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

2026년 5월 7일 업데이트: 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.

연구 개요

상세 설명

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.

연구 유형

중재적

등록 (추정된)

90

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

    • MErkez
      • Elâzığ, MErkez, 터키 (Türkiye), 23200
        • Firat University
        • 연락하다:
        • 수석 연구원:
          • Muhammet Şahin Elbastı, PhD

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인

건강한 자원 봉사자를 받아들입니다

아니

설명

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

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 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.
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.
다른 이름들:
  • Experimental: Isometric Exercise Group
실험적: 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.
Participants will perform controlled concentric and eccentric contractions using ankle weights through a limited range of motion (0-30° knee extension).
실험적: 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.
Participants will perform eccentric contractions against resistance during knee flexion, with assisted concentric return to the starting position.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
VMO Muscle Architecture (Ultrasound)
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
Pain Intensity (Visual Analog Scale, VAS)
기간: 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)
기간: 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
기간: 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
기간: 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)
기간: 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

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 5월 20일

기본 완료 (추정된)

2026년 6월 20일

연구 완료 (추정된)

2026년 8월 1일

연구 등록 날짜

최초 제출

2026년 4월 27일

QC 기준을 충족하는 최초 제출

2026년 4월 27일

처음 게시됨 (실제)

2026년 5월 1일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 5월 12일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 5월 7일

마지막으로 확인됨

2026년 5월 1일

추가 정보

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아니

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슬개대퇴 통증 증후군에 대한 임상 시험

Isometric VMO Exercise에 대한 임상 시험

구독하다