Patellofemoral Pain SyndromeNCT05665452
Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome
A study testing Patellar mobilization, retinacula release, deep friction message, stretch and strength in people with Patellofemoral Pain Syndrome, run by Cairo University at 1 site in Egypt.
Trial summary
Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Patellofemoral Pain Syndrome
- What is being tested?
- Patellar mobilization, retinacula release, deep friction message, stretch and strength
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 59 participants
- Where
- 1 siteEgypt
- Study dates
- 15 Jan 2023to 18 Mar 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age ranging between 18 and 35 years
- Tenderness of medial and lateral borders of patella
- Retropatellar pain
- Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks
- Positive patellar compression test
- Pain intensity is more than 3 at visual analogue scale
- Had a history of insidious onset
- Had anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squatting
Who cannot join
- Previous patellar realignment surgery or patellar fracture
- Had a history of traumatic patellar dislocation
- Had a history of previous knee surgery
- Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis
- Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction
- Taking corticosteroids or nonsteroidal anti-inflammatory medication
- Inability to attend treatment program to the end of sessions
Trial locations and contacts
1 site in 1 country.
About this study
Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises.
Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.
Read the detailed description
this is interventional study in which patients will receive stretching and strengthening exercises in control group. in addition, experimental group will receive the same exercises of control group in addition to patellar mobilization, retinacula release and deep friction message.
- Conditions
- Patellofemoral Pain Syndrome
- Being tested
- Patellar mobilization, retinacula release, deep friction message, stretch and strength
- Keywords
- patellofemoral pain syndrome, strength, stretch, mobilization, release, deep friction message, retinacula
- Medical subject headings
- Patellofemoral Pain Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Patellar mobilization, retinacula release, deep friction message, stretch and strengthProcedure or surgery
All exercises will be performed for 30 to 45 minutes per session, 3 times per week for 4 weeks (12 sessions). Group (1): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise).
Group (2): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). manual therapy consists from iliotibial band release, deep friction message for lateral retinacula and medial patella mobilization.
| Study group | Role | What they receive |
|---|---|---|
| Group (1) | Active comparator | patients will receive stretch and strength exercises Receives: Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strength |
| Group (2) | Experimental | patients will receive stretch, strength, patellar mobilization, retinacula release and deep friction message Receives: Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strength |
What is being measured
The primary outcome is the main question the study is designed to answer.
Changes in pain that felt during ascending, descending, squatting and prolonged sitting
Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.
Measured: It will be assessed one week before and after treatment
Changes in functional disability
Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.
Measured: It will be assessed one week before and after treatment
Secondary outcomes (8)
Changes in hip abductors strength
It will be assessed using handheld dynamometer
Measured: It will be assessed one week before and after treatment
Changes in hip external rotators strength
It will be assessed using handheld dynamometer
Measured: It will be assessed one week before and after treatment
changes in quadriceps strength
It will be assessed using handheld dynamometer
Measured: It will be assessed one week before and after treatment
changes in functional performance
It will be assessed using step down test
Measured: It will be assessed one week before and after treatment
changes in hamstring flexibility
It will be assessed using 90-90 test
Measured: It will be assessed one week before and after treatment
changes in gastrocnemius flexibility
It will be assessed using ankle dorsiflexion range of motion
Measured: It will be assessed one week before and after treatment
changes in knee valgus
It will be assessed using Q angle
Measured: It will be assessed one week before and after treatment
changes in foot pronation
It will be assessed using navicular drop test
Measured: It will be assessed one week before and after treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Dec 2022
- Study start15 Jan 2023
- Primary completion11 Dec 2023
- Study completion18 Mar 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Patellofemoral Pain SyndromeStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 59 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Nadia Abdo Mohamed Abdelhafez, Cairo University
- Investigators
- Nadia A Mohamed, Msc, Principal investigator, Assistant lecturer at orthopedic department of faculty of physical therapy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05665452
- Sponsor's protocol ID
- P.T.REC/012/004020
- Status last verified
- Aug 2024
- First submitted
- 26 Oct 2022
- Last updated
- 21 Aug 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Abdo N, Youssef EF, Ibrahim MM. Efficacy of adding manual therapy to hip and knee exercises in patients with patellofemoral pain syndrome: a double-blinded randomized controlled clinical trial. Sci Rep. 2025 Sep 23;15(1):32655. doi: 10.1038/s41598-025-17453-9.
