- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04669834
Effect of Core Stability Exercise on Isolated Patellofemoral Osteoarthritis.
Effect of Core Stability Exercise on Temporal Activation of Core Muscles and Vasti in Isolated Patellofemoral Osteoarthritis.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
A) Procedures for evaluation:
The practical section of the studywill be undertaken in 6 weeks (2 sessions a week). Measurement will be taken before the start of treatment program then after the end of 6 weeks treatment program f in the following manner:
- Patients will be asked to respond to the questions of the Kujala scale.
- The eleven-point numerical rating scale will be used to measure pain severity
Investigators will collect the EMG activity of VMO, VL, GM, multifidus, and TrA using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels highresolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
Electromyographic data will be sampled at 1000 Hz and bandpass filtered at 50-200 Hz. For each muscle, three electrodes will be used; two electrodes will be placed ~ 30 mm apart in the direction of the muscle fibers and a ground electrode will be placed over the closest bony prominence. Before placement of the electrodes, the subject's skin will be cleaned with alcohol to reduce impedance and excess hair will be removed to eliminate shifting of the electrodes if needed. The stair-stepping task will consist of ascending 2 steps (each step will be 40 cm in width, 20 cm in height, without handrails. The depth of the first and second steps will be 30 cm and 40 cm, respectively) . Participants will be asked to stand on the floor confronting the stairs and 20 cm away from the edge of the initial step.
The stair ascent task will be performed barefooted while arms hanged at the side of the body. Patients will start ascending the steps immediately in response to a command, at their normal speed with their affected limb. Investigators aren't going to control the speed of stair ascent, because controlling the timing of stair-stepping can alter the electromyographic signal as shown earlier for gait in asymptomatic subjects. Before data acquisition, participants will be asked to perform one practice trial of stair ascent to get familiarized with the task. Then the participants will perform three test trials with thirty seconds of rest after each trial to prevent fatigue. The raw data will be stored on a personal computer for analysis with a custom program in Matlab (Math Works, Natick, Massachusetts, USA). Investigators will use a mean of data in three trials for analysis. b) Procedures for treatment: All patients will receive a traditional physical therapy program in the form of TENS , stretching hamstring, quadriceps and calf muscles
- Group (A) Patients in this group will receive a traditional therapeutic knee rehabilitation program based on a recent systematic review in the form of mini-squatting exercise (up to 45O knee flexion measured by a universal goniometer) , strengthening of hip abductors and external rotators using clamshell exercise . No emphasis will be placed on stabilizing the core musculature before initiating any of those exercises.
To increase the intensity of exercise, elastic resistance bands will be used.
- Group (B) Patients in this group will receive the same program as group (A) plus core stability exercise and the principles of core stability will be explained to patients before initiation of treatment and patients will be asked to comply with these principles during exercise. These principles include learning how to activate transversus abdominus by abdominal bracing without allowing pelvis tilting and ensure neutral spine and diaphragmatic breathing during exercise.
c) Statistical Analysis: Data management and analysis will be conducted using the statistical package for social studies (SPSS) version 22 for windows (IBM SPSS, Chicago, IL, USA). Investigators will conduct the 2X2 Mixed Design MANOVA test to compare the onset and duration of each muscle, pain intensity, and performance of functional activities between group A (traditional therapeutic knee rehabilitation) and group B (core stability) pre-treatment and post-treatment.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Giza, Egypt, 11432
- Faculty of physical therapy, Cairo University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria: patients included if they had
- Anterior- or retro-patellar knee pain aggravated by at least two activities that load the PFJ (eg; stair ambulation, squatting and/or rising from sitting) .
- Pain during these activities presented on most days during the past month and their pain severity was ≥ 4 on an 11 point numerical pain scale during aggravating activities .,
- A grade less than (2) from postero-anterior views on the Kellgren - Lawrence (KL) grading scale.
Exclusion Criteria:
- concomitant pain from tibiofemoral joint or other knee structures .
- current or previous pain in the hip, lumbar spine or foot that had lasted longer than 3 months and/or required intervention.
- a history of lower extremity, pelvis or spine fractures; spine, hip, knee or foot surgeries; hip or patellar subluxation/ dislocation.
- injury to any of knee ligaments or meniscus.
- systemic diseases (e.g. rheumatoid arthritis), neurological conditions or fibromyalgia .
- The professional athletes; people who exercise more than two hours a day or every other day, will be excluded.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
OTHER: group A
Patients in this group will receive a traditional therapeutic knee rehabilitation program based on a recent systematic review in the form of mini-squatting exercise (up to 45 degree knee flexion measured by a universal goniometer) , strengthening of hip abductors and external rotators using clamshell exercise .
