Patellofemoral Pain Syndrome
Conditions
Keywords
Telerehabilitation, Conventional Physical Therapy, Patellofemoral Pain Syndrome, Hybrid Telerehabilitation
Brief summary
Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders affecting approximately 25% of active young adults, and it is frequently associated with persistent anterior knee pain, functional limitations, and reduced quality of life. Despite the widespread use of conventional face-to-face physical therapy, many patients experience barriers related to accessibility, cost, and long-term adherence to rehabilitation programs
Detailed description
Patellofemoral pain syndrome (PFPS) is a common, overuse-related musculoskeletal condition causing widespread anterior knee pain that is exacerbated by joint-loading activities like running, squatting, and climbing stairs. Affecting over 22% of the general population, PFPS is a complex disorder with high recurrence rates that frequently frustrate both patients and clinicians. Its etiology is multifactorial, stemming from structural and neuromuscular impairments, particularly quadriceps weakness and reduced gluteal activation, which lead to dynamic knee valgus and excessive joint stress. While conventional in-person physical therapy focusing on targeted strengthening remains the standard treatment, digital healthcare alternatives are rapidly expanding. Telerehabilitation delivers physical therapy remotely using telecommunication technologies through real-time synchronous or recorded asynchronous methods. To combine the benefits of both approaches, hybrid telerehabilitation integrates remote digital tracking with periodic face-to-face clinical sessions. Ultimately, these remote and hybrid models aim to improve patient adherence and reduce financial or logistical barriers like travel time, while maintaining the diagnostic accuracy and personalized feedback of traditional, hands-on care.
Interventions
OTHERPhysical Therapy Approaches
All three groups (Hybrid Telerehabilitation, Pure Telerehabilitation, and Conventional Physical Therapy) followed identical exercise progressions over 6 weeks (3 sessions/week, 18 sessions total) targeting proximal hip and knee strengthening. Exercise dosage, intensity, and progression remained standardized across delivery modes to isolate rehabilitation method effects. The exercise program will progress through three phases to allow gradual restoration of strength, control, and functional ability.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
1. Participants must have a prior clinical diagnosis of PFPS made by an orthopedic physician, which was then confirmed and verified by the principal investigator through physical therapy assessment. The diagnosis is characterized by anterior or retropatellar knee pain aggravated by at least one activity that loads the patellofemoral joint during weight bearing, such as stair climbing, squatting, running, or prolonged sitting. 2. Participants aged between 18 and 35 years. 3. Participants with BMI ≤ 25 kg/m² to ensure inclusion of individuals within a normal weight range. 4. Insidious onset of anterior knee pain with a duration greater than 12 weeks. 5. Experienced a minimum pain level of 3/10 on a visual analogue scale (VAS) during activity within the previous week.
Exclusion criteria
Participants meeting any of the following conditions will be excluded from the study: 1. Individuals with previous knee surgery, fracture, ligament reconstruction, patellar dislocation, osteoarthritis, meniscal injuries, inflammatory joint disease, or other conditions that may mimic or contribute to anterior knee pain. 2. Participants with neurological, cardiovascular, or systemic musculoskeletal disorders that may affect gait, strength, or exercise tolerance 3. Pregnant women will be excluded due to potential alterations in joint biomechanics and safety considerations during exercise interventions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | up to 6 weeks | The pain intensity was assessed using the Visual Analogue Scale (VAS), where patients rated their pain at rest and during movement over the previous week on a 0-10 cm scale, with 0 indicating no pain and 10 representing unbearable pain. Pain scores were recorded before and after the intervention. Interpretation of clinical relevance often goes beyond statistical significance, and the minimal clinically important difference (MCID) for pain intensity on the VAS has been investigated in a range of musculoskeletal conditions |
| Knee function assessment | up to 6 weeks | Knee function will be evaluated using the Kujala Anterior Knee Pain Scale (AKPS), which is a condition-specific, self-administered questionnaire designed to assess pain severity and functional limitations associated with patellofemoral pain syndrome. Participants will be asked to complete the questionnaire independently by responding to 13 weighted items that address symptoms and difficulty during daily and sports-related activities that load the patellofemoral joint, including walking, running, stair climbing, squatting, jumping, and prolonged sitting with the knee flexed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic knee valgus assessment | up to 6 weeks | A two-dimensional video analysis measured the knee valgus/varus frontal-plane projection angle (FPPA) during the Single-Legged Drop Jump test following established methodology |
| Quadriceps muscle strength assessment | up to 6 weeks | Quadriceps muscle strength will be assessed using the peak torque normalized to body weight (peak torque/body weight, Nm/kg ×100), which will be recorded during maximal knee extension at 60° of knee flexion |
Countries
Egypt
Outcome results
None listed