Patellofemoral Pain Syndrome
Conditions
Keywords
Core Stability Exercises, Proprioceptive Training, Patellofemoral Pain Syndrome, Pain and Function
Brief summary
This study will be conducted to investigate the effect of core stability exercises versus proprioceptive training in patients with patellofemoral pain syndrome.
Detailed description
Patellofemoral Pain Syndrome (PFPS) is one of the most prevalent musculoskeletal disorders causing anterior knee pain, particularly during activities that increase patellofemoral joint stress such as squatting, stair climbing, running, or prolonged sitting .Core stability exercises play a fundamental role in maintaining the kinetic chain alignment between the trunk, pelvis, and lower limb. Dysfunction of the lumbopelvic-hip complex can lead to compensatory movement patterns, increasing stress on the knee joint. Strengthening the core muscles, particularly the transversus abdominis, multifidus, and gluteal muscles, enhances postural control and optimizes force transmission during dynamic activities. Proprioceptive training, on the other hand, targets sensorimotor control by enhancing afferent feedback and neuromuscular coordination. Individuals with PFPS often present with impaired joint position sense and delayed neuromuscular responses around the knee, which may contribute to joint instability and persistent pain. Proprioceptive exercises, including balance, perturbation, and kinesthetic training, improve joint stability and coordination by stimulating mechanoreceptors and enhancing central processing of sensory input.Therefore, this study will aim to fill an important gap in the current literature by directly comparing the effects of core stabilization exercises and proprioceptive training on pain intensity, pain pressure threshold, quadriceps muscle strength, and proprioceptive acuity of knee, knee joint range of motion and functional ability in patients with PFPS
Interventions
OTHERCore Stability Exercises
core stability exercises including warm-up, main training, and cool-down phases; warm up exercises in the form of Cat-Camel exercise will be performed for 5-8 cycles to mobilize the spine and promote smooth segmental motion. The primary main training consisted of McGill's "Big Three" core stabilization exercises, which emphasize endurance and control of the deep stabilizing muscles, curl up, side bridge, and Quadrupedal stance, finallly the cool down phase had dynamic stretching at the end of each session to reduce muscle tension and promote recovery plus tradional therapy
OTHERProprioceptive Training
proprioceptive training consisted of group of exercises for balance on 1 leg on a stable surface and a unstable surface. in addition to tradional therapy.
OTHERtraditional therapy
tradional therapy in the form of interferential therapy, knee strengthening exercises, knee strengthening exercises, stretching exercises, patellar mobilization and ischemic compression
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
opaque sealed envelope
Intervention model description
Core Stability Exercises and Proprioceptive Training
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* A confirmed diagnosis of Patellofemoral Pain Syndrome (PFPS) based on clinical and radiographic examination, with no evidence of other knee pathologies, as verified by an orthopaedic physician * Presence of unilateral PFPS for a minimum duration of three months, indicating a chronic condition * Age between 18 and 40 years, representing the typical symptomatic population affected by PFPS * Body Mass Index (BMI) less than 30 kg/m², ensuring exclusion of obesity as a confounding factor. * Report of increased anterior knee pain during at least two of the following patellofemoral stress-provoking activities: stair ascent or descent, squatting, kneeling, running, or prolonged sitting * A positive patellar grind test (Clarke's sign) confirming involvement of the patellofemoral joint
Exclusion criteria
* Presence of chronic pain conditions unrelated to Patellofemoral Pain Syndrome (PFPS) as Rheumatoid arthritis, Chronic neuropathic pain, chronic low back pain and knee and hip osteoarthritis. * Pregnancy or history of recent trauma affecting the pelvic or knee region * History of corticosteroid injection in the affected knee * Presence of ankle arthritis or gouty arthritis, which may alter lower-limb biomechanics * History of previous surgical intervention involving the lumbar spine, hip, knee, or foot * Presence of lower-limb structural deformities, including pes planus, knee valgus, or knee varus deformities
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | up to four weeks | pain will be assessed by VAS which line on a 100 mm , where 0 indicates no pain and 100 indicates the worst possible pain. |
| knee disability | up to four weeks | knee disability will be assessed by Kujala Patellofemoral Questionnaire.Which is a 13-item questionnaire including different items on pain related to functioning and activities. The categories within each item are weighted and item scores summed to provide an overall index scored from 0 to 100, where the maximum score of 100 represents no disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pressure pain threshold | up to four weeks | The pressure algometer will be used to assess pressure pain threshold |
| knee range of motion | up to four weeks | The electro goniometer will be used to assess knee range of motion. |
| knee proprioception (joint position error) | up to four weeks | proprioception will beassesseds by electrogoniometer. The participant's knee will be passively positioned at a target angle (e.g., 30° flexion) then returned to the starting position, then the patient will be asked to actively reproduce the target angle.The absolute angular error (degrees) between the target and reproduced angles will be recorded. |
| quadriceps muscle strength | up to four weeks | Quadriceps muscle strength will be measured by a handheld dynamometer. |
Contacts
CONTACTmohamed hassan, phd
Outcome results
None listed