"Mulligan Technique vs Phonophoresis With Chitosan for Patellofemoral Pain"

NCT07445607 | Not Yet Recruiting DMC

• 1 other identifier: CUPT-MULLIGAN-2026
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

Patellofemoral pain syndrome (PFPS) is a common knee condition causing pain and dysfunction. This study aims to compare the effectiveness of two physical therapy treatments for PFPS: Mulligan mobilization with movement technique versus phonophoresis with chitosan gel. Forty-five participants with patellofemoral pain syndrome will be randomly assigned to one of three groups: (1) Mulligan technique group, (2) Phonophoresis with chitosan gel group, or (3) Control group receiving standard physical therapy exercises. Each group will receive treatment 3 times per week for 4 weeks. The researchers want to determine which treatment is more effective in improving neuromuscular control, reducing pain, and improving function in patients with patellofemoral pain syndrome. Participants will be assessed before and after the treatment period. This study may help physical therapists and healthcare providers choose the most effective treatment approach for patients with patellofemoral pain.

Conditions

Patellofemoral Pain Syndrome

Outcome Measures

Primary Outcomes (2)

• Maximal rate of force development (RFD)

  Calculated from the slope of force- or torque-time curves obtained during rapid, explosive voluntary contractions also termed ballistic or rapid actions has become a key metric for assessing explosive strength in diverse populations, including athletes, older adults, and clinical patients

  Baseline and 6 weeks

• Pain at patella

  Pain measured using the Kujala Anterior Knee Pain Scale (AKPS). The scale ranges from 0 to 100 points, with 0 indicating maximum disability and 100 indicating no disability. Higher scores indicate better outcome (less pain and better function)

  Baseline and 6 weeks

Study Arms (3)

Mulligan Technique Group

EXPERIMENTAL

Participants receive hip and knee strengthening exercises combined with Mulligan mobilization with movement (MWM) technique for the patellofemoral joint. MWM is performed in three sets of 10 repetitions, with a 30-second rest interval between sets. Treatment sessions are conducted 3 times per week for 6 weeks.

Procedure: Mulligan technique

Phonophoresis with Chitosan Group

EXPERIMENTAL

Phonophoresis (ultrasound with chitosan gel) is applied at 1 MHz, 1.0 W/cm², continuous mode, for 5 minutes, 3 times per week for 6 weeks before hip and knee exercises.

Procedure: Phonophoresis with Chitosan Gel

Control Group ( Standard Physical Therapy Group)

ACTIVE COMPARATOR

Participants receive standard physical therapy for patellofemoral pain consisting of hip and knee strengthening exercises, stretching, and functional training. Sessions are conducted 3 times per week for 6 weeks. Exercises include hip and knee strengthening exercises and stretches for the quadriceps, hamstring, iliotibial band, and calf muscles with weekly progression.

Behavioral: Standard Physical Therapy Exercise Program

Interventions

Mulligan technique PROCEDURE

Each mobilization with movement (MWM) is performed in three sets of 10 repetitions, with a 30-second rest interval between sets, 3 times per week for 6 weeks, before hip and knee strengthening exercises.

Mulligan Technique Group

Phonophoresis with Chitosan Gel PROCEDURE

Phonophoresis (ultrasound with chitosan gel) is applied at 1 MHz, 1.0 W/cm², continuous mode, for 5 minutes, 3 times per week for 6 weeks before hip and knee exercises.

Phonophoresis with Chitosan Group

Standard Physical Therapy Exercise Program BEHAVIORAL

Participants attend 3 sessions per week for 6 weeks. Each session includes stretching and hip and knee focused exercises. Progression involves weekly increases in repetitions and resistance based on pain levels (less than 3/10).

Control Group ( Standard Physical Therapy Group)

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Insidious onset of anterior knee pain
• Retro patellar or peripatellar pain
• Pain duration more than four weeks (chronic/subacute)
• Pain severity ≥ 3/10 on Visual Analog Scale (VAS)
• Pain during at least two of the following activities: stair ascent or descent, squatting, prolonged sitting (theater sign), or kneeling
• Positive patellar compression test (pain reproduced by compressing the patella into the trochlear groove)
• Patellar tenderness along the medial or lateral borders
• Age between 18 and 35 years
• Baseline Kujala score (Arabic version): approximately 67-71 (indicating moderate to severe dysfunction)

You may not qualify if:

• Traumatic injury (e.g., dislocation, fracture, ligament or meniscus pathology)
• Inflammatory arthritis (e.g., rheumatoid arthritis, gout)
• Prior knee surgery
• Current use of NSAIDs or corticosteroids

Sponsors & Collaborators

• Ahram Canadian University: lead

Study Sites (1)

Ahram Canadian unveracity

Cairo, Giza Governorate, 12573, Egypt

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Interventions

Phonophoresis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Drug Administration Routes; Drug Therapy; Therapeutics

Central Study Contacts

Mennat-Allah Ali Elshafey, Master degree

CONTACT

+201227232387; Mennatallah.elshafey@acu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Master's degree in biomechanics department physical therapy ,Cairo unveracity

Study Record Dates

• First Submitted: February 22, 2026
• First Posted: March 3, 2026
• Study Start: February 15, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: March 3, 2026

Record last verified: 2026-02

Locations

EG (1)