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Effects of Isometric, Isotonic, and Eccentric VMO Exercises in Patellofemoral Pain Syndrome (VMO-PFPS)

7 maggio 2026 aggiornato da: Muharrem Gökhan Beydağı, Firat University

Comparison of the Effects of Isometric, Isotonic, and Eccentric Vastus Medialis Oblique Strengthening Exercises Applied in Terminal Knee Extension Range on Pain, Function, and Muscle Architecture in Individuals With Patellofemoral Pain Syndrome: A Randomized Controlled Trial

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition characterized by anterior knee pain, especially during activities such as stair climbing, squatting, running, and prolonged sitting. Weakness or delayed activation of the vastus medialis oblique (VMO) muscle is considered an important contributing factor in the development of PFPS.

This study aims to compare the effects of three different types of VMO strengthening exercises (isometric, isotonic, and eccentric) applied within the terminal knee extension range (0-30°) on pain, functional performance, and muscle architecture in individuals with PFPS.

Participants will be randomly assigned to one of three exercise groups. All participants will receive a standardized physiotherapy program, including heat therapy, TENS, and therapeutic ultrasound, followed by group-specific VMO strengthening exercises. The intervention will be performed three times per week for 8 weeks.

Outcomes will be assessed before and after the intervention and will include pain intensity (Visual Analog Scale), functional performance (WOMAC, 30-second sit-to-stand test, and stair test), and muscle architecture parameters measured by ultrasound imaging.

The results of this study are expected to provide evidence for optimizing rehabilitation strategies in individuals with PFPS.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Patellofemoral pain syndrome (PFPS) is a prevalent condition affecting physically active individuals and is associated with anterior knee pain during functional activities. Alterations in patellofemoral joint biomechanics, particularly related to quadriceps muscle imbalance and insufficient activation of the vastus medialis oblique (VMO), are considered key contributing factors.

Although VMO strengthening is widely used in clinical practice, there is limited evidence comparing the effects of different contraction types-specifically isometric, isotonic, and eccentric exercises-applied within the terminal knee extension range (0-30°), where patellofemoral joint stress and stabilization demands are highest.

This study is designed as a three-arm, parallel-group, randomized controlled trial to investigate the comparative effects of these exercise modalities on pain, functional outcomes, and muscle architecture. The intervention period will last 8 weeks, with sessions conducted three times per week.

A total of 90 participants aged 18-40 years with clinically diagnosed PFPS will be recruited and randomly allocated into three groups: isometric, isotonic, and eccentric exercise groups. All participants will receive a standardized physiotherapy protocol including superficial heat application, transcutaneous electrical nerve stimulation (TENS), and therapeutic ultrasound prior to exercise.

Primary outcomes will include pain intensity assessed by the Visual Analog Scale (VAS) and functional status evaluated using the WOMAC index, 30-second sit-to-stand test, and stair ascent/descent test. Secondary outcomes will include ultrasonographic assessment of muscle architecture, including muscle thickness, fascicle length, pennation angle, and physiological cross-sectional area of the VMO muscle. Additionally, selected hip muscles (adductor group and tensor fascia lata) will be evaluated.

Assessments will be performed at baseline (T0) and after the 8-week intervention (T1) by a blinded assessor. Randomization will be conducted using a computer-generated sequence with allocation concealment.

Statistical analyses will include repeated measures analysis to evaluate within-group and between-group differences, with significance set at p < 0.05.

The findings of this study are expected to contribute to evidence-based rehabilitation by identifying the most effective type of VMO strengthening exercise for improving clinical outcomes and muscle structure in individuals with PFPS.

