Enhancing Stability and Function in Adolescent

Proprioceptive Neuromuscular Facilitation Versus Core Training for Enhancing Stability and Function in Adolescent With Patellofemoral Pain Syndrome

This study investigated the comparative effects of proprioceptive neuromuscular facilitation (PNF) stretching and core strength exercises on static balance in adolescents with patellofemoral pain syndrome (PFPS).

Study Overview

• Status: Completed
• Conditions: Patellofemoral Pain Syndrome; Adolescents
• Intervention / Treatment: Other: core exercises; Other: Proprioceptive Neuromuscular Facilitation

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Gamasa, Egypt, 35712
    • Amira Hussin Mohammed

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Participants were between 16 and 18 years old.
• Patients had to have experienced anterior knee pain for at least 4 weeks, with the pain being exacerbated by at least two of the following activities: jumping, running, prolonged sitting, stair climbing, kneeling, and squatting (Chevidikunnan et al., 2016).
• Participants could not have undergone any surgical procedures on their lower limbs.
• Pain during the previous week needed to be greater than 30 mm on a 100 mm visual analogue scale (VAS) (Appendix I) (Rathleff et al., 2015).
• A spectrum of BMI was sought, with participants recruited to represent normal BMI percentile categories for both boys and girls. The normal BMI percentile categories for both boys and girls were defined as the 5th percentile to less than the 85th percentile (Appendix II) (King et al., 2012).

Exclusion Criteria:

• Adolescents with cruciate ligament injuries, meniscal injuries, collateral ligament injuries, and tenderness associated with any of these structures, any intra-articular injury, and tenderness over the iliotibial band, patellar tendon, pes anserine tendons, or evidence of joint effusion.

  • Adolescents with referred pain from the hip or lumbar region, or a known case of articular cartilage damage.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Core exercises; The participants were taught how to contract their deep abdominal muscles to obtain core muscle activation. The patient should be contracting the abdominal muscles, lifting her lower belly up away from pubic bone, while breathing slowly and normally. The patient should not hold her breath	Other: core exercises; The core muscle strength training program were lasted for 8 weeks and comprised of 3 training sessions per week, with a total of 24 sessions. Each session were lasted for 30 to 45 minutes, starting with a brief warm-up exercise program consisting of low-intensity core strength exercises to prepare the neuromuscular system for the training loads and ending with a cool-down program
Experimental: Proprioceptive Neuromuscular Facilitation; The hold-relax proprioceptive neuromuscular facilitation stretching protocol consisted of passively moving the dominant leg into a position where the subjects felt mild discomfort and holding that position for 30 seconds. Subjects were then asked to isometrically contract the stretched muscle for 10 seconds; this were followed by muscle relaxation in the same position for 30 seconds, before being stretched to a new point of mild discomfort. The leg were then released	Other: Proprioceptive Neuromuscular Facilitation; The hold-relax proprioceptive neuromuscular facilitation stretching protocol consisted of passively moving the dominant leg into a position where the subjects felt mild discomfort and holding that position for 30 seconds. Subjects were then asked to isometrically contract the stretched muscle for 10 seconds; this were followed by muscle relaxation in the same posi¬tion for 30 seconds, before being stretched to a new point of mild discomfort. The leg were then released

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Visual analogue scale (VAS-100 mm) for pain	All adolescents were assessed before and after the 8-week intervention period
Dynamic postural stability test and single leg test using the Biodex Balance System SD	All adolescents were assessed before and after the 8-week intervention period

Secondary Outcome Measures

Outcome Measure	Time Frame
Self-administered Anterior Knee Pain Scale (AKPS) or Kujala Patellofemoral Score	All adolescents were assessed before and after the 8-week intervention period

Collaborators and Investigators

• Sponsor: Delta University for Science and Technology
• Investigators: Principal Investigator: Amira H Mohammed, PHD, Delta University for Science and Technology

Study record dates

Study Major Dates

• Study Start (Actual): April 20, 2024
• Primary Completion (Actual): July 12, 2024
• Study Completion (Actual): July 12, 2024

Study Registration Dates

• First Submitted: November 19, 2024
• First Submitted That Met QC Criteria: November 19, 2024
• First Posted (Estimated): November 20, 2024

Study Record Updates

• Last Update Posted (Estimated): November 20, 2024
• Last Update Submitted That Met QC Criteria: November 19, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Pathologic Processes; Joint Diseases; Disease; Syndrome; Patellofemoral Pain Syndrome
• Other Study ID Numbers: Patellofemoral Pain syndrome

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: data availability by requesting from the corresponding author and after publication
• IPD Sharing Time Frame: after 12 months from November 2024

Drug and device information, study documents

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