Comparative Effects of Clamshells and Frog Pump Exercises

Comparative Effects of Clamshells and Frog Pump Exercises on Gluteus Medius Strengthening and Lower Extremity Function in Runners With Iliotibial Band Syndrome

Iliotibial band syndrome is where a tendon called iliotibial band gets irritated or swollen from rubbing against hip or knee when it gets too tensed. Iliotibial band (ITB) syndrome (ITBS) is the most common cause of lateral knee pain among athletes who are involved in sports that require continuous running or repetitive knee flexion and extension. The incidence ranges from 1.6% to 12% in runners. The aim of the study is to compare the effects of clamshells and frog pump exercises on gluteus medius strengthening and lower extremity function in runners with iliotibial band syndrome.

Study Overview

• Status: Completed
• Conditions: Iliotibial Band Syndrome
• Intervention / Treatment: Other: Clamshell Exercise; Other: Frog pump exercise

Detailed Description

This study will be a randomized clinical trial and will be conducted in Pakistan Sports Board Lahore. Non-probability convenient sampling will be used to collect the data. Sample size of 32 subjects with age group between 18-30 years (males) will be taken. Data will be collected from the runners with tight ITB, by using tools LEFS, HOS-SS, and Hand held dynamometer. An informed consent will be taken. A total of 26 subjects will be selected by following inclusion and exclusion criteria and will equally divided in to two groups by random number generator table. Both the Groups will continue the conventional training with Group A will receive clamshell Exercise, and Group B will receive frog pump exercise in their respective training programs. Outcome measures will be measured at baseline and after 2 weeks. Data analysis will be done by SPSS version 25.

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Lahore, Pakistan, 54000
    • Pakistan Sports Board

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• • Age (18-30yrs)

  • Gender (Males)
  • Positive Ober's test
  • Positive Noble's compression test
  • Suffering pain from past 3 months
  • Running approximately 5km/week

Exclusion Criteria:

• • Osteoporosis

  • Previous knee trauma/surgery
  • Patellofemoral joint pain
  • Popliteus tendinitis
  • Lateral meniscal injure

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group A: Clamshell Exercise; Group B will be given frog pumps exercises in their regular training program. These exercises are given as: In (0-2) week ,2 sets 10 repetitions; In (2-4)week, 3 sets of 10 repetitions; In (4-6)week, 3 sets of 15 repetitions	Other: Clamshell Exercise; Clamshell Exercise: The clamshell exercise keeps the hips moving, it strengthens both the gluteus medius AND gluteus maximus. The gluteus medius is the main abductor (movement away from the midline of the body) and external rotator of the hip.
Active Comparator: Group B: Frog Pump Exercise; Group B will be given frog pumps exercises in their regular training program. These exercises are given as: In (0-2) week ,2 sets 10 repetitions; In (2-4)week, 3 sets of 10 repetitions; In (4-6)week, 3 sets of 15 repetitions	Other: Frog pump exercise; Frog pump exercise: The frog hip thrust mainly targets the gluteal muscles responsible for thigh extension and abduction. The exercise also works the hamstrings on the back of the thighs which helps in hip extension.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Manual Muscle Testing (MMT)	For measuring the strength of Hip muscles, Manual Muscle Testing (MMT) is used. Manual Muscle Testing (MMT) is a standardised set of assessments that measure muscle strength and function against specific criteria and is commonly used in clinical practice by physiotherapists. Grading Scale Range: 0 to 5 0 None No visible or palpable contraction; Trace Visible or palpable contraction with no motion; Poor Full ROM gravity eliminated; Fair Full ROM against gravity; Good Full ROM against gravity, moderate resistance; Normal Full ROM against gravity, maximum resistance	upto 6th weeks
Hip Outcome Score (HOS)	The hip outcome score (HOS) is a questionnaire used to measure the function of the Hip. The HOS is a patient-completed measure that consists of an "Activities of Daily Living" subscale (17 scored items) and a "Sports" subscale (9 scored items) in which the response options are presented as 5-point Likert scales (Scores 0-4).	upto 6th weeks
Lower Extremity Functional Scale (LEFS)	The lower extremity functional scale (LEFS) measures the function and disability of the lower extremity. LEFS is a well-known and validated instrument for the measurement of lower extremity function. The LEFS was developed in a group of patients with various musculoskeletal disorders. The LEFS rating scale categories are: (1) "extreme difficulty or unable to perform," (2) "quite a bit of difficulty," (3) "moderate difficulty," (4) "a little bit of difficulty," and (5) "no difficulty." LEFS score = SUM (points for all 20 activities) Interpretation: Minimum score: 0 Maximum score: 80 The lower the score the greater the disability.	upto 6th weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Samrood Akram, Mphil, Riphah International University,Lahore

Publications and helpful links

General Publications

• Khaund R, Flynn SH. Iliotibial band syndrome: a common source of knee pain. Am Fam Physician. 2005 Apr 15;71(8):1545-50.
• Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-9. doi: 10.2165/00007256-200535050-00006.
• McKay J, Maffulli N, Aicale R, Taunton J. Iliotibial band syndrome rehabilitation in female runners: a pilot randomized study. J Orthop Surg Res. 2020 May 24;15(1):188. doi: 10.1186/s13018-020-01713-7.
• Friede MC, Innerhofer G, Fink C, Alegre LM, Csapo R. Conservative treatment of iliotibial band syndrome in runners: Are we targeting the right goals? Phys Ther Sport. 2022 Mar;54:44-52. doi: 10.1016/j.ptsp.2021.12.006. Epub 2021 Dec 27.
• Baker RL, Souza RB, Fredericson M. Iliotibial band syndrome: soft tissue and biomechanical factors in evaluation and treatment. PM R. 2011 Jun;3(6):550-61. doi: 10.1016/j.pmrj.2011.01.002.
• Fredericson M, Guillet M, Debenedictis L. Innovative solutions for iliotibial band syndrome. Phys Sportsmed. 2000 Feb;28(2):53-68. doi: 10.3810/psm.2000.02.693.

Study record dates

Study Major Dates

• Study Start (Actual): October 5, 2023
• Primary Completion (Actual): March 8, 2024
• Study Completion (Actual): March 10, 2024

Study Registration Dates

• First Submitted: June 27, 2023
• First Submitted That Met QC Criteria: July 25, 2023
• First Posted (Actual): August 3, 2023

Study Record Updates

• Last Update Posted (Actual): April 30, 2024
• Last Update Submitted That Met QC Criteria: April 29, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: pain; strength; gluteus medius; iliotibial band syndrome
• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Leg Injuries; Disease; Cumulative Trauma Disorders; Sprains and Strains; Knee Injuries; Syndrome; Iliotibial Band Syndrome
• Other Study ID Numbers: REC/RCR & AHS/23/0411

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No