Effects of Attentional Focus Strategies During Isokinetic Quadriceps Training on Strength and Functional Performance in Individuals With Patellofemoral Pain Syndrome.

NCT07384858 | Recruiting

• 1 other identifier: 2025/714
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Patellofemoral pain syndrome (PFPS) is a multifactorial musculoskeletal condition that is common particularly among young and physically active individuals, negatively affecting activities of daily living and physical performance. Although exercise therapy is considered the gold standard in the management of PFPS, there is limited evidence regarding the effectiveness of motor learning strategies applied during exercise. This study aims to shed light on how motor learning approaches can be optimized in clinical rehabilitation by comparing the effects of internal and external focus strategies used during exercise on muscle activation, functional performance, and pain. This research will make a methodological contribution to the literature through the objective evaluation of muscle mechanical properties using isokinetic assessment and the MyotonPRO device. The findings are expected to clarify the effects of attentional focus strategies on therapeutic outcomes in PFPS rehabilitation and have the potential to provide an evidence-based guide for physiotherapy practice. In this way, the study may contribute to the development of new approaches aimed at improving both clinical effectiveness and patient adherence.

Conditions

Patellofemoral Pain, PFP

Outcome Measures

Primary Outcomes (3)

• Kujala Patellofemoral Pain Score

  Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.

  baseline

• Kujala Patellofemoral Pain Score

  Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.

  Week 3 of the Treatment

• Kujala Patellofemoral Pain Score

  Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.

  Week 6 of the Treatment

Secondary Outcomes (21)

• Visual Analog Scale

  baseline

• Visual Analog Scale

  Week 3 of the Treatment

• Visual Analog Scale

  Week 6 of the Treatment

• Isokinetic Muscle Strength Assessment (Isoforce)

  baseline

• Isokinetic Muscle Strength Assessment (Isoforce)

  Week 3 of the Treatment

Study Arms (2)

Internal focus

EXPERIMENTAL

Other: Internal focus group

External focus

EXPERIMENTAL

Other: External focus

Interventions

Internal focus group OTHER

Internal focus refers to directing attention to one's own body movements or muscle activity while performing a task (e.g., focusing on contracting a specific muscle). During isokinetic strength exercises, this group is instructed with commands such as: "Tighten your quadriceps" and "Straighten your knee."

Internal focus

External focus OTHER

External focus refers to directing attention to the effect of a movement on the environment or an external object, rather than on the body itself. During isokinetic exercise, this group is given the instruction: "Increase and maintain the performance indicator on the screen."

External focus

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Aged between 18 and 45 years.
• Diagnosed with patellofemoral pain syndrome (PFPS).
• Anterior or retropatellar knee pain persisting for at least four weeks with a VAS score \> 3.
• Pain exacerbated by at least two functional activities (e.g., squatting, stair climbing, prolonged sitting).
• Willing to regularly participate in the 6-week program throughout the study period.

You may not qualify if:

• History of patellar subluxation or dislocation.
• Anterior or posterior cruciate ligament insufficiency.
• Lower extremity fractures.
• Neurological or systemic musculoskeletal disorders.
• Rheumatoid arthritis or other inflammatory joint diseases.
• History of knee surgery, meniscal injury, or any other underlying musculoskeletal condition that would prevent the participant from performing the exercises.
• Pregnancy or postpartum period.
• Participation in a similar exercise program within the last 3 months.
• Radiographic evidence of osteoarthritis classified as Kellgren-Lawrence grade 2 or higher.

Sponsors & Collaborators

• Istanbul University - Cerrahpasa: lead

Study Sites (1)

Istanbul University-Cerrahpasa

Istanbul, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• SEZEN KARABÖRKLÜ ARGUT, Assistant Professor

  Istanbul University-Cerrahpaşa, Faculty of Health Science

  STUDY DIRECTOR

Central Study Contacts

SEDA ATEŞ, bachelor degree

CONTACT

90+ 5388543087; seda.ates@ogr.iuc.edu.tr

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: PRINCIPAL INVESTIGATOR
• PI Title: physiotherapist

Study Record Dates

• First Submitted: December 17, 2025
• First Posted: February 3, 2026
• Study Start: February 2, 2026
• Primary Completion (Estimated): September 2, 2026
• Study Completion (Estimated): September 2, 2026
• Last Updated: February 11, 2026

Record last verified: 2026-01

Locations

TU (1)