Patellofemoral Pain Syndrome
Conditions
Brief summary
This is a Randomized Controlled Trial (RCT) regarding the conservative treatment of patellofemoral pain (PFP) with an impairment based rehabilitation program. Those with PFP can have a variety of impairments, such as knee and hip muscle weakness, poor movement patterns, weak core activation and muscle tightness. Several recent RCT trials have looked at treating single impairments, but to date no RCT have address individualized patient impairments during a rehabilitation program. Abnormal muscle firing patterns have also been identified during functional tasks; such as jogging, stair climbing, and performing a single leg squat. Conflicting studies have produced changes to the quadriceps and hip muscle firing patterns with those with PFP. The abnormal activation patterns has been suggested to be why strengthening programs alone do not improve movement patterns during functional tasks for those with PFP. Patterned electrical neuromuscular stimulation (PENS) is a novel form of electrical stimulation that replicates proper firing patterns based off healthy electromyography patterns. The purpose of the study is to investigate the benefits of PENS with a impairment based rehabilitation program for the treatment of PFP. The rationale for this investigation is to assess the benefits of PENS with therapeutic exercise at improving altered firing patterns of the lower extremity muscles during functional tasks.
Interventions
DEVICEPENS
Sponsors
Accelerated Care Plus
Mid-Atlantic Athletic Trainers' Association
University of Virginia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
15 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Insidious onset of symptoms * Presence of peri- or retro patellar knee pain during at least two of the following functional activities: Stair ascent or descent, Running, Kneeling, Squatting, Prolonged sitting, Jumping * Pain for more than 3 months * Pain \>3/10 on VAS * 85 or less on the Anterior Knee Pain Scale
Exclusion criteria
* Previous knee surgery * Internal Derangement * Ligamentous instability * Other sources of anterior knee pain(patella tendonitis, osgood schlatter, knee plica, etc) * Neurological Involvement * Any biomedical device * Muscular abnormalities * Currently pregnant * Hypersensitivity to electrical stimulation * Active infection over the site of the electrode placement
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Pain Assessed by Visual Analog Scale (VAS) | Pain recorded by the VAS will be collected for 4 weeks | Current and Worse VAS |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Patient reported outcomes | Up to 4 weeks | 4 patient reported outcomes on pain and function before and after the intervention. These patient reported outcomes are the Anterior Knee Pain Scale, the Activities of Daily Living Scale, the Godin Leisure Scale, and the Fear Avoidance Belief Questionnaire. |
| Changes in lower extremity kinematics | Up to 4 weeks | Trunk, hip, knee and ankle movement during the single leg squat, stair ambulation, lunges, walking and jogging |
| Changes in core strength | Up to 4 weeks | Trunk endurance will be assessed by front and side plank tasks. |
| Changes in Quadriceps Muscle Strength | Up to 4 weeks | Muscle strength of the quadriceps will be measured by individuals performing a maximum contraction against a small device that will measure force output |
| Changes in Hamstring Muscle Strength | Up to 4 weeks | Muscle strength of the hamstring will be measured by individuals performing a maximum contraction against a small device that will measure force output |
| Changes in Gluteus Medius Muscle Strength | Up to 4 weeks | Muscle strength of the gluteus medius will be measured by individuals performing a maximum contraction against a small device that will measure force output |
| Changes in core activation | Up to 4 weeks | Core activation will be assessed by real time ultrasound to examine the size of the core muscles |
| Changes in Lower Extremity Electromyography during a step down task | Up to 4 weeks | EMG activity of six lower extremity muscles during a step down task |
| Changes in Lower Extremity Electromyography during a single leg squat | Up to 4 weeks | EMG activity of six lower extremity muscles during a single leg squat |
| Changes in Lower Extremity Electromyography during a lunge | Up to 4 weeks | EMG activity of six lower extremity muscles during a lunge |
| Changes in Lower Extremity Electromyography during walking | Up to 4 weeks | EMG activity of six lower extremity muscles during walking |
| Changes in Lower Extremity Electromyography during jogging | Up to 4 weeks | EMG activity of six lower extremity muscles during jogging |
| Changes in Hip Adductor Muscle Strength | Up to 4 weeks | Muscle strength of the hip adductors will be measured by individuals performing a maximum contraction against a small device that will measure force output |
Countries
United States
Outcome results
None listed