Effect of Adding Inguinal Ligament Mobilization to Talonavicular Joint Mobilization on Patellofemoral Pain Syndrome

NCT07734051 | Enrolling By Invitation DMC

• 1 other identifier: TNJ on PFPS
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be conducted to:

• To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain intensity subjects with PFPS
• To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS.
• To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS .
• To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS .

Conditions

Patellofemoral Pain Syndrome

Outcome Measures

Primary Outcomes (4)

• pain intensity

  1.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on pain intensity in subjects with PFPS. and it is measured by Visual Analogue Scale (100 mm (10-cm) straight line with descriptive anchors at each extreme to measure pain intensity)

  Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.

• pain threshold

  2.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS. and it is measured by pressure algometer (a handheld diagnostic device used to objectively quantify pain sensitivity by measuring the exact force at which a patient begins to feel pain).

  Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.

• knee function

  3.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS. and it is measured by Kujala Patelofemoral Pain Questionnaire (in score from 13-question survey used to measure knee pain, function, and symptoms related to the kneecap. It scores from 0 to 100 points, where 100 means no pain or disability).

  Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.

• Q angle

  4.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS. and it is measured by Goniometer (in angles)

  Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.

Study Arms (4)

group A recieving inguinal ligament mobilization

EXPERIMENTAL

Group A: An intervention group (n = 20) receiving inguinal ligament mobilization (ILM) with conventional physical therapy exercises.

Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises

group B recieving talonavicular joint mobilization

EXPERIMENTAL

Group B: An intervention group (n = 20) receiving talonavicular joint mobilization (TJM) with conventional physical therapy exercises.

Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises

group C recieving talonavicular joint mobilization and inguinal ligament mobilization

EXPERIMENTAL

Group C: An intervention group (n = 20) receiving combined inguinal ligament mobilization, talonavicular joint mobilization and conventional physical therapy exercises.

Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises

group D recieving conventional physical therapy exercises

PLACEBO COMPARATOR

Group D: A control group (n = 20) receiving conventional physical therapy exercises only

Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises

Interventions

inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises OTHER

2 sessions per week for total 4 weeks of treatment

group A recieving inguinal ligament mobilization; group B recieving talonavicular joint mobilization; group C recieving talonavicular joint mobilization and inguinal ligament mobilization; group D recieving conventional physical therapy exercises

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosis of PFPS, based on clinical and radiographic criteria (no other knee pathologies) referred by orthopedic physicians.
• Subjects diagnosed with unilateral PFP with at least three months.
• Age of subjects ranges from 18 to 40 years .
• BMI less than 30 kg/ m2.
• Subjects complaining from increasing pain severity after at least two of the following provocative activities as (Stair ascent and descent, Squatting, Kneeling, running, or prolonged sitting).
• Subjects included in the study should record a positive grind test.
• Subjects with tension of inguinal ligament either "mechanical strain, injury, repetitive movement or pelvic instability as anterior pelvic tilting" which leads to PFPS based on positive inguinal ligament tension test.
• Foot pronation position "mobile type" which leads to PFPS based on positive "The wear test or the wet foot test".
• Q angle in men 18-22 degree and in women 22 25 degree.

You may not qualify if:

• Chronic pain conditions unrelated to PFPS.
• Pregnancy or recent trauma to the pelvic or knee region. (Mills et al., 2005).
• History of steroid injection of the knee.
• Ankle arthritis, gouty arthritis.
• History of any surgical intervention of the back, hip, knee or foot.
• Lower limb deformity such as pes-planus, knee valgus or varus deformities.
• Previous lower limb disease such as hip and tibiofemoral osteoarthritis.
• Diabetes or Peripheral neuropathy.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faqus

Fāqūs, Sharkeya, 055, Egypt

Location

Related Publications (1)

• Petersen W, Ellermann A, Gosele-Koppenburg A, Best R, Rembitzki IV, Bruggemann GP, Liebau C. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2264-74. doi: 10.1007/s00167-013-2759-6. Epub 2013 Nov 13.

  PMID: 24221245 BACKGROUND

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• mohamed is mohamed, PHD

  doctoral degree in cairo uneversity

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: A randomized controlled trial (RCT).
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Effect of adding Inguinal Ligament Mobilization to talonavicular joint mobilization on Patellofemoral Pain Syndrome (princibal investigator)

Model Details: Group A: An intervention group (n = 20) receiving inguinal ligament mobilization (ILM) with conventional physical therapy exercises. Group B: An intervention group (n = 20) receiving talonavicular joint mobilization (TJM) with conventional physical therapy exercises. Group C: An intervention group (n = 20) receiving combined inguinal ligament mobilization, talonavicular joint mobilization and conventional physical therapy exercises. Group D: A control group (n = 20) receiving conventional physical therapy exercises only which is "Straight leg raise "SLR" exercise, Quadriceps setting exercise, Side Lying Hip Abduction, Side lying hip adduction, self stretching exs for Calf, Hamstring, Quadriceps muscles"

Study Record Dates

• First Submitted: February 27, 2026
• First Posted: July 29, 2026
• Study Start: March 1, 2026
• Primary Completion: August 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: July 29, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)