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IRCT20181023041432N1 IRCT 2021-05-25 King Edward Medical University, Lahore Effect of exercises in Anterior Knee Pain The comparison of effectiveness of open kinetic chain and close kinetic chain neuromuscular training in patients with patellofemoral pain syndrome 2021-05-05 anticipated 60 Complete https://irct.ir/trial/54656 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: A sampling frame will be formed for all the diagnosed patients with patellofemoral pain syndrome, presenting to the physiotherapy department of Mayo Hospital through simple random sampling technique sample will be drawn and patients will be randomized blindly and assigned through a computer-generated random number table via opaque concealed envelops into two groups i.e. group 1 (neuromuscular close kinetic chain group), group 2 (neuromuscular close kinetic chain), Blinding description: Clinical parameters like pain, functional status and Quadricep angle will be collected through VAS ,Kujala anterior knee pain scale and Q-angle measurement, and will be noted before and after the treatment by different accessor than the one who apply the treatment. Patients in both groups will be blind regarding the treatment in other group. 2-3 Patellofemoral Pain syndrome. Intervention 1: Intervention group 1: neuromuscular closed kinetic chain group Week 1: Setting Exercises for Co-Contraction: :2 sets of 10 repetition with 3 second hold in each repetition and 1 minute interval between the each set , Alternating Isometrics and Rhythmic Stabilization: 2 sets of 10 repetition with 3 second hold in each repetition and 1 minute interval between the each set, Scooting on a Wheeled Stool: :2 sets of 10 repetition and 1 minute interval between the each set, Partial Squats: 2 sets of 10 repetition without hold and 1 minute interval between the each set ,Week 2: Setting Exercises for Co-Contraction: :2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set, Alternating Isometrics and Rhythmic Stabilization: :2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set, Scooting on a Wheeled Stool: :3 sets of 10 repetition and 1 minute interval between the each set, Partial Squats :2 sets of 10 repetition with 3 second hold and 1 minute interval between the each set, Closed-Chain Isometrics against Elastic Resistance: 2 sets of 10 repetition and 1 minute interval between the each set , Unilateral Closed-Chain Terminal Knee Extension: 2 sets of 10 repetition and 1 minute interval between the each set , Close chain hip abduction: 2 sets of 10 repetition and 1 minute interval between the each set , Week 3: Setting Exercises for Co-Contraction: :3 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set ,Alternating Isometrics and Rhythmic Stabilization: :3 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set. Partial Squats :3 sets of 10 repetition with 5 second hold and 1 minute interval between the each set, Closed-Chain Isometrics against Elastic Resistance: 3 sets of 10 repetition and 1 minute interval between the each set, Unilateral Closed-Chain Terminal Knee Extension: 3 sets of 10 repetition and 1 minute interval between the each set , Forward, Backward, and Lateral Step-Ups and Step-Downs: 2 sets of 10 repetition and 1 minute interval between the each set , Partial Lunges: 2 sets of 10 repetition and 1 minute interval between the each set, Close chain hip abduction: 3 sets of 10 repetition with 5 second hold and 1 minute interval between the each set , Week 4:Setting Exercises for Co-Contraction: :3 sets of 10 repetition with 10 second hold in each repetition and 1 minute interval between the each set, Alternating Isometrics and Rhythmic Stabilization: :3 sets of 10 repetition with 10 second hold in each repetition and 1 minute interval between the each set ,Full Squats :3 sets of 10 repetition with 5 second hold and 1 minute interval between the each set Closed-Chain Isometrics against Elastic Resistance: 3 sets of 15 repetition and 1 minute interval between the each set , Unilateral Closed-Chain Terminal Knee Extension: 3 sets of 15 repetition and 1 minute interval between the each set , Forward, Backward, and Lateral Step-Ups and Step-Downs: 3 sets of 10 repetition and 1 minute interval between the each set, Full Lunges: 3 sets of 10 repetition and 1 minute interval between the each set, Close chain hip abduction: 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set. Intervention 2: Intervention group 2: neuromuscular open kinetic chain , Week 1: Quadriceps Setting (Quad Sets) :2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set , Straight-Leg Raise: 1 sets of 10 repetition without hold, Hamstring Setting (Hamstring Sets): 2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set , Side lying hip abduction: 1 sets of 10 repetition without hold, Prone hip extension: 1 sets of 10 repetition without hold Week 2: Straight-Leg Raise: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set, Side lying hip abduction: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set, Prone