None listed
Conditions
Brief summary
Patellofemoral pain is common in people who participate in activities and sports that involve running. Improved treatment outcomes in patellofemoral pain are required as recent research has established a link between patellofemoral pain and future osteoarthritis of the knee. Common interventions such as quadriceps strengthening exercises are effective at reducing pain for many people with patellofemoral pain. Quadriceps strengthening is likely to have an effect in improving patellofemoral pain because of resultant increases in quadriceps size and strength. However some people with patellofemoral pain are unable to perform exercises with a resistance that significantly strengthens the quadriceps because pain limits their ability to perform the exercises. Blood flow restricted training can increase muscle size and strength at lower resistance than typical strengthening programs, and may therefore be a suitable method of improving quadriceps size and strength in those unable to perform traditional quadriceps strengthening exercises effectively. Blood flow restricted training involves placing an inflatable cuff around a limb before performing strengthening exercises. The placement of the cuff reduces blood flow within the limb during the exercise. It is hypothesised that limited blood flow causes the muscle to work harder than in normal blood flow conditions, and therefore improvements in muscle size and strength can be obtained at lower resistance than conventional exercises. This study will compare 8 weeks of low resistance quadriceps strengthening with blood flow restriction to the current gold standard treatment of 8 weeks of quadriceps strengthening. Participants will be assessed at 0, 4, 8, 24 and 52 weeks.
Interventions
The intervention group will perform Low intensity blood flow restriction training on the affected leg only.
This group will perform 15 minutes (total) of exercises on the stationary bicycle, leg press and leg extension. These exercises will be performed 3 times per week for 8 weeks.
The cycling will be for 5 minutes based at an intensity that the participant considers "light".
The blood flow restriction training group will perform exercises at 30 % of their maximum strength for 4 sets. The se
The intervention group will perform Low intensity blood flow restriction training on the affected leg only. This group will perform 15 minutes (total) of exercises on the stationary bicycle, leg press and leg extension. These exercises will be performed 3 times per week for 8 weeks. The cycling will be for 5 minutes based at an intensity that the participant considers "light". The blood flow restriction training group will perform exercises at 30 % of their maximum strength for 4 sets. The sets will consist of repetitions of 30, 15, 15 and 15. Each repetition will take 3 seconds, and there will be a 30 second rest between each set. Physiotherapists will prescribe the exercises. The blood flow restriction will be applied using a pneumatic cuff with a handheld sphygmomanometer (width 10cm). The cuff will be applied to the proximal thigh. The cuff will be applied only for the leg press and leg extension exercises and will remain on between sets of exercises, but removed after the exercise is completed (cuff will remain on for approximately 4 minutes for leg press and 4 minutes for leg extension, with a 2 minute break between exercises with the cuff off). Arterial occlusion pressure will be measured with Doppler ultrasound on initial assessment, by placing the ultrasound over the tibial artery at the ankle, and the cuff around the proximal thigh. The cuff will be inflated until the artery is occluded (this process is the equivalent of taking a blood pressure reading). The pressure of the cuff to be used during exercises will be 60% of the arterial occlusion pressure. Participants will tick off which exercises were completed on each session in an exercise log to monitor adherence to the program.
Sponsors
Lachlan Giles
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
Pain at the front of the knee for 8 weeks or longer Atraumatic onset of symptoms Pain with any two of running, squatting, prolonged sitting, jumping, kneeling.
Exclusion criteria
Knee ligament injury, knee surgery, dislocation/subluxation Inflammatory arthritis Participated in strengthening exercises with leg weights for longer than 4 weeks in the past 6 months. Cardiovascular conditions, including high blood pressure (>140/90), diabetes, unexplained chest pain or heart condition, fainting or dizzy spells during physical activity/exercise that causes loss of balance, pregnancy or other contra-indications to exercise. Conditions affecting blood flow or blood clotting
Outcome results
None listed