Adjunctive Effects of Heat vs Contrast Therapy With Otago Exercises on Patellofemoral Pain Syndrome (PFPS OEP CT HT)

May 18, 2026 updated by: Umber Nawaz, Lahore University of Biological and Applied Sciences

Adjunctive Effects of Heat Versus Contrast Therapy With Otago Exercises on Pain, Swelling, Range of Motion and Functional Limitations in Patients With Patellofemoral Pain Syndrome

The goal of this clinical trial is to determine the adjunctive effects of heat therapy and contrast therapy when combined with the Otago exercise program in individuals with patellofemoral pain syndrome aged 18 to 40 years. The study aims to assess whether these interventions can help reduce pain and swelling, improve knee range of motion, and decrease functional limitations associated with patellofemoral pain syndrome. Researchers will compare two groups one receiving heat therapy with the Otago exercise program and the other receiving contrast therapy with the Otago exercise program to see which approach provides greater improvement in outcomes. Participants will undergo regular supervised sessions that include the assigned thermal therapy and a structured set of Otago exercises targeting lower limb strength, balance, and mobility.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 57000
        • Ghurki Trust Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Participants having age group between 18 and 40 years with anterior, retropatellar, or peripatellar pain with at least severity of 3/10 on the numerical pain rating scale.

Participants who have reported anterior knee pain for at least three months during at least two of the following activities: seating for prolonged periods of time; ascending and descending stairs; squatting; running and jumping, or have had experienced crepitus (popping, or crackling) while walking or running, pain on palpation, insidious pain lasting at least two months.

Positive patellar compression and Grind tests.

Clinical evidence of lateral patellar tracking, given its established role in patellofemoral joint dysfunction.

Pain produced by at least two of the following four tests: (i) isometric muscle contraction with a mild bent knee, (ii) patellofemoral joint line palpation, (iii) compression of patella against the femur and (iv) active resisted knee extension were enrolled in the study.

Exclusion Criteria:

Pain lasting less than three months, previous knee operations, meniscal lesions, patellar instability (subluxation/dislocation), clinical evidence of tendinopathy or ligamentous injury, fractures or dislocations involving the pelvis, spinal surgical history, osteoporosis, pregnancy, neurological diseases or radiological findings of chondromalacia beyond grade 2 on MRI, ultrasound, or X-ray.

Recent participation in lower-limb rehabilitation or structured training within six weeks, or prior diagnoses of rheumatoid arthritis, gout, or other rheumatic knee disorders.

Use of NSAIDs in the preceding four weeks, prior history of cancer, infection, psychiatric conditions, cognitive impairment, autoimmune pathology, or neurological dysfunction likely to interfere with walking ability.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group: Heat therapy with Otago exercises

Heat Therapy:

  • Frequency: 3 sessions/week for 4 weeks
  • Intensity: Mild to moderate heat (40°C)
  • Time: 15 minutes/session
  • Type: Passive superficial heat via electrical hot pack

Otago Exercise Program:

  • Frequency: 3 sessions/week supervised + daily home exercise for 4 weeks
  • Intensity: Progressively increasing strength and balance
  • Time: 30 minutes/session (includes warm-up and cool-down)
  • Type: Functional, strength, and balance exercises for lower limbs

Routine Physical Therapy (Medial Patellar Mobilization):

  • Frequency: 3 sessions/week for 4 weeks
  • Intensity: Gentle grade I/II mobilization
  • Time: 3 sets of 10 repetitions
  • Type: Passive sustained medial glides of patella
Other: Heat therapy+Otago exercise program
Heat therapy is a non-surgical technique being recognized for its application in knee pain management. HT enhances blood flow, alleviates pain, and aids tissue repair. It have been effective in knee osteoarthritis but have yet to be fully explored for the treatment of PFPS.
Other Names:
  • Hot pack
  • Electrical Hot pack
Other: Contrast therapy+ Otago exercise program
Contrast therapy (CT), a commonly used thermal treatment, is gaining attention as a non-invasive option for managing knee pain. By alternating between heat and cold, CT helps stimulate circulation, reduce swelling, and ease joint stiffness. While it has shown benefits in other knee conditions, its potential role in treating patellofemoral pain syndrome (PFPS) is still not well established.
Active Comparator: Active Experimental Group: Contrast therapy with Otago exercises

Contrast Therapy:

  • Frequency: 3 sessions/week for 4 weeks
  • Intensity: Heat (38-40°C) and cold (12-14°C)
  • Time: 15 minutes/session (4 min heat + 1 min cold cycles)
  • Type: Alternating hot/cold packs

Otago Exercise Program:

  • Frequency: 3 sessions/week supervised + daily home exercise for 4 weeks
  • Intensity: Progressively increasing strength and balance
  • Time: 30 minutes/session (includes warm-up and cool-down)
  • Type: Functional, strength, and balance exercises for lower limbs

Routine Physical Therapy (Medial Patellar Mobilization):

  • Frequency: 3 sessions/week for 4 weeks
  • Intensity: Gentle grade I/II mobilization
  • Time: 3 sets of 10 repetitions
  • Type: Passive sustained medial glides of patella
Other: Heat therapy+Otago exercise program
Heat therapy is a non-surgical technique being recognized for its application in knee pain management. HT enhances blood flow, alleviates pain, and aids tissue repair. It have been effective in knee osteoarthritis but have yet to be fully explored for the treatment of PFPS.
Other Names:
  • Hot pack
  • Electrical Hot pack

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Swelling
Time Frame: 4 Weeks
Measured by a tape (Girth measurement)
4 Weeks
Range Of Motion
Time Frame: 4 Weeks
Measured by a universal goniometer.
4 Weeks
Pain Intensity
Time Frame: 4 Weeks
Assessed by using the NPRS scale. 0-4 scored as No pain to mild pain 5-7 scored as Moderate pain 8-10 scored as Severe pain
4 Weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Functional limtations
Time Frame: 4 Weeks
The Oxford Knee Score (OKS), knee pain severity and functional capacity using a scoring system from 0 (most severe impairment) to 48 (full function and no pain).
4 Weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Lahore University of Biological and Applied Sciences

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 10, 2025

Primary Completion (Actual)

May 10, 2026

Study Completion (Actual)

May 12, 2026

Study Registration Dates

First Submitted

December 6, 2025

First Submitted That Met QC Criteria

December 6, 2025

First Posted (Actual)

December 19, 2025

Study Record Updates

Last Update Posted (Actual)

May 20, 2026

Last Update Submitted That Met QC Criteria

May 18, 2026

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • LCPT/DPT/ERB/31
  • U1111-1332-0257 (Registry Identifier: WHO- Universal Trial Number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Will be shared after research publication

IPD Sharing Time Frame

6 months

IPD Sharing Access Criteria

Researcher, Layman,

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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