No emphasis will be placed on stabilizing the core musculature before initiating any of those exercises.
|
mini-squatting exercise and clamshell exercise
|
EXPERIMENTAL: group B
Patients in this group will receive the same program as group (A) plus core stability exercise , but the principles of core stability will be explained to patients before initiation of treatment and patients will be asked to comply with these principles during exercise.
These principles include learning how to activate transversus abdominus by abdominal bracing without allowing pelvis tilting and ensure neutral spine and diaphragmatic breathing during exercise.
|
mini-squatting exercise and clamshell exercise
the principles of core stability will be explained to patients before initiation of treatment and patients will be asked to comply with these principles during exercise.
These principles include learning how to activate transversus abdominus by abdominal bracing without allowing pelvis tilting and ensure neutral spine and diaphragmatic breathing during exercise.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change of EMG onset of multifidus,
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of multifidus using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG duration of multifidus,
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of multifidus using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG onset of transversus abdominus (TrA) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of TrA using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG duration of transversus abdominus (TrA) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of TrA using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG onset of gluteus medius (GM) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of GM using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG duration of gluteus medius (GM) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of GM using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG onset of vastus medialis obliqus (VMO) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of VMO using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG duration of vastus medialis obliqus (VMO) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of VMO using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG onset of vastus lateralis (VL) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of VL using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
The change of EMG duration of vastus lateralis (VL) muscle
Time Frame: baseline and six weeks
|
investigators will collect the EMG activity of VL using bipolar Ag-AgCl disposable surface electrodes (Better signal solution medical supply Co., limited, Zhongshan, China) and eight channels high-resolution wireless bio amplifier (WBA) system (Biomation, Almonte, Canada).
|
baseline and six weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
pain intensity
Time Frame: baseline and six weeks
|
The eleven-point numerical rating scale will be used to measure pain severity for patients.where
the endpoints are the extremes of no pain and pain as bad as it could be or worst pain.
increasing the value means more intense pain.
|
baseline and six weeks
|
performance of functional activities
Time Frame: baseline and six weeks
|
kujala scale will be used to evaluate the performance of functional activities.
This questionnaire includes 13 questions and the scores range from 0 to 100, where 100 indicates the highest efficiency of the knee and 0 indicates the highest disability.
|
baseline and six weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Aladdin A. balbaa, professor, Cairo University
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- (P.T.Rec/012/002987)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Chondromalacia Patellae
-
University of Sao Paulo General HospitalCompleted
-
Cairo UniversityNot yet recruiting
-
Instituto Mexicano del Seguro SocialCompletedChondromalacia PatellaeMexico
-
Kayseri City HospitalCompletedChondromalacia PatellaeTurkey
-
University of VirginiaCompletedPatellofemoral Pain Syndrome | Chondromalacia PatellaUnited States
-
Cairo UniversityCompletedIs Lower Limb Neuromotor Control Diverse in Females With PF OA Contrasted With Asymptomatic ControlsChondromalacia PatellaeEgypt
-
Sheba Medical CenterZinman College of Physical Education and Sports SciencesUnknownCartilage Diseases | ChondromalaciaIsrael
-
Gaziler Physical Medicine and Rehabilitation Education...RecruitingChondromalacia PatellaeTurkey
-
Gaziler Physical Medicine and Rehabilitation Education...CompletedChondromalacia PatellaeTurkey
-
Cairo UniversityCompletedChondromalacia PatellaeEgypt
Clinical Trials on a traditional therapeutic knee rehabilitation program
-
Cairo UniversityNot yet recruiting
-
Universidad de GranadaRecruiting
-
Fundación Pública Andaluza para la Investigación...UnknownHomebased Cardiac Rehabilitation Program After Ischemic Heart DiseaseSpain
-
Alper PercinCompletedTemporomandibular Joint Dysfunction Syndrome | Autonomic Nervous System ImbalanceTurkey
-
University of ÉvoraEnrolling by invitationKnee Injuries | Rehabilitation | Lower Extremity ProblemPortugal
-
Sherin Hassan Mohammed MehaniCompletedMechanical Ventilation ComplicationEgypt
-
Istanbul UniversityNot yet recruitingScleroderma, Systemic | Rehabilitation | Physiotherapy | Rheumatology | Hand Rheumatism | Video Games
-
Istituto Ortopedico GaleazziCompletedOsteoarthritis | Rehabilitation | Knee Arthroplasty | Total Knee Replacement | Virtual Reality TherapyItaly
-
Sara Magdy IbrahimAlexandria UniversityCompletedHearing Impaired ChildrenEgypt