Effect of Core Exercises on Patellofemoral Pain Syndrome

Effect of Adding Core Exercises to Hip and Knee-focused Exercises on Patellofemoral Pain Syndrome

the goal of this interventional study is to Investigate the effect of core strengthening exercises on pain, strength, function, and balance in patients with PFPS.

Study Overview

• Status: Recruiting
• Conditions: Patellofemoral Pain Syndrome
• Intervention / Treatment: Other: Core strengthening exercises; Other: Traditional treatment

Detailed Description

Purpose: Patellofemoral pain syndrome is a frequent musculoskeletal disorder, which can result from core muscles instability that can lead to pain, function and altered dynamic balance. The objective of this study is to assess the effect of core muscle strengthening on pain, function, strength and dynamic balance in patients with patellofemoral pain syndrome.

Subjects and Methods: Forty-four patients with age ranging from 18 to 35 years with patellofemoral pain syndrome will be divided into study (N=22) and control (N=22) groups. Both groups will be given 6 weeks of conventional physical therapy program and an additional core muscle strengthening for the study group. The tools are being used to assess the outcome are 1- Visual Analogue Scale,2- handheld dynamometer,3-AKPS 4- BIODEX Balance.

Hypotheses:

It will be hypothesized that:

1. There is no effect of core strengthening exercises on pain in treating PFPS.
2. There is no effect of core strengthening exercises on muscle strength in treating PFPS.
3. There is no effect of core strengthening exercises on function in treating PFPS.

• Study Type: Interventional
• Enrollment (Estimated): 44
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rana Ibrahim Ahmed, Bachelor Physical Therapy-MUST; Phone Number: 01151082787; Email: ranaibrahim066@gmail.com

Study Locations

• Egypt
  • Giza, Egypt
    • Recruiting
    • Cairo University
    • Contact: Rana Ibrahim, Bachelor; Phone Number: 01151082787; Email: ranaibrahim066@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Patients of both genders with an age range of 18- 35 years old.
2. Gradual development of pain in the front of the knee lasting more than 12 weeks.
3. Patients with body mass index 18- 25 kg m2.

4. Pain is aggravated by at least 2 of the following activities: jumping, running, prolonged sitting, stair climbing, kneeling, and squatting.

   1. Positive patellar grinding test.
   2. Insidious onset of symptoms, unrelated to a traumatic damage.

Exclusion Criteria:

1. Traumatic patellar subluxation or dislocation.
2. A history of any of the following conditions: meniscal or other intra articular pathologic conditions; cruciate or collateral ligament involvement.
3. Any lower limb bony or congenital deformities.
4. Previous knee and hip joint surgeries.
5. Osteoarthritis in the ankle, knee, or hip joints.
6. Conditions that affect muscle strength such as diabetes mellitus or rheumatoid arthritis.

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: Study group; Group B (study group) (core strengthening exercises added to evidence-based approaches group) The core muscle strength training program The core muscle strength training program will last for 6 weeks and comprise of two training sessions per week, with a total of 12 sessions for the study group. During the main part of the training, the "big 3" exercises as described by McGill will be conducted. These include the curl-up, side bridge, and quadruped position.	Other: Core strengthening exercises; By core strengthening exercise, could be improved pain, balance, and function in patients with patellofemoral pain syndrome. In that case, this will not only improve their postural stability and neuromuscular control, but we believe it will improve their overall functional, performance, and quality of life. Currently, limited evidence exists about the effectiveness of core strengthening exercises on pain, function and dynamic balance in patellofemoral pain syndrome. By addressing core strengthening exercise, physical therapists can advise new treatment methods for patellofemoral pain syndrome (Chevidikunnan et al., 2016); Other: Traditional treatment; hip and knee-focused exercises
Active Comparator: Control group; Group A (control group) (evidence-based approaches group): The participants in the control group will receive only a hip and knee- focused exercise program.; Hip-focused exercise: Based on previous studies, hip-focused exercises will consist of side- lying hip abduction, hip external rotation (clamshell), and prone hip extension.; Knee-focused exercise The knee-focused exercise regime will be based on previous studies and consist of supine straight leg raises, supine terminal knee extensions (from 10° flexion to full extension), and a mini squat (45° flexion) with the back supported against the wall (to reduce stabilizing requirements from the hip muscles).	Other: Traditional treatment; hip and knee-focused exercises

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain	by Visual analog scale	6 weeks
knee function	by Anterior knee pain scale ( AKPS) ( Kujala )	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle strength	By hand held dynamometer	6 weeks
Balance	By Biodex balance system	6 weeks

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: rana ibrahim ahmed, Bachelor Physical Therapy-MUST, Misr University for Science and Technology; Study Chair: Nasr Awad Abd Elkader, Assistant Professor, Physical Therapy for Musculoskeletal Disorders and its Surgeries Faculty of Physical Therapy Cairo University; Study Director: Abdelgalil Allam Abdelgalil, Lecturer of Physical Therapy, Physical Therapy for Musculoskeletal Disorders and its Surgeries Faculty of Physical Therapy Cairo University; Study Director: Mohammed Safwat Hamza, Associate Professor, Faculty of Medicine Misr University for Science and Technology

Study record dates

Study Major Dates

• Study Start (Actual): August 4, 2024
• Primary Completion (Estimated): January 15, 2025
• Study Completion (Estimated): January 30, 2025

Study Registration Dates

• First Submitted: December 26, 2024
• First Submitted That Met QC Criteria: December 26, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 26, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: core strengthening exercises, hip and knee-focused exercises, patellofemoral pain syndrome
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Mental Disorders; Pathologic Processes; Joint Diseases; Disease; Somatoform Disorders; Syndrome; Patellofemoral Pain Syndrome
• Other Study ID Numbers: No:P.T.REC/012/005347

Drug and device information, study documents

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