Eccentric Biased Exercises Effect on Functional Outcomes in Iliopsoas Tendonitis

Effect of Eccentric Biased Exercises on Pain, Range of Motion and Quality of Life in Iliopsoas Tendonitis.

Hip and pelvis injuries represent 2-5% of all injuries. Among these injuries, groin pain is the most common finding. The most common injuries in the hip, pelvis, and thigh area are musculotendinous, (eg, quadriceps strain, adductor tendinitis) and, less commonly, iliopsoas tendinitis). Iliopsoas tendonitis is an inflammation of the tendon or area surrounding the tendon. Major causes of iliopsoas tendinitis are acute trauma and overuse resulting from repetitive hip flexion. Patients often present with anterior hip or groin pain of insidious onset. Initially, the patient may note pain after the onset of aggravating activity with resolution soon afterward.

The hip may be held in slight flexion and external rotation to ease tension on the musculotendinous unit. The patient's gait may demonstrate a shortened stride length on the affected side and increased knee flexion in the heel strike and midstance phases.This study aims to determine effects of eccentric biased exercises on pain ,ROM and quality of life in patients with iliopsoas tendonitis.

This Randomised controlled trial will be conducted at Riphah Rehab Training and Research Center in Lahore over time span of 9-month period. A sample size of 44 Participants age 20 to 55 meeting the inclusion criteria will be selected informed consent will be signed by the participants. Participants will be divided into two groups .

Group A will be controlled group receiving the standard physical therapy. Group B will be experimental group which will receive eccentric biased exercises. Outcome measures will be pain measured by Numeric Pain Rating scale, Range of Motion will be assessed by universal goniometer and quality of Life will be measured by HAGOS Score. Inclusion criteria include patients within age group 20-55 both male, female and trangenders included who have pain in hip groin region Exclusion criteria Include patients with any sign of inflammation ,severe pain ,trauma and fracture are excluded. Data will be analyzed using IBMM SPSS 25.0

Study Overview

• Status: Completed
• Conditions: Iliopsoas Syndrome; Eccentric Exercise Training
• Intervention / Treatment: Other: ECCENTRIC BIASED EXERCISES FOR ILIOPSOAS TENDONITIS

Detailed Description

Iliopsoas tendonitis is known to be an inflammatory condition of the iliopsoas tendon, this tendon connects the iliopsoas muscle to the hip bone and have a key role in hip flexion movement, inflammation of this tendon results in groin pain that causes significant pain and impaired mobility. Inflammation of this tendon is usually due to overuse injury, repetitive movement on hip joint or trauma. The current literatures suggest less prevalence of iliopsoas tendonitis and showed it as an uncommon condition because it is most often overlapped with the symptoms of other hip pathologies, especially anterior hip and groin pain. Early assessment and appropriate physiotherapy management is essential for recovery.

Objective: To determine the effects of Eccentric biased exercises on pain, range of motion and quality of life in patients with Iliopsoas Tendonitis.

Methods: A randomized clinical trial was conducted at Riphah Rehabilitation Clinic Lahore on 44 participants. Participants were assigned randomly into two groups: Group A received standardized physical therapy and Group B received standardized physical therapy combined with eccentric biased exercises. Both groups underwent 3 therapeutic appointments a week for a course of 6-weeks. Numeric Pain Rating Scale (NPRS), Universal Goniometer (UG) and HAGOS scale were utilized to determine pain, range of motion and hip related quality of life at baseline and post treatment values were calculated.

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

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Riphah International University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patient with age group 20 to 45
• Male ,female and transgenders.
• Patient with positive Thomas test for Iliopsoas tightness.
• Patient with positive left Ober test for ITB tightness.
• Patient with significant weakness (in MMT scores) of all hip musculature
• Patient with groin pain on the resisted side will be included with average 4-7 .

Exclusion Criteria:

