Influence of Training Surface and Mechanical Load on the Prevalence of Patellofemoral Pain in Recreational Runners

NCT07408700 | Active Not Recruiting

• 1 other identifier: Correc
• Study Type: observational
• Target: 134
• Locations: 1 country
• Sites: 1

Brief Summary

Background. Patellofemoral pain (PFP) is one of the most common causes of knee pain in recreational runners and is exacerbated by activities that load the patellofemoral joint. Although biomechanical differences between running surfaces and elevation profiles have been documented, the influence of terrain type and training load on PFP in non-professional runners remains poorly defined. Objective. To examine the association between predominant training terrain and the presence of PFP in non-professional runners, and to describe its functional severity. Secondarily, to analyze the relationship between terrain exposure, elevation, training load and volume with PFP, as well as the potential influence of previous knee history and footwear rotation. Methods. An observational, analytical, cross-sectional study conducted through an online survey targeting recreational runners. The primary outcome will be the presence of patellofemoral pain, defined according to the 2016 International Consensus, and functional severity will be assessed using the Spanish-validated Kujala Anterior Knee Pain Scale. Exposures will include the percentage of kilometers run on each terrain type, positive and negative elevation gain, internal load (session rating of perceived exertion × duration), training volume, and running pace. Potential confounders will include age, sex, body mass index, running experience, training frequency, previous knee history, lower-limb strength, accumulated elevation gain, and footwear rotation. Descriptive analyses and logistic regression models will be performed to identify independent associations. Expected results. To estimate the prevalence of PFP in recreational runners, identify terrain- and load-related factors associated with its occurrence, and define a predictive model to inform prevention strategies and training planning.

Conditions

Patello Femoral Pain Syndrome

Keywords

Patellofemoral Pain Syndrome; Running; Surfaces; Exercise; Workload; Epidemiology

Outcome Measures

Primary Outcomes (1)

• Measurement of patellofemoral pain over the previous three months.

  This variable will be defined according to the International Consensus on Patellofemoral Pain. Participants will be classified as positive cases if they report anterior or retropatellar knee pain in the previous three months, exacerbated by at least one weight-bearing, knee-flexion activity (e.g., running, stair ambulation, slopes, or squatting), with a duration of ≥4 weeks or ≥2 episodes during that period

  Screening visit

Secondary Outcomes (7)

• Measurement of functional severity of patellofemoral pain

  Screening visit

• Measurement of terrain exposure (previous 3 months)

  Screening visit

• Measurement of weekly positive and negative elevation gain

  Screening visit

• Measurement of the percentage of downhill kilometers

  Screening visit

• Measurement of training intensity and internal load (previous 4 weeks)

  Screening visit

Other Outcomes (9)

• Measurement of age

  Screening visit

• Measurement of gender

  Screening visit

• Measurement of body mass index

  Screening visit

Study Arms (1)

Observational group

Non-professional / recreational adult runners who train regularly and perform the majority of their training on asphalt, trail, or mountain terrain.

Other: Runner sample

Interventions

Runner sample OTHER

Runners with lower or different exposure to these factors: other predominant terrain types (e.g., asphalt or trail), lower accumulated elevation gain, and/or lower levels of internal load and training volume.

Observational group

Eligibility Criteria

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

Study Population

Adult non-professional / recreational runners who train regularly and perform the majority of their training on asphalt, trail, or mountain terrain.

You may qualify if:

• Participants aged 18 years or older.
• Recreational (non-professional) runners.
• Have run regularly over the previous 3 months (at least once per week).
• Are able to report their predominant training terrain (asphalt, trail, or mountain).
• Have or do not have patellofemoral pain.
• Have provided written informed consent.

You may not qualify if:

• Have had a complete cessation of running for ≥4 weeks within the previous 3 months.
• Have undergone major knee or ankle surgery within the past year.
• Have a diagnosis of conditions that clearly alter gait or running pattern.
• Present severe knee disorders that preclude accurate assessment of patellofemoral pain.
• Have incomplete questionnaires for essential variables (terrain type, patellofemoral pain, AKPS, training load, or training volume)

Sponsors & Collaborators

• University of Oviedo: lead

Study Sites (1)

Universidad de Oviedo

Oviedo, Principality of Asturias, 33006, Spain

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome; Motor Activity

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Behavior

Study Officials

• Rubén Cuesta-Barriuso, PhD

  Universidad de Oviedo

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 6, 2026
• First Posted: February 13, 2026
• Study Start: February 12, 2026
• Primary Completion: April 3, 2026
• Study Completion: May 11, 2026
• Last Updated: May 1, 2026

Record last verified: 2026-02

Locations

ES (1)