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Hamstring ShortnessPFPSNCT07013617

Effect of Specific Versus General Hamstring Stretch on Clinical Outcomes in Patellofemoral Pain Syndrome (PFPS)

A study testing Transcutaneous Electrical Nerve Stimulation Device, Strength exercises for lower limb and Hamstring Stretch Muscle Energy Technique(MET) (General ) in people with Hamstring Shortness and Patellofemoral Pain Syndrome, run by Cairo University at 1 site in Egypt.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This randomized, Single-blind, parallel-group trial will compare the effects of three hamstring stretching interventions-general hamstring Muscle Energy Technique (MET), medial hamstring MET, and lateral hamstring MET-each combined with standardized TENS and progressive hip/knee strengthening, on hamstring flexibility… Read more about this study

Who is it for?
Ages 18 to 37 years
What is being tested?
Transcutaneous Electrical Nerve Stimulation Device, Strength exercises for lower limb and Hamstring Stretch Muscle Energy Technique(MET) (General )
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteEgypt
Study dates
14 Jun 2025to Nov 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

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 37 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Anterior or retropatellar knee pain lasting at least three months
  • Pain reproduced by at least two functional tasks: squatting, kneeling, prolonged sitting, stair climbing, hopping or running
  • Pain intensity of ≥3 on a Visual Analog Scale
  • positive active knee extension test (inability to achieve greater than 160° of knee extension with the hip at 90° of flexion)
  • Body mass index (BMI) < 30 Kg/m² and > 18Kg/m²

Who cannot join

  • Previous knee surgery
  • History of knee pathologies, such as meniscal injury' ligament injury, or knee osteoarthritis
  • Psychological, cardiovascular' or neurological disorders
  • Dizziness or fainting while doing exercises, pregnancy, or any contraindications to exercise
  • Physical therapy treatment in the last 3 months

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Amna Ibrahim Shemila, BSc contact

201157072513

10722021419373@pg.cu.edu.eg

Ahmed Omar Abdelnaeem, lecturer contact

201140736820

ahmed.omar@pt.cu.edu.eg

Egypt1 site
  • faculty of physical therapy Cairo university

    Giza, Giza Governorate, 12613

    Amna Ibrahim Shemila, BSc, 201157072513, 10722021419373@pg.cu.edu.eg

    Ahmed Omar Abdelnaeem, lecturer, 2011407368020, ahmed.omar@pt.cu.edu.eg

Other trials in Egypt

About this study

Official title: Effect Of Hamstring Stretch On Clinical Outcomes In Patellofemoral Pain Syndrome

This randomized, Single-blind, parallel-group trial will compare the effects of three hamstring stretching interventions-general hamstring Muscle Energy Technique (MET), medial hamstring MET, and lateral hamstring MET-each combined with standardized TENS and progressive hip/knee strengthening, on hamstring flexibility (knee-extension ROM), anterior knee pain (Arabic Kujala score), pain intensity visual analogue scale (VAS), and lower-limb strength (hand-held dynamometer) in adults with patellofemoral pain syndrome (PFPS).

Read the detailed description

Patients with chronic PFPS will be randomized (1:1:1) into:

General MET group: standard non-specific hamstring MET stretch

Medial MET group: targeted medial-hamstring MET stretch

Lateral MET group: targeted lateral-hamstring MET stretch

All groups receive:

TENS: 20 min asymmetric biphasic square-pulse, 120 μs pulse width, 180 Hz, electrodes around patella (5-7 cm apart)

Strengthening: 3×/week for 4 weeks; hip/knee exercises, start 3×10 reps → 3×20, progress with weights or resistance bands.

Outcomes are measured pre-intervention and at 4 weeks. Analysis by mixed-design MANOVA (α < 0.05).

Being tested
Transcutaneous Electrical Nerve Stimulation Device, Strength exercises for lower limb, Hamstring Stretch Muscle Energy Technique(MET) (General ), Medial Hamstring Muscle energy technique(MET) stretch, Lateral hamstring Muscle Energy Technique(MET)Stretch
Keywords
patellofemoral pain syndrome, PFPS, hamstring flexibility, active knee extension test, medial hamstring, lateral hamstring, specific hamstring stretch, Muscle Energy Technique, TENS, Visual Analogue Scale, Hand Held Dynamometer (HHD), Kujala Score
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.

  • Transcutaneous Electrical Nerve Stimulation DeviceDevice

    Also called TENS

    Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.

  • Strength exercises for lower limbOther

    Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.

  • Hamstring Stretch Muscle Energy Technique(MET) (General )Other

    Also called Non-Specific hamstring stretch MET

    The participant will be supine and the leg will be taken into hip flexion until a tightness is felt then patient will be asked to push down with his lower leg and hold the contraction for 10 seconds then relax for 2 to 3 seconds then the therapist will take the patient's leg into further flexion for 30 seconds this will be repeated for 3 times each session .

