• Primary Completion: July 15, 2025
• Study Completion: July 15, 2025
• Last Updated: June 18, 2025

Record last verified: 2024-08

Locations

PA (1)