Comparison of Effects of Mobilization With Movement and Kinesiotaping in Patellofemoral Pain Syndrome

Comparison of Short-Term Effects of Mobilization With Movement and Kinesiotaping on Pain, Function and Balance in Patellofemoral Pain Syndrome: A Randomized Control

Patellofemoral Pain Syndrome (PFPS), also known as the anterior knee pain, is one of the most common musculoskeletal disorders. Most of the patients suffer from knee pain for long time. The aim of this study was to investigate the short-term effects of Mobilization with movement and Kinesiotaping on pain, function and balance in patient with PFPS.

Study Overview

• Status: Completed
• Conditions: Patellofemoral Pain Syndrome
• Intervention / Treatment: Other: Mulligan's Straight leg-raise with traction; Other: Mulligan's Mobilization with Movement; Other: Exercise; Other: Kinesiotaping

Detailed Description

Patellofemoral Pain Syndrome is one of the most common musculoskeletal problem in the world. It's incidence is also becoming higher and most people who have knee pain suffer from it for long time. In the treatment of PFPS, conservative treatment methods are preferred prior to surgical ones. When the literature was reviewed, no study in which Mobilization with movement (MWM) method was used and in which the effects of it was shown and compared with (Kinesiotaping) KT has been found so far with respect to the treatment of PFPS. Thirty-five female patients diagnosed with unilateral PFPS were randomly assigned into 2 groups. The patients in the first group (n=18) received two techniques of Mobilization with movement intervention while Kinesiotaping was applied to the other group (n=17). Both groups were treated with exercise. All patients received 4 sessions of treatment twice a week for a period of 2 weeks and followed up in accordance with a 6-week-home exercise program. Primary outcomes: pain severity, knee range of motion, hamstring flexibility, and physical performance (10-step stair climbing test, timed up and go test), Kujala Patellofemoral Pain Scoring and Y-Balance test were assessed.

• Study Type: Interventional
• Enrollment (Actual): 35
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 45 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• having knee pain at least 3 months and more than 3 points according to visual analog scale

Exclusion Criteria:

• no complying to the rehabilitation
• if patient wants to finished and want to complete study, they were excluded
• having meniscus, bursa, ligament, patellar tendon lesions, patellofemoral dislocation and/or recurrent subluxation, undergone lower extremity surgery

