"Mulligan Technique vs Phonophoresis With Chitosan for Patellofemoral Pain" ("MTPP")

February 27, 2026 updated by: Mennat Allah Aldesouky, Ahram Canadian University

Mulligan Technique Vs Phonophoresis With Chitosan Gel on Neuromuscular Control in Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is a common knee condition causing pain and dysfunction. This study aims to compare the effectiveness of two physical therapy treatments for PFPS: Mulligan mobilization with movement technique versus phonophoresis with chitosan gel.

Forty-five participants with patellofemoral pain syndrome will be randomly assigned to one of three groups: (1) Mulligan technique group, (2) Phonophoresis with chitosan gel group, or (3) Control group receiving standard physical therapy exercises. Each group will receive treatment 3 times per week for 4 weeks.

The researchers want to determine which treatment is more effective in improving neuromuscular control, reducing pain, and improving function in patients with patellofemoral pain syndrome. Participants will be assessed before and after the treatment period.

This study may help physical therapists and healthcare providers choose the most effective treatment approach for patients with patellofemoral pain.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
45

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Egypt
    • Giza Governorate
      • Cairo, Giza Governorate, Egypt, 12573
        • Ahram Canadian unveracity
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Insidious onset of anterior knee pain
  • Retro patellar or peripatellar pain
  • Pain duration more than four weeks (chronic/subacute)
  • Pain severity ≥ 3/10 on Visual Analog Scale (VAS)
  • Pain during at least two of the following activities: stair ascent or descent, squatting, prolonged sitting (theater sign), or kneeling
  • Positive patellar compression test (pain reproduced by compressing the patella into the trochlear groove)
  • Patellar tenderness along the medial or lateral borders
  • Age between 18 and 35 years
  • Baseline Kujala score (Arabic version): approximately 67-71 (indicating moderate to severe dysfunction)

Exclusion Criteria:

  • Traumatic injury (e.g., dislocation, fracture, ligament or meniscus pathology)
  • Inflammatory arthritis (e.g., rheumatoid arthritis, gout)
  • Prior knee surgery
  • Current use of NSAIDs or corticosteroids

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Mulligan Technique Group
Participants receive hip and knee strengthening exercises combined with Mulligan mobilization with movement (MWM) technique for the patellofemoral joint. MWM is performed in three sets of 10 repetitions, with a 30-second rest interval between sets. Treatment sessions are conducted 3 times per week for 6 weeks.
Procedure: Mulligan technique
Each mobilization with movement (MWM) is performed in three sets of 10 repetitions, with a 30-second rest interval between sets, 3 times per week for 6 weeks, before hip and knee strengthening exercises.
Experimental: Phonophoresis with Chitosan Group
Phonophoresis (ultrasound with chitosan gel) is applied at 1 MHz, 1.0 W/cm², continuous mode, for 5 minutes, 3 times per week for 6 weeks before hip and knee exercises.
Procedure: Phonophoresis with Chitosan Gel
Phonophoresis (ultrasound with chitosan gel) is applied at 1 MHz, 1.0 W/cm², continuous mode, for 5 minutes, 3 times per week for 6 weeks before hip and knee exercises.
Active Comparator: Control Group ( Standard Physical Therapy Group)
Participants receive standard physical therapy for patellofemoral pain consisting of hip and knee strengthening exercises, stretching, and functional training. Sessions are conducted 3 times per week for 6 weeks. Exercises include hip and knee strengthening exercises and stretches for the quadriceps, hamstring, iliotibial band, and calf muscles with weekly progression.
Behavioral: Standard Physical Therapy Exercise Program
Participants attend 3 sessions per week for 6 weeks. Each session includes stretching and hip and knee focused exercises. Progression involves weekly increases in repetitions and resistance based on pain levels (less than 3/10).

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Maximal rate of force development (RFD)
Time Frame: Baseline and 6 weeks
Calculated from the slope of force- or torque-time curves obtained during rapid, explosive voluntary contractions also termed ballistic or rapid actions has become a key metric for assessing explosive strength in diverse populations, including athletes, older adults, and clinical patients
Baseline and 6 weeks
Pain at patella
Time Frame: Baseline and 6 weeks
Pain measured using the Kujala Anterior Knee Pain Scale (AKPS). The scale ranges from 0 to 100 points, with 0 indicating maximum disability and 100 indicating no disability. Higher scores indicate better outcome (less pain and better function)
Baseline and 6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ahram Canadian University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 22, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 27, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 3, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 3, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 27, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • CUPT-MULLIGAN-2026

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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