Effects of Proximal Strengthening Exercises in Patellofemoral Pain Syndrome Among Basketball Players

Effects of Proximal Strengthening Exercises on Pain and Function in Patellofemoral Pain Syndrome Among Basketball Players

This research study aims to compare the effectiveness of two different exercise approaches in treating Patellofemoral Pain Syndrome (PFPS) in basketball players. It employs a randomized clinical trial with 32 participants aged 18-40 diagnosed with PFPS. The participants are divided into two groups: Isolated Strengthening Exercises (ISE) and Combined Strengthening Exercises (CSE). The ISE group focuses solely on quadriceps strengthening exercises, while the CSE group incorporates both quadriceps and proximal strengthening exercises for the hip and core muscles. Outcome measures include pain levels, functionality, and physical performance assessments recorded at baseline and after 6 weeks. Statistical analysis using independent t-tests in SPSS will determine which approach is more effective. This study seeks to provide evidence on whether the combination of proximal strengthening exercises enhances the reduction of pain and improvement in functionality for basketball players with PFPS, compared to isolated strengthening exercises alone.

Study Overview

• Status: Recruiting
• Conditions: Patellofemoral Syndrome
• Intervention / Treatment: Other: Isolated Strengthening Exercises; Other: Combined Strengthening Exercises

Detailed Description

Patellofemoral Pain Syndrome (PFPS) is a common knee condition that affects basketball players and can lead to significant pain and functional limitations. The syndrome involves pain around or behind the patella (kneecap) due to malalignment and abnormal tracking of the patella within the femoral groove. Isolated strengthening exercises targeting the quadriceps have been widely recommended as a treatment approach for PFPS. However, recent research suggests that incorporating proximal strengthening exercises, focusing on the hip and core muscles, may enhance treatment outcomes. This study aims to investigate the comparative effectiveness of isolated strengthening exercises alone versus combined with proximal strengthening exercises in reducing pain and improving functionality in basketball players with PFPS. This research will employ a randomized clinical trial design to assess the impact of different strengthening exercise protocols on pain and functionality among basketball players diagnosed with PFPS. A sample of 32 basketball players aged 18-40 years, diagnosed with PFPS by a qualified orthopedic specialist and physiotherapists will be recruited for the study. Participants will be randomly assigned into two groups: The Isolated Strengthening Exercises (ISE) group and the Combined Strengthening Exercises (CSE) group, which includes both isolated and proximal strengthening exercises. The ISE group will follow a structured program consisting of isolated strengthening exercises targeting the quadriceps, focusing on exercises such as leg extensions, squats, and lunges. The CSE group will perform the same isolated strengthening exercises but with the addition of proximal strengthening exercises for the hip and core muscles, including exercises such as hip abduction, clamshells, and planks. Outcome measures, including pain levels using NPRS, functionality using the KOOS-PF, Step-down test, single leg squat Hop test, and range of motion assessments, will be recorded at baseline after 6 weeks. Statistical analysis, including independent t-tests, will be performed to compare the outcomes between the ISE and CSE groups using SPSS version 26.0.

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

Contacts and Locations

• Study Contact: Name: Muhammad Asrar Yousaf, Phd; Phone Number: 03004099505; Email: asrar.yousaf@riphah.edu.pk
• Study Contact Backup: Name: Allah Nawaz, DPT; Phone Number: 03337764672; Email: allahnawaz909@gmail.com

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 54782
      • Recruiting
      • Physio wellness centre
      • Contact: Sana Sarwar, DPT; Phone Number: 03324027932; Email: phstherapist@gmail.com
      • Principal Investigator: Allah Nawaz, DPT
      • Sub-Investigator: Muhammad Asrar Yousaf, PhD

Participation Criteria

Eligibility Criteria

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

Description

Inclusion criteria:

• Professional male basketball players of the age group 18-40 years
• Practicing players of basketball (3-5 times a week)
• Players who experience pain around Patella
• Pain severity between 3 and 10 during stair descending test for PFPS
• Positive diagnostic patellofemoral syndrome maneuvers including Shrug test, Grind test and Perkins test

Exclusion criteria:

• Past surgery of affected leg
• Systemic illness (diabetes, systemic lupus erythematosus)
• Individuals havening significant knee pathologies such as ACL tear, Meniscal tear
• Referred pain originating from other points of body
• Knee deformities or signs of knee OA in knee x-ray

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: Isolated Strengthening Exercises; Isolated strengthening exercises refers to set of exercises that are used to treat a specific part of body. In our study, isolated strengthening exercises including 10 repetition of 3 sets of legs extensions,10 repetition of 3 sets squats and 10 repetition of 3 sets lunges are used. These exercises aim to improve the pain and range of motion of knee by acting on quadriceps.	Other: Isolated Strengthening Exercises; Isolated strengthening exercises can be beneficial for individuals with Patellofemoral Pain Syndrome (PFPS) to help address muscle imbalances and alleviate pain.
Experimental: Combined Strengthening Exercises; The Combined strengthening group will perform the same isolated strengthening exercises, but with the addition of proximal strengthening exercises for the hip and core muscles. These exercises include 10 repetitions of bridging(3 sets), 10 repetitions of clamshells(2 sets), 10 repetition of 3 sets of legs extensions,10 repetition of 3 sets squats,10 repetition of 3 sets lunges and 10 repetitions of planks(2 sets).	Other: Isolated Strengthening Exercises; Isolated strengthening exercises can be beneficial for individuals with Patellofemoral Pain Syndrome (PFPS) to help address muscle imbalances and alleviate pain.; Other: Combined Strengthening Exercises; Combined strengthening exercises for Patellofemoral Pain Syndrome (PFPS) typically include a mix of quadriceps strengthening exercises, hip strengthening exercises, and core stability exercises. The goal is to address muscle imbalances and improve the overall stability of the knee joint.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Single-legged hop tests	Single-legged hop tests are functional tests that have been used to identify individuals who can regain dynamic knee stability after an ACL injury.	6 weeks
Numeric pain rating scale	The Numeric pain rating scale is a self-reported, or clinician-administered, measurement tool consisting of a numerical point scale with extreme anchors of no pain to extreme pain. The scale is typically set up on a horizontal or vertical line, ranges most commonly from 0-10 or 0-100, and can be administered in written or verbal form. The 0 on scale shows no pain, 1-4 shows mild pain, 5 and 6 shows moderate pain and 7-10 shows severe pain.	6 weeks
Knee Injury and Osteoarthritis outcome score for Patellofemoral injury	Knee Injury and Osteoarthritis Outcome Score Patellofemoral is one subjective type of questionnaire developed as an extension with the aim of estimating the immediate and long-term symptoms and function among people with Patellofemoral pain syndrome. Higher scores show pain severity whereas lower score shows mild or no pain.	6 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Muhammad Asrar Yousaf, Phd, Riphah International University

Publications and helpful links

General Publications

• Mostafaee N, Pashaei-Marandi M, Negahban H, Pirayeh N, Saki Malehi A, Ebrahimzadeh MH. Examining the diagnostic accuracy of common physical examination and functional tests in the diagnosis of patellofemoral pain syndrome among patients with anterior knee pain. Physiother Theory Pract. 2022 Dec 19:1-13. doi: 10.1080/09593985.2022.2158053. Online ahead of print.
• You S, Shen Y, Liu Q, Cicchella A. Patellofemoral Pain, Q-Angle, and Performance in Female Chinese Collegiate Soccer Players. Medicina (Kaunas). 2023 Mar 16;59(3):589. doi: 10.3390/medicina59030589.

Study record dates

Study Major Dates

• Study Start (Actual): May 5, 2023
• Primary Completion (Estimated): February 5, 2024
• Study Completion (Estimated): February 5, 2024

Study Registration Dates

• First Submitted: November 9, 2023
• First Submitted That Met QC Criteria: November 9, 2023
• First Posted (Actual): November 14, 2023

Study Record Updates

• Last Update Posted (Actual): January 30, 2024
• Last Update Submitted That Met QC Criteria: January 28, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: Pain; Squat; Patellofemoral syndrome; Clamshell; Isolated exercise
• Additional Relevant MeSH Terms: Pathologic Processes; Disease; Joint Diseases; Musculoskeletal Diseases; Syndrome; Patellofemoral Pain Syndrome
• Other Study ID Numbers: REC/RCR & AHS/23/0430

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