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
Other: Effects of Mulligan's Mobilization; The patients in this arm (n=18) received two techniques pertaining to Mulligan's Mobilization with movement approach (Mulligan's Straight Leg-Raise with Traction and Tibial Gliding) along with an exercise therapy. Patients received 4 sessions of treatment twice a week for a period of 2 weeks and followed up in accordance with a 6-week-home exercise program. Primary outcomes: pain severity, knee range of motion, hamstring flexibility, and physical performance (10-step stair climbing test, timed up and go test), Kujala Patellofemoral Pain Scoring and Y-Balance test were assessed before the treatment, 45 minutes after the initial treatment, at the end of the 4-session-treatment during 2-week period and 6 weeks later.	Other: Mulligan's Straight leg-raise with traction; Mulligan's Straight leg raise technique was performed on patients with patellofemoral pain syndrome. The extremity on which the practice would be performed in supine position was grasped from the ankle level and was, then, subjected to traction longitudinally. Afterwards, the knee was lifted up passively while in extension and was kept for waiting for a few seconds at the point where tension was felt and was, then, returned to its initial position. The practice was repeated 10 times, and 3 sets of practice at 1-minute-intervals were performed.; Other: Mulligan's Mobilization with Movement; Mulligan's Mobilization with Movement technique was performed on patients with patellofemoral pain syndrome. Each patient was tested in every direction in the course of the active knee flexion-extension movement so as to find out the best pain-free tibial gliding direction (medial-lateral part of the tibia, anterior-posterior, internal-external rotation). At the time of the active movement of the knee, the tibial gliding direction where pain was felt at the least was selected as the treatment direction of mobilization technique along with movement. The practice was performed by doing 10 repetitions for 3 sets and by providing 1-minute-resting time between the sets.; Other: Exercise; All the patients were provided with several exercises within the scope of the home exercise program, such as hamstring muscle stretching, quadriceps isometric exercises, 4-way-strengthening with exercise elastic bands for the muscles of the hip, knee locking on foot and mini-squatting exercises. They were asked to do these exercises in 3 sets a day along with 10 repetitions for a period of 6 weeks.
Other: Effects of Kinesiotaping; Patients in this arm were applied kinesiotaping on quadriceps and hamstring muscle along with an exercise therapy. Patients received 4 sessions of treatment twice a week for a period of 2 weeks and followed up in accordance with a 6-week-home exercise program. The same assessment parameters was conducted on this arm too.	Other: Exercise; All the patients were provided with several exercises within the scope of the home exercise program, such as hamstring muscle stretching, quadriceps isometric exercises, 4-way-strengthening with exercise elastic bands for the muscles of the hip, knee locking on foot and mini-squatting exercises. They were asked to do these exercises in 3 sets a day along with 10 repetitions for a period of 6 weeks.; Other: Kinesiotaping; Kinesiotaping was applied on patient with patellofemoral pain syndrome. To maintain proprioceptive stimulation in the quadriceps (from origo towards insertio) and to alleviate the tension of hamstring muscle, a 'Y''-shaped kinesiotape was applied by using the muscle technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knee pain measured with Visual Analog Scale	Patient's knee pain was measured with Visual Analog Scale	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knee joint range of motion was measured Universal goniometer.	Universal goniometer was used for evaluating the knee joint range of motion.	6 weeks
Balance measured with Y- Balance Test	The dynamic balance measurements of the patients were evaluated through Y- Balance Test	6 weeks
Function was measured with 10-step-ascent & descent stair-climbing test.	To evaluate the functional performances of the patients, 10-step-ascent & descent stair-climbing test was used.	6 weeks
Function was measured Kujala patellofemoral scoring system	Patient's function was measured with Kujala patellofemoral scoring system	6 weeks
Function was measured with timed up&go test	To evaluate the functional performances of the patients, timed up&go test was used.	6 weeks
Hamstring muscle flexibility was measured Universal goniometer.	Universal goniometer was used for evaluating the hamstring muscle flexibility.	6 weeks

Collaborators and Investigators

• Sponsor: Hacettepe University
• Investigators: Study Director: Volga Bayrakcı Tunay, Prof., supervisor of the study

Publications and helpful links

General Publications

• Djordjevic OC, Vukicevic D, Katunac L, Jovic S. Mobilization with movement and kinesiotaping compared with a supervised exercise program for painful shoulder: results of a clinical trial. J Manipulative Physiol Ther. 2012 Jul;35(6):454-63. doi: 10.1016/j.jmpt.2012.07.006. Epub 2012 Aug 24. Erratum In: J Manipulative Physiol Ther. 2012 Oct;35(8):659.
• Kuru T, Yaliman A, Dereli EE. Comparison of efficiency of Kinesio(R) taping and electrical stimulation in patients with patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2012;46(5):385-92. doi: 10.3944/aott.2012.2682.
• Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med. 2010 Jul;29(3):379-98. doi: 10.1016/j.csm.2010.03.012.

Study record dates

Study Major Dates

• Study Start: May 1, 2013
• Primary Completion (Actual): August 1, 2015
• Study Completion (Actual): August 1, 2015

Study Registration Dates

• First Submitted: March 2, 2016
• First Submitted That Met QC Criteria: March 8, 2016
• First Posted (Estimate): March 14, 2016

Study Record Updates

• Last Update Posted (Estimate): March 15, 2016
• Last Update Submitted That Met QC Criteria: March 13, 2016
• Last Verified: March 1, 2016

More Information

Terms related to this study

• Keywords: Balance; Knee; Taping; Function; Mobilization
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease; Joint Diseases; Musculoskeletal Diseases; Syndrome; Somatoform Disorders; Patellofemoral Pain Syndrome
• Other Study ID Numbers: LUT 12/175

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No