Mikhled Knee Exercise Program With and Without Stecco Fascial Manipulation Effect in Patellofemoral Pain Syndrome

NCT07716163 | Not Yet Recruiting

• 1 other identifier: REC/RCR & AHS/25/0130
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

To compare the effects of the Mikhled Knee Exercise Program with and without Stecco Fascial Manipulation on pain, range of motion, and functional outcomes Patellofemoral Pain Syndrome.

Conditions

Knee Pain; Patellofemoral Pain Syndrome; Patellofemoral Pain (PFPS); Fascial Manipulation

Keywords

Fascia, Manipulation, Pain, Patellofemoral pain, Range of motion

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS)

  It is a simple and widely used tool for assessing pain intensity, where patients rate their pain from 0 (no pain) to 10 (worst imaginable pain). It is highly reliable (ICC ranging from 0.87 to 0.96) and valid for assessing pain associated with knee injuries. It is sensitive to changes in pain levels over time, making it suitable for both baseline and follow-up assessments

  6 weeks

• Range of Motion (Flexion) by Universal Goniometer

  It is a standard instrument to measure the knee joint's flexion angle. It is essential for evaluating knee mobility following injury or surgery. The tool has shown excellent reliability (ICC \> 0.90) and good validity when used by trained clinicians. During measurement, the fulcrum is placed over the lateral epicondyle of the femur. The stationary arm is aligned with the lateral midline of the femur, pointing toward the greater trochanter, while the movable arm is aligned with the lateral midline of the fibula, pointing toward the lateral malleolus

  6 weeks

• Anterior Knee Pain Scale (AKPS)

  The Anterior Knee Pain Scale, also known as the Kujala Score, is a self-reported questionnaire used to evaluate functional limitations and pain in individuals with patellofemoral disorders. It includes 13 items assessing activities like walking, squatting, and running. For knee-related conditions, it demonstrates high reliability (ICC \> 0.90) and strong content validity in both clinical and research settings

  6 weeks

Study Arms (2)

Mikhled Knee Exercises with Stecco Fascial Manipulation

ACTIVE COMPARATOR

Participants will receive the Mikhled Knee Exercise Program (MKEP) three times per week for 6 weeks under physiotherapist supervision. The program includes wall slides, step-downs, eccentric decline squats, lateral step-ups, terminal knee extensions, single-leg stance with trunk rotation, and quadriceps isometric exercises (2-3 sets of 10-15 repetitions), with progressive advancement based on individual tolerance. In addition, participants will receive Stecco Fascial Manipulation for 10-15 minutes, 1-2 times per week, targeting the Centers of Coordination (CCs) of the hip, thigh, and knee to improve fascial mobility, reduce pain, and enhance knee function.

Other: Mikhled Knee Exercises with Stecco Fascial Manipulation

Mikhled Knee Exercises Program (MKEP)

EXPERIMENTAL

Participants in Group B will also perform the Mikhled Knee Exercise Program three times per week for six weeks, following the same structure and progression as Group A. This includes the same set of functional and strengthening exercises aimed at restoring proper patellar alignment and improving knee function, such as wall slides, step-downs, eccentric squats, lateral step-ups, closed-chain terminal knee extensions, single-leg stance with trunk rotation, and isometric quadriceps holds. Exercise intensity will begin at two sets of 10 repetitions and gradually increase to three sets of 15 repetitions, with resistance and complexity progressing over time based on the patient's response

Other: Mikhled Knee Exercise Program (MKEP)

Interventions

Mikhled Knee Exercise Program (MKEP) OTHER

Intervention: Mikhled Knee Exercise Program (MKEP) Frequency: 3 sessions per week Duration: 6 weeks Session Duration: 30-45 minutes Supervision: Supervised by a physiotherapist Exercises: Wall slides, step-downs, eccentric decline squats, lateral step-ups, closed kinetic chain terminal knee extensions, single-leg stance with trunk rotation, and quadriceps isometric exercises Dosage: 2-3 sets of 10-15 repetitions per exercise Progression: Gradual increase in exercise intensity and difficulty based on participant tolerance and clinical progress.

Mikhled Knee Exercises Program (MKEP)

Mikhled Knee Exercises with Stecco Fascial Manipulation OTHER

Intervention: Mikhled Knee Exercise Program (MKEP) Frequency: 3 sessions per week Duration: 6 weeks Session Duration: 30-45 minutes Supervision: Supervised by a physiotherapist Exercises: Wall slides, step-downs, eccentric decline squats, lateral step-ups, closed kinetic chain terminal knee extensions, single-leg stance with trunk rotation, and quadriceps isometric exercises Dosage: 2-3 sets of 10-15 repetitions per exercise Progression: Gradual increase in exercise intensity and difficulty based on participant tolerance and clinical progress. Intervention: Stecco Fascial Manipulation Frequency: 1-2 sessions per week (within the treatment session) Duration: 6 weeks Application Time: 10-15 minutes per session Provider: Performed by a trained physiotherapist Target Area: Centers of Coordination (CCs) in the fascia of the hip, thigh, and knee Technique: Manual fascial manipulation tailored to identified fascial restrictions

Mikhled Knee Exercises with Stecco Fascial Manipulation

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female participants between the ages of 25-45 years (16)
• Diffused anterior knee pain for at least 8 weeks (16)
• Pain exacerbated by climbing stairs, prolonged sitting, walking, running, squatting, knee flexion, and isometric quadriceps contraction (14).
• Patients had never received Stecco fascial manipulation and MKEP before.

You may not qualify if:

• Tendonitis
• Osgood-Schlatter syndrome
• Fracture
• Patellar sublaxation or dislocation
• Previous history of surgery
• Meniscus or ligament damage
• Heart diseases
• Neurological deficits
• Pregnancy

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Dr. Abid Harif Awan's Physiotherapy Clinic

Lahore, Punjab Province, 54000, Pakistan

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome; Pain

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Saba Rafiq, MS OMPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, PhD

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The assessor will be blind to the treatment groups to guarantee accuracy and minimize bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 16, 2026
• First Posted: July 21, 2026
• Study Start: July 1, 2026
• Primary Completion: August 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: July 21, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)