Tipo di studio

Interventistico

Iscrizione (Stimato)

90

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

  • Turchia (Türkiye)
    • MErkez
      • Elâzığ, MErkez, Turchia (Türkiye), 23200
        • Firat University
        • Contatto:
        • Investigatore principale:
          • Muhammet Şahin Elbastı, PhD

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Aged between 18 and 40 years
  • Clinically diagnosed with patellofemoral pain syndrome
  • Presence of anterior knee pain for at least 3 months
  • Pain during activities such as stair climbing, squatting, running, or prolonged sitting
  • Pain intensity of at least 3/10 on the Visual Analog Scale (VAS)
  • Willingness to participate and provide written informed consent

Exclusion Criteria:

  • History of knee trauma or surgery
  • Meniscal injury, ligament injury, or knee instability
  • Advanced osteoarthritis
  • Neurological disorders
  • Rheumatologic diseases
  • Participation in a structured knee rehabilitation program within the last 6 months
  • Pregnancy

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Isometric Exercise Group
Participants in this group will receive a standardized physiotherapy program (hot pack, TENS, and therapeutic ultrasound) followed by isometric VMO strengthening exercises performed in the terminal knee extension range (0-30°). Exercises will be performed 3 sets of 10 repetitions, with 10-second contractions, three times per week for 8 weeks.
Altro: Isometric VMO Exercise
Isometric contractions of the vastus medialis oblique muscle will be performed with the knee supported at approximately 15° flexion, emphasizing maximal voluntary contraction without joint movement.
Altri nomi:
  • Experimental: Isometric Exercise Group
Sperimentale: Isotonic Exercise Group
Participants will receive the same standardized physiotherapy program followed by isotonic (concentric and eccentric) VMO strengthening exercises performed within the 0-30° knee extension range using external resistance. Exercises will be performed 3 sets of 10-15 repetitions, three times per week for 8 weeks.
Altro: Isotonic VMO Exercise
Participants will perform controlled concentric and eccentric contractions using ankle weights through a limited range of motion (0-30° knee extension).
Sperimentale: Eccentric Exercise Group
Participants will receive the same standardized physiotherapy program followed by eccentric VMO strengthening exercises performed within the 0-30° knee extension range. Exercises will be performed 3 sets of 10-15 repetitions, three times per week for 8 weeks.
Altro: Eccentric VMO Exercise
Participants will perform eccentric contractions against resistance during knee flexion, with assisted concentric return to the starting position.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
VMO Muscle Architecture (Ultrasound)
Lasso di tempo: Baseline and Week 8
Muscle thickness, fascicle length, pennation angle, and physiological cross-sectional area of the vastus medialis oblique muscle will be assessed using ultrasound imaging.
Baseline and Week 8

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Pain Intensity (Visual Analog Scale, VAS)
Lasso di tempo: Baseline and Week 8
Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.
Baseline and Week 8
Functional Status (WOMAC Index)
Lasso di tempo: Baseline and Week 8
Functional status will be evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), including pain, stiffness, and physical function subscales. Higher scores indicate worse functional status.
Baseline and Week 8
30-Second Sit-to-Stand Test
Lasso di tempo: Baseline and Week 8
The number of repetitions completed in 30 seconds will be recorded to assess lower extremity functional strength.
Baseline and Week 8
Stair Ascent and Descent Test
Lasso di tempo: Baseline and Week 8
Time required to ascend and descend a standardized 9-step staircase will be recorded in seconds.
Baseline and Week 8
Hip Muscle Architecture (Ultrasound)
Lasso di tempo: Baseline and Week 8
Muscle architecture parameters of the hip muscles (adductors and tensor fascia lata) will be evaluated using ultrasound imaging.
Baseline and Week 8

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Firat University

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

20 maggio 2026

Completamento primario (Stimato)

20 giugno 2026

Completamento dello studio (Stimato)

1 agosto 2026

Date di iscrizione allo studio

Primo inviato

27 aprile 2026

Primo inviato che soddisfa i criteri di controllo qualità

27 aprile 2026

Primo Inserito (Effettivo)

1 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

12 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

7 maggio 2026

Ultimo verificato

1 maggio 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • FU_MGBeydagi_PFAS_B_2026/05

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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