  • Medial Hamstring Muscle energy technique(MET) stretchOther

    Also called specific medial hamstring MET stretch

    The Participant will be supine' then the therapist will take his leg in flexion, abduction and external rotation at the same time until he feels tightness then he will ask the patient to push his leg down and in or toward him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more abduction 'external rotation and flexion for 30 seconds, this will be repeated for 3 times each session

  • Lateral hamstring Muscle Energy Technique(MET)StretchOther

    Also called Specific lateral hamstring MET stretch

    The Participant will be supine' then the therapist will take his leg in flexion, adduction and internal rotation at the same time until he feels a tightness then he will ask the patient to push his leg down and out or away from him him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more adduction 'internal rotation and flexion for 30 seconds, this will be repeated for 3 times each session

Study groups in NCT07013617
Study groupRoleWhat they receive
Arm A (general hamstring stretch group)Active comparator* General hamstring Muscle energy technique (MET) * TENS 20 min * Hip/knee strengthening program
Receives: Device: Transcutaneous Electrical Nerve Stimulation Device; Other: Strength exercises for lower limb; Other: Hamstring Stretch Muscle Energy Technique(MET) (General )
Arm B (medial hamstring stretch)Active comparator* Medial hamstring MET * TENS 20 min * Hip/knee strengthening program
Receives: Device: Transcutaneous Electrical Nerve Stimulation Device; Other: Strength exercises for lower limb; Other: Medial Hamstring Muscle energy technique(MET) stretch
Arm C (lateral hamstring stretch)Active comparator* Lateral hamstring MET * TENS 20 min * Hip/knee strengthening program
Receives: Device: Transcutaneous Electrical Nerve Stimulation Device; Other: Strength exercises for lower limb; Other: Lateral hamstring Muscle Energy Technique(MET)Stretch

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. hamstring flexibility (knee extension range of motion )

    measuring knee extension range of motion(hamstring flexibility) by active knee extension test using kinovea software

    Measured: 4 weeks

  2. Arabic Kujala Anterior knee pain score

    Arabic Kujala Anterior knee pain score is used to measure pain and functional activities in anterior knee pain patients consisting of 13 questions, the Patient will be asked to mark the most suitable answer for him. Each answer has points up to 5 or 10, and the total score is 100.

    The higher the score, the better for the patient.

    Measured: 4 weeks

Secondary outcomes (2)
  1. pain intensity by visual analogue scale (VAS)

    from 0 to 10 centimeter line patient will detect on it the usual pain felt and the worst pain during the day

    Measured: 4 weeks

  2. lower limb strength using handheld dynamometer

    using handheld dynamometer to assessment the strength of hip abductor, extensors, external rotators and knee extensors

    Measured: 4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jun 2025
  2. Study start14 Jun 2025 (estimated)
  3. Primary completionOct 2025 (estimated)
  4. Study completionNov 2025 (estimated)

Resources

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
Single blind
Who is masked
Participant
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07013617
Sponsor's protocol ID
P.T.REC/012/005812
Acronym
PFPS
Status last verified
Jun 2025
First submitted
2 Jun 2025
Last updated
15 Jun 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zahra Rojhani-Shirazi, Mohamad Reza Salimifard, Fatemeh Barzintaj. Comparison of the effects of static stretching and muscle energy technique on Hamstring flexibility, pain, and function in athletes with patellofemoral pain. J Adv Pharm Edu Res 2021;11(S1):33-38.

  • Lopes HS, Waiteman MC, Priore LB, Glaviano NR, Bazett-Jones DM, Briani RV, Azevedo FM. There is more to the knee joint than just the quadriceps: A systematic review with meta-analysis and evidence gap map of hamstring strength, flexibility, and morphology in individuals with gradual-onset knee disorders. J Sport Health Sci. 2024 Jul;13(4):521-536. doi: 10.1016/j.jshs.2023.08.004. Epub 2023 Sep 3.

    PubMed 37669706
  • Wallis JA, Roddy L, Bottrell J, Parslow S, Taylor NF. A Systematic Review of Clinical Practice Guidelines for Physical Therapist Management of Patellofemoral Pain. Phys Ther. 2021 Mar 3;101(3):pzab021. doi: 10.1093/ptj/pzab021.

    PubMed 33533400
  • Hamdan M, Haddad B, Isleem U, Hamad A, Hussein L, Shawareb Y, Hadidi F, Alryalat SA, Samarah O, Khanfar A, Alzoubi B. Validation of the Arabic version of the Kujala patellofemoral pain scoring system. J Orthop Sci. 2019 Mar;24(2):290-293. doi: 10.1016/j.jos.2018.09.008. Epub 2018 Oct 10.

    PubMed 30316659
  • John Gibbons. (2022). Muscle energy techniques: a practical guide for physical therapists / JOHN GIBBONS (second edition). Lotus publishing / North Atlantic book

  • Puig-Divi A, Escalona-Marfil C, Padulles-Riu JM, Busquets A, Padulles-Chando X, Marcos-Ruiz D. Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives. PLoS One. 2019 Jun 5;14(6):e0216448. doi: 10.1371/journal.pone.0216448. eCollection 2019.

    PubMed 31166989
  • Hott A, Brox JI, Pripp AH, Juel NG, Liavaag S. Patellofemoral pain: One year results of a randomized trial comparing hip exercise, knee exercise, or free activity. Scand J Med Sci Sports. 2020 Apr;30(4):741-753. doi: 10.1111/sms.13613. Epub 2020 Jan 5.

    PubMed 31846113
  • Constantinou A, Mamais I, Papathanasiou G, Lamnisos D, Stasinopoulos D. Comparing hip and knee focused exercises versus hip and knee focused exercises with the use of blood flow restriction training in adults with patellofemoral pain. Eur J Phys Rehabil Med. 2022 Apr;58(2):225-235. doi: 10.23736/S1973-9087.22.06691-6. Epub 2022 Jan 5.

    PubMed 34985237

Questions about this trial

What is this clinical trial studying?

A study testing Transcutaneous Electrical Nerve Stimulation Device, Strength exercises for lower limb and Hamstring Stretch Muscle Energy Technique(MET) (General ) in people with Hamstring Shortness and 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 5 inclusion and 5 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: opening soon, as of the sponsor's last update on 15 Jun 2025. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Amna Ibrahim Shemila, BSc (201157072513, 10722021419373@pg.cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

hamstring flexibility (knee extension range of motion ) (time frame: 4 weeks). 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 NCT07013617, which also lists 8 linked publications.

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 15 Jun 2025.

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