Active Release and Myofascial Release Technique in Patients With Patellofemoral Pain Syndrome

NCT07854041 | Recruiting

• 1 other identifier: Bisma
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Patellofemoral pain syndrome (PFPS) is often associated with imbalance and weakness in several key muscle group. These include the quadriceps (especially the vastus medialis oblique), hip abductors and external rotators and hamstrings as well as tightness in iliotibial band and gastrocnemius. Exercises involving isometrics, stretching, strengthening of knee along with core muscles has improved range, strength, coordination and motor control. This study aim to determine the effects of active release along with myofascial release technique on pain, range of motion and function in patients with patellofemoral pain syndrome. This study will be a randomized controlled trial and will be conducted in Riphah Rehabilitation Clinic Lahore (Physiotherapy Department) and Ghurki Trust Hospital Lahore. Non-probability consecutive sampling will be used to collect the data. Sample size of 30 subjects with age group between 15-40 years will be taken. Data will be collected from the patients having present complaint of anterior knee pain. Outcome measures will be taken by using Numeric pain rating scale (NPRS), Anterior knee pain scale (AKPS)for pain, Universal Goniometer (GU) for Range of motion and KOOS PS scale to assess physical function in patient with knee pain. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive RICE protocol, ice, stretching, strengthening and knee isometrics exercises, while Group A will receive active release and Group B will receive myofascial release technique. Outcome measures will be measured at baseline and after 6 weeks. Data analysis will be done by SPSS version 25.

Conditions

Patello Femoral Pain Syndrome

Keywords

Active release technique; Anterior knee pain; Range of motion; myofascial release; Patello Femoral pain Syndrome

Outcome Measures

Primary Outcomes (3)

• Lower Extremity Functional Scale

  The lower extremity functional scale (LEFS) is a valid patient-rated outcome measure (PROM) for the measurement of lower extremity function. The scale consist of 4 groups with 20 questions. The questions in these group focus on activities with increasing physical demands like questions from walking between rooms to running on uneven ground. The scoring of this scale varies from 0 (extreme difficulty/unable to perform activity) to 4 (no difficulty). The total score can be obtained by summing the scores of the individual items. The maximum score of 80 indicates no functional limitations and the minimum score of 0 indicates extreme limitations

  Baseline; 6 Weeks

• Patellofemoral Pain and Osteoarthritis Subscale of Knee injury and Osteoarthritis Outcome Score

  Patellofemoral pain and patellofemoral osteoarthritis are highly prevalent knee disorders associated with pain and functional limitations. The subscale of the Knee Injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF) was developed to evaluate patients with patellofemoral pain and osteoarthritis.

  Basleine; 6 Weeks

• Visual Analogue Scale

  The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain"

  Baseline; 6 Week

Study Arms (2)

Active release technique

EXPERIMENTAL

Before applying active release technique, assess the knee joint, by palpating the area of tightness, tenderness and restricted movement .Then apply specific pressure to affected tissues, such as the quadriceps, hamstrings, iliotibial band (IT band) or patellar tendon, depending on the findings of the evaluation. The patient will then actively move the knee joint through prescribed range of motions, while the therapist maintain contact and provides appropriate pressure. This process is repeated several times, with the therapist adjusting pressure and movements as needed to improve tissue mobility and reduce pain.

Other: Group A

Myofascial Release Technique

ACTIVE COMPARATOR

For Myofascial release technique therapist will use their hands to apply sustained pressure to restricted areas fascia, gradually lengthening and releasing the tissue. Gentle stretching techniques can also be used to lengthen the tissue and muscles, improving flexibility and range of motion.

Other: Group B

Interventions

Group A OTHER

Before applying active release technique, assess the knee joint, by palpating the area of tightness, tenderness and restricted movement .Then apply specific pressure to affected tissues, such as the quadriceps, hamstrings, iliotibial band (IT band) or patellar tendon, depending on the findings of the evaluation. The patient will then actively move the knee joint through prescribed range of motions, while the therapist maintain contact and provides appropriate pressure. This process is repeated several times, with the therapist adjusting pressure and movements as needed to improve tissue mobility and reduce pain.

Active release technique

Group B OTHER

For Myofascial release technique therapist will use their hands to apply sustained pressure to restricted areas fascia, gradually lengthening and releasing the tissue. Gentle stretching techniques can also be used to lengthen the tissue and muscles, improving flexibility and range of motion.

Myofascial Release Technique

Eligibility Criteria

• Age: 15 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Experience retro patellar pain for at least three months, including pain at rest or during activities such as ascending or descending stairs, jumping, running, squatting, kneeling, or prolonged sitting (12).
• Patients with + ive Squat test in the absence of any pathology
• Patients also must have presented with an insidious onset of symptoms unrelated to trauma and a positive Clark test (19).
• Reduced knee range of motion, especially extension

You may not qualify if:

• A history of significant lower extremity, pelvic, or spinal surgery/fracture, or traumatic lesions of ligaments or meniscus within the past six months.
• Presence of other orthopedic conditions (e.g., ACL rupture, meniscal tears), neurological disorders (e.g., multiple sclerosis, paralysis), rheumatological diseases (e.g., rheumatoid arthritis, ankylosing spondylitis), or congenital conditions leading to osteoarthrosis.
• Current pregnancy
• A history of connective tissue disease, patellofemoral dislocation or subluxation, osteoarthrosis of the knees.
• Other forms of anterior knee pain (e.g., Osgood-Schlatter disease, tendon pain, bursitis). A history of referred pain from the lumbar spine (12). or

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Riphah Rehabilitation Clinic

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (5)

• Khammar F, Taghizadeh Delkhoush C, Ehsani F. Study of the electromyographic activity in patellofemoral pain syndrome accompanied by secondary myofascial pain syndrome specifically affecting the popliteus muscle following dry needling: a randomized clinical trial. J Man Manip Ther. 2025 Jun;33(3):195-206. doi: 10.1080/10669817.2024.2396709. Epub 2024 Aug 28.

  PMID: 39196042 BACKGROUND

• Kaya D, Callaghan MJ, Ozkan H, Ozdag F, Atay OA, Yuksel I, Doral MN. The effect of an exercise program in conjunction with short-period patellar taping on pain, electromyogram activity, and muscle strength in patellofemoral pain syndrome. Sports Health. 2010 Sep;2(5):410-6. doi: 10.1177/1941738110379214.

  PMID: 23015969 BACKGROUND

• Mv VK, Subramanian NB, S S, Kotamraju S, Krishnan M. Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome. Bioinformation. 2023 Apr 30;19(4):454-459. doi: 10.6026/97320630019454. eCollection 2023.

  PMID: 37822824 BACKGROUND

• Callaghan MJ, Selfe J. Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev. 2012 Apr 18;2012(4):CD006717. doi: 10.1002/14651858.CD006717.pub2.

  PMID: 22513943 BACKGROUND

• Petersen W, Rembitzki IV, Bruggemann GP, Ellermann A, Best R, Koppenburg AG, Liebau C. Anterior knee pain after total knee arthroplasty: a narrative review. Int Orthop. 2014 Feb;38(2):319-28. doi: 10.1007/s00264-013-2081-4. Epub 2013 Sep 22.

  PMID: 24057656 BACKGROUND

Study Officials

• Syed Shakil ur Rehman, PhD

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Syed Shakil ur Rehman, PhD

CONTACT

+92 320 786661; shakil.urrehman@riphah.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: September 27, 2026
• First Posted: October 2, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): January 1, 2027
• Last Updated: October 2, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)