Ilium Mobilization in Patellofemoral Pain Syndrome Treatment

Efficacy of Adding Posterior Ilium Mobilization With Movement to Treatment of Patellofemoral Pain Syndrome

Aim of the study is to investigate the effect of adding posterior ilium mobilization on knee pain, knee function, anterior pelvic tilt, dynamic knee valgus, muscle strength of extensors, abductors and external rotators of hip and knee extensors in patients with patellofemoral pain syndrome.

Study Overview

• Status: Completed
• Conditions: Patellofemoral Pain Syndrome
• Intervention / Treatment: Other: strengthening and stretching exercises; Other: posterior ilium mobilization

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt
    • Faculty of physical therapy, Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 35 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Age of the subjects between 18-35 years.
2. BMI will be ≤ 29.5
3. Anterior or retro patellar knee pain for at least 6 weeks duration.
4. Foot posture index score from +6 to +12.
5. Anterior pelvic tilt angle more than 8 degree.
6. Pain elicited at least by two of the following four tests; (i) Isometric muscle contraction with slight bent knee,(ii) palpation of the patellofemoral joint line, (iii) patellar compression against the femoral bone (iv) active resisted knee extension.
7. Pain intensity more than 3 at ANPS and provoked by at least two of the following activities: running, walking, hopping, squatting, stair negotiation, kneeling, or prolonged sitting.

Exclusion Criteria:

1. Meniscal or other intraarticular pathologic conditions; cruciate or collateral ligament involvement.
2. A history of traumatic patellar subluxation or dislocation.
3. Previous surgery in the knee, ankle and hip joints.
4. Knee, ankle and hip joints osteoarthritis.
5. Taking non-steroidal anti-inflammatory drugs or corticosteroids within 24 h before the test.
6. History of brain injury or vestibular disorder within the last 6 months.
7. Pregnant female.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control group	Other: strengthening and stretching exercises; the participants will receive strengthening exercises on the hip and knee joint beside that they will receive stretching exercises
Experimental: Study group	Other: strengthening and stretching exercises; the participants will receive strengthening exercises on the hip and knee joint beside that they will receive stretching exercises; Other: posterior ilium mobilization; the therapist will mobilize the innominate on the affected side posteriorly

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in pain	Arabic Numeric pain rating scale will be used to assess pain changes during walking, hopping, squatting, stair negotiation, kneeling, or prolonged sitting. This scale measures pain severity on a scale of 0 to 10 points, with 0 representing no pain and 10 signifying the most severe pain possible.	It will be assessed at baseline and after 4 weeks
Changes in knee functional disability	The Arabic version of Anterior knee pain scale will be used to assess the knee functional disability. It is a self-administered, weighted questionnaire that analyzes 13 items, including pain and function, with a maximum score of 100 points and minimum score of 0 points. Higher scores indicate greater lower extremity function. It documents responses to six activities linked with anterior knee pain (walking, running, jumping, climbing stairs, squatting, and sitting for prolonged periods with knee bent).	It will be assessed at baseline and after 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in hip abductors strength	Handheld dynamometer will be used to assess changes in muscle strength	It will be assessed at baseline and after 4 weeks
Changes in hip extensors strength	Handheld dynamometer will be used to assess changes in muscle strength	It will be assessed at baseline and after 4 weeks
Changes in hip external rotators strength	Handheld dynamometer will be used to assess changes in muscle strength	It will be assessed at baseline and after 4 weeks
Changes in knee extensors strength	Handheld dynamometer will be used to assess changes in muscle strength	It will be assessed at baseline and after 4 weeks
Changes in dynamic knee valgus	Cell phone Camera, tripod device and Kinovea Computer Program (KCP) will be used to assess knee frontal plane projection angle to detect changes in knee valgus during step down test	It will be assessed at baseline and after 4 weeks
Changes in pelvic tilt angle	Palpation Meter (PALM) will be used to assess changes in pelvic tilt angle	It will be assessed at baseline and after 4 weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2023
• Primary Completion (Actual): May 1, 2024
• Study Completion (Actual): May 1, 2024

Study Registration Dates

• First Submitted: January 23, 2023
• First Submitted That Met QC Criteria: January 23, 2023
• First Posted (Actual): February 1, 2023

Study Record Updates

• Last Update Posted (Actual): May 30, 2025
• Last Update Submitted That Met QC Criteria: May 24, 2025
• Last Verified: September 1, 2024

More Information

Terms related to this study

• Keywords: strength; mobilization; patellofemoral pain syndrome; stretch; ilium; innominate
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Mental Disorders; Pathologic Processes; Joint Diseases; Disease; Somatoform Disorders; Syndrome; Patellofemoral Pain Syndrome
• Other Study ID Numbers: Ilium mobilization

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