Comparison of IASTM and Muscle Energy Technique in Patellofemoral Pain Syndrome.

Compare the Effects of Instrument Assisted Soft Tissue Mobilization (IASTM) and Muscle Energy Technique on Iliotibial Band Tightness in Patients With Patellofemoral Syndrome.

The aim of this randomized controlled trial is to compare the effect of Instrument Assisted Soft Tissue Mobilization (IASTM) and muscle energy technique on iliotibial band tightness on pain, range of motion and functional mobility in patients with patellofemoral pain syndrome.

Study Overview

• Status: Recruiting
• Conditions: Patellofemoral Pain Syndrome
• Intervention / Treatment: Other: Graston technique+ Conventional PT; Other: Muscle energy technique + Conventional PT

Detailed Description

Patellofemoral pain syndrome (PFPS) is termed as anterior knee pain and is characterized by peripatellar or retro patellar pain as a result of changes in the physical and biochemical components of the patellofemoral joint due to increased load during activities such as running, squatting, going up and down stairs, cycling and jumping. Patellofemoral syndrome is one of the most common knee conditions seen by clinicians. In active individuals, it may account for 25% to 40% of all knee problems The iliotibial band is a lateral thickening of the fascia which attaches to the tensor fascia lata proximally. Most of the lateral retinaculum (superficial oblique and deep transverse portion) arises from the ITB, therefore the ITB indirectly provides lateral stabilisation and acts as a passive restraint to medial patella glide. A tight ITB could theoretically lead to lateral patella tracking, lateral patella tilt and lateral patella compression. Several authors have suggested that tightness in the iliotibial band may contribute to patellofemoral syndrome and knee pain by pulling the patella laterally, thereby causing abnormal tracking of the patella in the trochlear groove.

The Instrument-Assisted Soft Tissue Mobilization (IASTM) technique is the most frequent soft tissue mobilization techniques. It involves the use of a tool that causes mechanical micro-traumatic injury to the treated area. As a result, an inflammatory reaction is elicited, speeding up the healing process and restoring the flexibility and integrity of the tissue and cartilage healing. The therapeutic effects of this approach appear to include decreasing tissue adhesion, enhancing the number of fibroblasts, and stimulating collagen synthesis.

Muscle energy technique is a soft tissue technique designed to improve musculoskeletal function through stretching tight muscles and fascia, to reduce pain and improve circulation. MET is characterized by a patient-induced skeletal muscle contraction against physiotherapist resistance in a controlled direction and position. The pathological barrier of a muscle is located through joint positioning which is followed by active muscle contraction by the patient moving away from the resistance followed by relaxation of the muscle. A new pathological barrier is located through passive movement and the process is repeated.

The rationale for the use of these techniques is to compare the effects of IASTM and MET of iliotibial band tightness in improving pain, range of motion and functional mobility in patients with patellofemoral pain syndrome.

• Study Type: Interventional
• Enrollment (Estimated): 48
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: KINZA ANWAR, MS-OMPT; Phone Number: +92-3239735427; Email: kinza.anwar@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan, 46600
      • Recruiting
      • Pakistan Railway Hospital
      • Contact: KINZA ANWAR, MS-OMPT; Phone Number: +92-3239735427; Email: kinza.anwar@riphah.edu.pk
      • Contact: ALEEZAE SHAMIM, MS-OMPT*
      • Sub-Investigator: ALEEZAE S SHAMIM, MS-OMPT*

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• • Age between 18 and 35 years

  • Both Genders.
  • Anterior or retro patellar knee pain for at least the past 3 months.
  • Knee pain during at least 3 of the following activities: ascending/descending stairs, squatting, hopping/ running, and prolonged sitting.
  • Retro patellar pain in patellar grind test (positive clarke's sign).
  • A score of at least 3 on the visual analog scale (VAS).
  • Positive Ober's test.

Exclusion Criteria:

• • Any meniscal or ligament tears of knee.

  • Knee osteoarthritis.
  • Any previous surgery of lower limb.
  • Patellar fracture or fracture of lower extremity.
  • Having received knee injections of corticosteroids or hyaluronic acid.
  • Osteoporosis of knee joint.

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
Active Comparator: Graston technique+ Conventional PT	Other: Graston technique+ Conventional PT; IASTM technique (graston technique) on iliotibial band. Frequency 2 sessions of stroking with 20 seconds rest in between 3 times/week for 3 consecutive weeks Intensity as tolerated by patient. Conventional PT including 1- Therapeutic ultrasound at frequency of 3.5 MHZ for 10 minutes. 2- Stretching exercise of hamstrings. 3-Isometric exercises of Quadriceps
Other: Muscle energy technique + Conventional PT	Other: Muscle energy technique + Conventional PT; Muscle energy technique (post facilitation stretch) on iliotibial band. Frequency 10 repetitions 3 times/week for 3 consecutive weeks Intensity starting from 50 percent resistance across barrier provided by physiotherapist.. Conventional PT including 1- Therapeutic ultrasound at frequency of 3.5 MHZ for 10 minutes. 2- Stretching exercise of hamstrings. 3-Isometric exercises of Quadriceps.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual analogue scale (VAS)	The VAS is a reliable, valid, responsive, and frequently used pain outcome measure. It consists of a bidirectional 10 cm straight line with two labels, that is, "no pain" and "worst possible pain", located at either end of the line. VAS consists of a bidirectional 10 cm straight line with two labels, that is, "no pain" and "worst possible pain", located at either end of the line. Patients are instructed to draw a vertical mark on the line indicating their pain level.	3 weeks
Goniometer	A goniometer is an instrument that measures the available range of motion at a joint.	3 weeks
Kujala questionnaire	The Kujala AKPS is a 13-item screening instrument designed to assess Patellofemoral pain in adolescents and young adults. The total score of the questionnaire is equal to 100, which shows the maximum function of the knee joint.	3 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: KINZA ANWAR, MS-OMPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): October 2, 2024
• Primary Completion (Estimated): September 25, 2025
• Study Completion (Estimated): September 28, 2025

Study Registration Dates

• First Submitted: September 12, 2024
• First Submitted That Met QC Criteria: September 12, 2024
• First Posted (Actual): September 19, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 20, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: MET; patellofemoral pain syndrome; IASTM; iliotibial band
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Pathologic Processes; Joint Diseases; Disease; Syndrome; Patellofemoral Pain Syndrome
• Other Study ID Numbers: REC/01872 Aleezae Shamim

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