hip extension: 2 sets of 10 repetition with 5 second hold in each repetition hold and 1 minute interval between the each set, Straight-Leg Lowering: 2 sets of 10 repetition without hold and 1 minute interval between the each set, Multiple-Angle Isometric Exercises (quadriceps and hamstrings ) 2 sets of 10 repetition with 10 second hold and 1 minute interval between the each set, Short-Arc Terminal Knee Extension : 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set Week 3: Straight-Leg Raise: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Side lying hip abduction: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Prone hip extension: 2 sets of 10 repetition with 5 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle), Straight-Leg Lowering: 2 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Short-Arc Terminal Knee Extension : 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Hamstring Curls: 2 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Standing hip abduction and extension: 2 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle• Full-Arc Extension: 2 sets of 10 repetition with 5 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle) Week 4: Straight-Leg Raise: 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set (with cuff weight around the ankle) , Side lying hip abduction: 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Prone hip extension: 3 sets of 10 repetition with 10 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle), Straight-Leg Lowering: 3 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Short-Arc Terminal Knee Extension : 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Hamstring Curls: 3 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Standing hip abduction and extension: 3 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Full-Arc Extension: 3 sets of 10 repetition with 10 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle). Yes - There is a plan to make this available What will be shared: data sets will be avaible on scientist demand , wishing to use them for non-commercial purposes When: after the completion of the study To whom: to people working in academic institutions Conditions: on scientist demand, wishing to use them for non-commercial purposes Where to obtain: Amna Zia , email Id: amna_zia_17@live.com How to obtain: Applicant can email to contact person and request the data set Comments:
public Amna Zia
Nelagumbad, Anarkali
Lahore Pakistan 54000 +92 324 4686993 amna_zia_17@live.com Mayo Hospital scientific Amna Zia
Nelagumbad, Anarkali
Lahore Pakistan 54000 +92 324 4686993 amna_zia_17@live.com Mayo Hospital Pakistan Diagnose cases of Patellofemoral pain syndrome on the basis of history and physical examination as anterior knee pain from more than 2 months during at least two of the following activities: remaining seated for a prolonged time; going up or down stairs; squatting; running and jumping . Positive findings in any of the test: i: Patellar grind test, ii: Resisted isometric quadriceps femoris muscle contraction test (pain in 2 out of 3 contraction is consider positive), iii: Eccentric step testing, iv: Increase in Q- angle, v:Ischiotibial muscles shortening, defined as a loss of more than 30 degrees of leg extension with thigh positioned at 90 degrees of flexion , vi: Positive patellar compression test 18 years 30 years Both History of surgery, trauma, dislocation of patella, degenerative joint disease, cardiac or locomotor disorders documented in history Chronic instability of the knee Disorders associated with meniscal and/or ligamentous injuries confirmed by physical examination. Rehabilitation Rehabilitation Intervention group 1: neuromuscular closed kinetic chain group Week 1: Setting Exercises for Co-Contraction: :2 sets of 10 repetition with 3 second hold in each repetition and 1 minute interval between the each set , Alternating Isometrics and Rhythmic Stabilization: 2 sets of 10 repetition with 3 second hold in each repetition and 1 minute interval between the each set, Scooting on a Wheeled Stool: :2 sets of 10 repetition and 1 minute interval between the each set, Partial Squats: 2 sets of 10 repetition without hold and 1 minute interval between the each set ,Week 2: Setting Exercises for Co-Contraction: :2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set, Alternating Isometrics and Rhythmic Stabilization: :2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set, Scooting on a Wheeled Stool: :3 sets of 10 repetition and 1 minute interval between the each set, Partial Squats :2 sets of 10 repetition with 3 second hold and 1 minute interval between the each set, Closed-Chain Isometrics against Elastic Resistance: 2 sets of 10 repetition and 1 minute interval between the each set , Unilateral Closed-Chain Terminal Knee Extension: 2 sets of 10 repetition and 1 minute interval between the each set , Close chain hip abduction: 2 sets of 10 repetition and 1 minute interval between the each set , Week 3: Setting Exercises for Co-Contraction: :3 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set ,Alternating Isometrics and Rhythmic Stabilization: :3 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set. Partial Squats :3 sets of 10 repetition with 5 second hold and 1 minute interval between the each set, Closed-Chain Isometrics against Elastic Resistance: 3 sets of 10 repetition and 1 minute interval between the each set, Unilateral Closed-Chain Terminal Knee Extension: 3 sets of 10 repetition and 1 minute interval between the each set , Forward, Backward, and Lateral Step-Ups and Step-Downs: 2 sets of 10 repetition and 1 minute interval between the each set , Partial Lunges: 2 sets of 10 repetition and 1 minute interval between the each set, Close chain hip abduction: 3 sets of 10 repetition with 5 second hold and 1 minute interval between the each set , Week 4:Setting Exercises for Co-Contraction: :3 sets of 10 repetition with 10 second hold in each repetition and 1 minute interval between the each set, Alternating Isometrics and Rhythmic Stabilization: :3 sets of 10 repetition with 10 second hold in each repetition and 1 minute interval between the each set ,Full Squats :3 sets of 10 repetition with 5 second hold and 1 minute interval between the each set Closed-Chain Isometrics against Elastic Resistance: 3 sets of 15 repetition and 1 minute interval between the each set , Unilateral Closed-Chain Terminal Knee Extension: 3 sets of 15 repetition and 1 minute interval between the each set , Forward, Backward, and Lateral Step-Ups and Step-Downs: 3 sets of 10 repetition and 1 minute interval between the each set, Full Lunges: 3 sets of 10 repetition and 1 minute interval between the each set, Close chain hip abduction: 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set Intervention group 2: neuromuscular open kinetic chain , Week 1: Quadriceps Setting (Quad Sets) :2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set , Straight-Leg Raise: 1 sets of 10 repetition without hold, Hamstring Setting (Hamstring Sets): 2 sets of 10 repetition with 5 second hold in each repetition and 1 minute interval between the each set , Side lying hip abduction: 1 sets of 10 repetition without hold, Prone hip extension: 1 sets of 10 repetition without hold Week 2: Straight-Leg Raise: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set, Side lying hip abduction: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set, Prone hip extension: 2 sets of 10 repetition with 5 second hold in each repetition hold and 1 minute interval between the each set, Straight-Leg Lowering: 2 sets of 10 repetition without hold and 1 minute interval between the each set, Multiple-Angle Isometric Exercises (quadriceps and hamstrings ) 2 sets of 10 repetition with 10 second hold and 1 minute interval between the each set, Short-Arc Terminal Knee Extension : 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set Week 3: Straight-Leg Raise: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Side lying hip abduction: 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Prone hip extension: 2 sets of 10 repetition with 5 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle), Straight-Leg Lowering: 2 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Short-Arc Terminal Knee Extension : 2 sets of 10 repetition with 5 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Hamstring Curls: 2 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Standing hip abduction and extension: 2 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle• Full-Arc Extension: 2 sets of 10 repetition with 5 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle) Week 4: Straight-Leg Raise: 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set (with cuff weight around the ankle) , Side lying hip abduction: 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Prone hip extension: 3 sets of 10 repetition with 10 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle), Straight-Leg Lowering: 3 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Short-Arc Terminal Knee Extension : 3 sets of 10 repetition with 10 second hold and 1 minute interval between the each set (with cuff weight around the ankle), Hamstring Curls: 3 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Standing hip abduction and extension: 3 sets of 10 repetition and 1 minute interval between the each set (with cuff weight around the ankle), Full-Arc Extension: 3 sets of 10 repetition with 10 second hold in each repetition hold and 1 minute interval between the each set (with cuff weight around the ankle) Pain. Timepoint: before intervention and 4 weeks after the intervention. Method of measurement: Visual Analogue scale. Functional status. Timepoint: before intervention and 4 weeks after the intervention. Method of measurement: Kujala Anterior knee pain scale. Q angle. Timepoint: before intervention and 4 weeks after the intervention. Method of measurement: Goniometer. King Edward Medical University, Lahore Approved 2019-08-21 Institution review board committee of King Edward Medical University, Lahore Nelagumbad, Anarkali Lahore Punjab Pakistan