• Patient with severe osteoarthritis.
• patient with recent history of trauma.
• patient with any fracture of hip and pelvis.
• patient with any signs of infection in the hip or groin region and will represent with warmth,fever,redness.
• Patients with other severe medical conditions like high vascular diseases should be contraindicated.
• Patient with recent surgery of hip.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: INTERVENTIONAL GROUP; ECCENTRIC BIASED EXERCISES FOR ILIOPSOAS TENDONITIS he subject assumed the right side lying position with a Perform Better. ● black monster band secured around the left ankle and the other end attached to a sturdy object behind her at about knee height.; The left hip will be maximally flexed with the knee flexed as well. This start position is similar to a running position.; To start the exercise, the subject slowly extended the hip, controlling against the pull into hip extension provided by the monster band for a count of "3" while keeping the knee flexed, until the hip was fully extended .; stretch on the iliopsoas at end range hip extension will be done; The subject will made a quick concentric contraction to the count of "1" quickly flexed the hip against the resistance of the band to move the left hip into full hip flexion to the start position.; The subject will be cued not to arch her back and to keep her abdominals engaged in order to stabilize the spine again	Other: ECCENTRIC BIASED EXERCISES FOR ILIOPSOAS TENDONITIS; Experimental: INTERVENTIONAL GROUP Arm Description: ECCENTRIC BIASED EXERCISES FOR ILIOPSOAS TENDONITIS he subject assumed the right side lying position with a Perform Better. ● black monster band secured around the left ankle and the other end attached to a sturdy object behind her at about knee height. ● The left hip will be maximally flexed with the knee flexed as well. This start position is similar to a running position. ● To start the exercise, the subject slowly extended the hip, controlling against the pull into hip extension provided by the monster band for a count of "3" while keeping the knee flexed, until the hip was fully extended . ● stretch on the iliopsoas at end range hip extension will be done ● The subject will made a quick concentric contraction to the count of "1" quickly flexed the hip against the resistance of the band to move the left hip into full hip flexion to the start position. ● The subject will be cued not to arch her back and to keep her abdominals engag
Placebo Comparator: traditional physical therapy; traditional physical therapy Description: Rest Icing for 7mins compression Elevation Subacute phase Hip stretches (iliopsoas, piriformis, hamstring, gluteals) Eccentric hip flexion of 15 reps. Lumbo-pelvic dislocation on Swiss ball (pelvic tilting anterior-posterior, medial lateral, clockwise/counter clockwise) Prone and supine core stability exercises ( 3 sets of 20 repetition for each arm and leg for endurance and control) twice per day over the course of 12 weeks pre and post intervention values will be taken on 1st day and after 12 weeks .The patients will be instructed to exercise into moderate pain, 5/10 on VAS which will be tolerated well without increase in the reactivity of the tendon.	Other: ECCENTRIC BIASED EXERCISES FOR ILIOPSOAS TENDONITIS; Experimental: INTERVENTIONAL GROUP Arm Description: ECCENTRIC BIASED EXERCISES FOR ILIOPSOAS TENDONITIS he subject assumed the right side lying position with a Perform Better. ● black monster band secured around the left ankle and the other end attached to a sturdy object behind her at about knee height. ● The left hip will be maximally flexed with the knee flexed as well. This start position is similar to a running position. ● To start the exercise, the subject slowly extended the hip, controlling against the pull into hip extension provided by the monster band for a count of "3" while keeping the knee flexed, until the hip was fully extended . ● stretch on the iliopsoas at end range hip extension will be done ● The subject will made a quick concentric contraction to the count of "1" quickly flexed the hip against the resistance of the band to move the left hip into full hip flexion to the start position. ● The subject will be cued not to arch her back and to keep her abdominals engag

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
universal goniometer	iometer for Range of Motion Goniometry is the art and science of measuring the joint ranges in each plane of the joint. A goniometer is the most common instrument used to measure range of motion. Here are some steps for measuring hip flexion with a goniometer: Have the patient lie on their back Flex the patient's hip while supporting their lower back with your hand Use landmarks on the pelvis to ensure that the measurement doesn't include motion in the lumbar spine Make sure the patient's pelvis is neutral at the beginning and end of the measurement The normal range of motion for hip flexion is 100-120 degrees, depending on the source. .	6 weeks
Numeric PAIN RATING SCALE	NPRS used to assess the pain representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable(21) The Numeric Pain Rating Scale (NPRS) is an 11-point scale used to measure pain intensity: 0: No pain 1-3: Mild pain 4-6: Moderate pain 7-10: Severe pain	6 weeks
HAGOS QUALITY OF LIFE QUESTIONNAIRE	The Copenhagen Hip and Groin Outcome Score is a patient-reported questionnaire that has six discrete subscales to assess Pain (10 items), Symptoms (7 items), Physical function in daily living (5 items), physical function in Sport and Recreation (8 items), Participation in Physical Activities (2 items) and hip and/or groin related Quality of Life (5 items). It has 37 items in total. Method of Use Six subscales make up the HAGOS questionnaire: Symptoms, Pain, ADL, Sport/Rec, PA, and QOL. Each subscale is rated independently, with a score ranging from 0 to 4 for each item. After the results are added together, the subscale scores are converted to a 0-100 scale. A score of 100 indicates the absence of hip and/or groin issues, while a score of 0 indicates significant hip and/or groin issues. The percentage of the total possible score attained is represented by the scores, which range from 0 to 100. There is no calculation of an overall score; instead, the subscales were examined.	6 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Saba Rafique, PhD, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): January 10, 2025
• Primary Completion (Actual): November 10, 2025
• Study Completion (Actual): December 22, 2025

Study Registration Dates

• First Submitted: February 17, 2026
• First Submitted That Met QC Criteria: February 17, 2026
• First Posted (Actual): February 23, 2026

Study Record Updates

• Last Update Posted (Actual): February 23, 2026
• Last Update Submitted That Met QC Criteria: February 17, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: pain; quality of life; range of motion
• Additional Relevant MeSH Terms: Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain
• Other Study ID Numbers: REC/RCR & AHS/24/0184

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