Core Stabilization for the Treatment of Anterior Knee Pain

The Effects of a Trunk Strengthening Program on Anterior Knee Pain in an Adolescent Athletic Population: a Randomized Clinical Trial

The investigators hypothesize that the use of trunk (core) stabilization exercises early in treatment combined with lower extremity exercises will enhance the outcome over lower extremity exercises alone in the treatment of young athletes with anterior knee pain.

Study Overview

• Status: Unknown
• Conditions: Patellofemoral Pain Syndrome
• Intervention / Treatment: Other: core stabilization; Other: lower extremity training only

• Study Type: Interventional
• Enrollment (Anticipated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ken Learman, PhD, PT; Phone Number: 330.941.7125; Email: klearman@ysu.edu
• Study Contact Backup: Name: Michael Morris, DPT; Phone Number: 330.707.9064; Email: mjmorris107@yahoo.com

Study Locations

• United States
  • Ohio
    • Poland, Ohio, United States, 44514
      • Recruiting
      • Poland Medical Center
      • Contact: Michael Morris, DPT; Phone Number: 330-757-7888

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years to 20 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects between 13-20 years of age clinically diagnosed with anterior knee pain.

• Pain should be peripatellar and should include at least 3 of the following:

  1. experienced during or after activity
  2. prolonged sitting
  3. with stair climbing or descending
  4. squatting
  5. kneeling.
• The subject should be active for at least 30 minutes per day.

Exclusion Criteria:

• Previous knee surgery
• Signs and symptoms of a specific structural diagnosis not consistent with AKP such as meniscal, ACL, PCL, or collateral ligament tears, pain referral from hip or lumbar spine (determined during examination), traumatic patellar dislocation, an inability to adequately understand or communicate in English.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Core stabilization; This arm will receive 3 weeks of core stabilization training followed by 3 weeks of lower extremity stretching and strengthening as appropriate to address impairments noted in the examination and to progress function.	Other: core stabilization
Active Comparator: Lower extremity training only; This arm with receive 6 weeks of impairment based stretching and strengthening to restore function.	Other: lower extremity training only

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower extremity functional scale	LEFS is a functional scale that estimates how much the subject's function is disrupted by their condition.	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Kujala anterior knee pain scale	The Kujala scale measures the amount and impact of anterior knee pain on the subject's life	6 weeks
Patient specific functional scale	The PSFS rates subject's ability to do the 3 functional activities that are bothered the most by the knee pain	6 weeks
Numeric pain rating scale	The NPRS measures the subject's current knee pain	6 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Global rating of change	The GRoC measures the subject's overall estimation of improvement.	6 weeks
Self-reported percent recovery	The subject reports their estimated overall percentage of improvement from the start of care	6 weeks

Collaborators and Investigators

• Sponsor: Youngstown State University
• Investigators: Principal Investigator: Kenneth E Learman, PhD, PT, Youngstown State University

Publications and helpful links

General Publications

• Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189-98. doi: 10.2165/00007256-200636030-00001.
• van Linschoten R, van Middelkoop M, Berger MY, Heintjes EM, Verhaar JA, Willemsen SP, Koes BW, Bierma-Zeinstra SM. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. BMJ. 2009 Oct 20;339:b4074. doi: 10.1136/bmj.b4074.
• Collins NJ, Bisset LM, Crossley KM, Vicenzino B. Efficacy of nonsurgical interventions for anterior knee pain: systematic review and meta-analysis of randomized trials. Sports Med. 2012 Jan 1;42(1):31-49. doi: 10.2165/11594460-000000000-00000.
• Earl JE, Hoch AZ. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med. 2011 Jan;39(1):154-63. doi: 10.1177/0363546510379967. Epub 2010 Oct 7.
• Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005 Mar;85(3):209-25.

Study record dates

Study Major Dates

• Study Start: April 1, 2014
• Primary Completion (Anticipated): July 1, 2018
• Study Completion (Anticipated): June 1, 2019

Study Registration Dates

• First Submitted: April 23, 2014
• First Submitted That Met QC Criteria: April 24, 2014
• First Posted (Estimate): April 25, 2014

Study Record Updates

• Last Update Posted (Estimate): January 24, 2017
• Last Update Submitted That Met QC Criteria: January 23, 2017
• Last Verified: January 1, 2017

More Information

Terms related to this study

• Keywords: patellofemoral pain syndrome; abdominal muscles
• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Patellofemoral Pain Syndrome
• Other Study ID Numbers: #093-2014