PubMed 40987761
Study at a glance
From the registry record, last updated by the sponsor on 21 Aug 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome
- ClinicalTrials.gov ID
- NCT05665452
- Acronym / sponsor ID
- P.T.REC/012/004020
- Conditions
- Patellofemoral Pain Syndrome
- Keywords
- patellofemoral pain syndrome, strength, stretch, mobilization, release, deep friction message, retinacula
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 59 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 15 Jan 2023 (actual)
- Primary completion
- 11 Dec 2023 (actual)
- Study completion
- 18 Mar 2024 (actual)
- First posted
- 27 Dec 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises.
Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.
Detailed description
this is interventional study in which patients will receive stretching and strengthening exercises in control group. in addition, experimental group will receive the same exercises of control group in addition to patellar mobilization, retinacula release and deep friction message.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group (1) | Active comparator | Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strengthpatients will receive stretch and strength exercises |
| Group (2) | Experimental | Procedure: Patellar mobilization, retinacula release, deep friction message, stretch and strengthpatients will receive stretch, strength, patellar mobilization, retinacula release and deep friction message |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Age ranging between 18 and 35 years
- Tenderness of medial and lateral borders of patella
- Retropatellar pain
- Duration of symptoms of patellofemoral pain syndrome is greater than 4 weeks
- Positive patellar compression test
Key exclusion criteria (7 listed)
- Previous patellar realignment surgery or patellar fracture
- Had a history of traumatic patellar dislocation
- Had a history of previous knee surgery
- Had any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritis
- Had a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunction
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Patellar mobilization, retinacula release, deep friction message, stretch and strengthAll exercises will be performed for 30 to 45 minutes per session, 3 times per week for 4 weeks (12 sessions). Group (1): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). Group (2): stretch exercises are performed for calf, hamstring, iliotibial band and quadriceps. strength exercises consist from open kinetic chain (hip abductors, hip external rotators and quadriceps) and closed kinetic chain exercises (mini wall squat exercise, forward step up exercise, lateral step up exercise and terminal knee extension exercise). manual therapy consists from iliotibial band release, deep friction message for lateral retinacula and medial patella mobilization. | Procedure or surgery | Group (1), Group (2) |
Primary outcome
Changes in pain that felt during ascending, descending, squatting and prolonged sitting
Time frame: It will be assessed one week before and after treatment
Pain during ascending, descending, squatting and prolonged sitting will be assessed using visual analogue scale, it is a horizontal line from 0 to 10, where 0 no pain and 10 maximum pain.
Changes in functional disability
Time frame: It will be assessed one week before and after treatment
Functional disability will be assessed using Kujala questionnaire.The scale ranges from 0 to 100 score where 100 represents no functional limitation.
8 secondary outcomes
Changes in hip abductors strength
Time frame: It will be assessed one week before and after treatment
Changes in hip external rotators strength
Time frame: It will be assessed one week before and after treatment
changes in quadriceps strength
Time frame: It will be assessed one week before and after treatment
changes in functional performance
Time frame: It will be assessed one week before and after treatment
changes in hamstring flexibility
Time frame: It will be assessed one week before and after treatment
changes in gastrocnemius flexibility
Time frame: It will be assessed one week before and after treatment
changes in knee valgus
Time frame: It will be assessed one week before and after treatment
changes in foot pronation
Time frame: It will be assessed one week before and after treatment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Aug 2024.
- Derived from this study: PubMed 40987761Abdo N, Youssef EF, Ibrahim MM. Efficacy of adding manual therapy to hip and knee exercises in patients with patellofemoral pain syndrome: a double-blinded randomized controlled clinical trial. Sci Rep. 2025 Sep 23;15(1):32655. doi: 10.1038/s41598-025-17453-9.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Nadia A Mohamed, Msc principal investigator
Assistant lecturer at orthopedic department of faculty of physical therapy
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Patellar mobilization, retinacula release, deep friction message, stretch and strength in people with Patellofemoral Pain Syndrome, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changes in pain that felt during ascending, descending, squatting and prolonged sitting (time frame: It will be assessed one week before and after treatment). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05665452, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Aug 2024.