Comparison of Exercise Therapies for Patellofemoral Pain

Summary

Patellofemoral Pain (PFP) is a common knee problem, primarily affecting adolescents and young adults. PFP is characterised by significant retropatellar and/or peripatellar pain and impairment of function and quality of daily life. Exercise therapy is unequivocally recommended as a core component of the management of PFP. Different exercise types (e.g. quadriceps strengthening, hip strengthening and functional/neuromuscular exercises) have been investigated, with knee and hip strengthening exercises as the most common and recommended types. These exercises approaches produce similar small to moderate effects on pain and physical function. However, the PFP population is very heterogeneous and "one-size-fits-all"-approaches presumably are sub-optimal because the heterogeneity is ignored. The heterogeneity probably explains the overall limited beneficial effects of exercise, and the lack of differences in direct comparisons of different exercise types. In that sense, it is not unlikely that certain patient characteristics may predict outcome success of either a hip training program or a training program that focus on the quadriceps but this remains to be shown.

This study has two aims:

1. To assess the comparative effectiveness of two different exercise programs (Quadricep Exercise \[QE\] vs. Hip Exercise \[HE\]) on self-reported pain and function in individuals with PFP.
2. To explore candidate patient characteristics that predict differential responses to the two exercise programs (QE vs HE) on self-reported pain and physical function in individuals with PFP.

According to the study aims we pursue the following hypothesis:

\- QE and HE have equivalent efficacy on self-reported pain after 12 weeks of treatment in patients with PFP.

The second study aim is to explore possible candidate patient characteristics that may associate with differential outcomes. As this is exploratory, the pursuit of this aim is hypothesis-free.

Conditions

• Patellofemoral Pain Syndrome

Interventions

OTHER

Quadriceps Exercise program

The exercise program is initiated at an individual clinical visit. An experienced physiotherapist introduces the participant to the exercise program and provides instructions to the individual exercises. An experienced physiotherapist provides the monthly supervision visits. The program details can be requested rom the responsible party. In brief the QE-program consists of: \- A short warm-up and 3 specific exercises for the quadriceps muscle Progression of the exercise intensity is done by adding (additional) external loads, such as elastic rubber bands, free weights, etc.

OTHER

Hip Exercise program

The exercise program is initiated at an individual clinical visit. An experienced physiotherapist introduces the participant to the exercise program and provides instructions to the individual exercises. An experienced physiotherapist provides the monthly supervision visits. The program details be requested rom the responsible party. In brief the HE-program consists of: \- A short warm-up and 3 specific exercises for the hip abductor and extensor muscles Progression of the exercise intensity is done by adding (additional) external loads, such as elastic rubber bands, body weight etc.

Sponsors & Collaborators

• Marius Henriksen

  lead OTHER

Principal Investigators

• Marius Henriksen, PT, PhD · Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospital

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2017-04-10

Primary Completion

2021-12-03

Completion

2022-03-03

Countries

• Denmark

Study Locations