Effect of Short Foot Exercise Combined With Focused Hip and Knee Exercises on Pain, Q Angle and Functional Outcomes in Female Patients With Patellofemoral Pain Syndrome

NCT07703072 | Not Yet Recruiting DMC

• 1 other identifier: UBAS/ERB/26/04/032
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to evaluate the effectiveness of short foot exercises combined with focused hip and knee strengthening on pain, Q-angle, and functional outcomes in female patients with patellofemoral pain syndrome (PFPS). Thirty-eight participants aged 18-45 years will be randomly assigned to either an experimental group (short foot + hip and knee exercises) or a control group (hip and knee exercises only) for a 6-week supervised rehabilitation program.

Conditions

Patellofemoral Pain Syndrome

Outcome Measures

Primary Outcomes (2)

• Kujala Anterior knee pain scale (AKPS)

  The Kujala AKPS is a 13-item questionnaire specifically designed to evaluate symptoms and functional limitations associated with patellofemoral disorders. It assesses domains such as limping, walking, running, stair climbing, squatting, sitting, swelling, and pain. Total scores range from 0 to 100. Scores ranging 90-100 indicating better knee function while score range from 0-50 shows significant pain and functional impairment.

  Baseline measurement and after 6 weeks intervention

• Visual Analogue Scale

  The Visual Analogue Scale is a 10-cm line used to assess the intensity of pain. Participants mark a point on the line that represents their current level of pain, ranging from 0 = no pain to 10 = worst possible pain. The distance in centimeters is measured to quantify pain severity.

  Baseline measurement and after 6 weeks intervention

Secondary Outcomes (1)

• Q angle

  Baseline measurement and after 6 weeks intervention

Study Arms (2)

(Short Foot + Hip and Knee Exercises)

EXPERIMENTAL

Participants in this group will receive a combined rehabilitation program consisting of short foot exercises (SFE) along with focused hip and knee strengthening exercises. The intervention aims to address both distal (foot) and proximal (hip and knee) biomechanical factors contributing to patellofemoral pain syndrome. The program will be supervised, conducted three times per week for 6 weeks, with progressive advancement from non-weight-bearing to functional weight-bearing activities.

Other: Short foot exercise + Hip and Knee Strengthening exercise

(Hip and Knee Exercises Only)

ACTIVE COMPARATOR

Participants in this group will receive a conventional rehabilitation program consisting of focused hip and knee strengthening exercises only. This program targets proximal muscle groups responsible for patellofemoral joint stability and function. The intervention will be supervised, conducted three times per week for 6 weeks, and matched in duration and intensity to the experimental group.

Other: Hip and Knee Strengthening Exercises

Interventions

Short foot exercise + Hip and Knee Strengthening exercise OTHER

Short Foot Exercises (SFE) Structured intrinsic foot muscle training involving medial longitudinal arch elevation without toe flexion, progressing from seated to standing and functional positions. Hip and Knee Strengthening Exercises Progressive strengthening program targeting hip abductors, external rotators, and quadriceps muscles through functional and resistance-based exercises.

(Short Foot + Hip and Knee Exercises)

Hip and Knee Strengthening Exercises OTHER

Hip and Knee Strengthening Exercises alone Progressive strengthening program focusing on hip abductors, external rotators, and quadriceps muscles, including both non-weight-bearing and functional weight-bearing exercises.

(Hip and Knee Exercises Only)

Eligibility Criteria

• Age: 18 Years - 45 Years
• Gender Eligibility Details: This study is restricted to female participants aged 18-45 years diagnosed with patellofemoral pain syndrome (PFPS). Females are specifically targeted due to the higher prevalence of PFPS in this population, which is attributed to anatomical and biomechanical factors such as increased Q-angle, wider pelvic structure, and a greater tendency toward dynamic knee valgus. Limiting the age range to 18-45 years ensures inclusion of skeletally mature individuals while minimizing the influence of age-related degenerative changes, such as knee osteoarthritis, that could confound study outcomes.
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosed cases of patellofemoral pain syndrome confirmed by this protocol.
• Females aged 18-45 years
• Anterior or retro patellar knee pain lasting ≥ 6 weeks
• Pain provoked by at least one PFJ-loading task, including:
• squatting,
• stair climbing/descending,
• running,
• prolonged sitting with knees flexed
• Pain elicited by at least two of four clinical tests;
• Pain during isometric quadriceps contraction at 20-30° knee flexion
• Pain on palpation of the patellofemoral joint line
• Pain during patellar compression
• Pain during active resisted knee extension

You may not qualify if:

• History of patellar instability, including subluxation or dislocation 2. Evidence of tibiofemoral pathology, such as: Ligamentous injuries, meniscal tears, and symptomatic knee effusion.
• \. Previous knee surgery within the last 12 months 4. Radiographic or clinical knee osteoarthritis. 5. Neurological disorders or systemic inflammatory diseases that may influence gait or pain perception.

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (1)

NUR FMH System

Lahore, Punjab Province, 54000, Pakistan

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Interventions

Papaverine

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Benzylisoquinolines; Alkaloids; Heterocyclic Compounds; Opiate Alkaloids; Isoquinolines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring

Study Officials

• Shoaib Waqas, PHD PT

  Lahore University of Biological and Applied Sciences

  STUDY CHAIR

Central Study Contacts

Afifa Khizar, MSPT

CONTACT

+923359077922; afifa.khizar15@gmail.com

Aroona Sattar

CONTACT

+923054630138; aroona.sattar@ubas.edu.pk

Study Design

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

Study Record Dates

• First Submitted: July 9, 2026
• First Posted: July 14, 2026
• Study Start: July 18, 2026
• Primary Completion (Estimated): October 30, 2026
• Study Completion (Estimated): November 15, 2026
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)