Comparison Study of Two Chiropractic Treatment Protocols for Knee Pain Due to Patellofemoral Pain Syndrome - Full Text View

Sponsor:	Cleveland Chiropractic College
Information provided by:	Cleveland Chiropractic College
ClinicalTrials.gov Identifier:	NCT00401050

Purpose

The purpose of this study is to compare outcomes of combined chiropractic care in anterior knee pain patients with patellofemoral pain syndrome.

Condition	Intervention
Patellofemoral Pain Syndrome	Procedure: chiropractic manipulative therapy Procedure: knee exercises Procedure: Graston Instrument Soft Tissue Mobilization (GISTM)

Study Type:	Interventional
Study Design:	Treatment, Randomized, Single Blind, Active Control, Parallel Assignment
Official Title:	A Randomized Clinical Trial Comparing Two Chiropractic Protocols for Patellofemoral Pain Syndrome: a Pilot Study

Further study details as provided by Cleveland Chiropractic College:

Primary Outcome Measures:

Anterior Knee Pain Scale (AKPS)before treatment, after last treatment and at 2 month follow up
Visual Analogue Scale (VAS) before treatment, after last treatment and at 2 month follow up

Secondary Outcome Measures:

a functional measure (step-ups, step-downs and squats) before treatment, after last treatment and at 2 month follow up
Patient Satisfaction Scale at 2 month follow up only

Estimated Enrollment:	20
Study Start Date:	June 2006
Estimated Study Completion Date:	June 2008

Detailed Description:

Exercise is standard of care for PFPS but gives limited pain reduction and functional improvement. Previous manipulative therapy for PFPS (with and without exercise) has been limited to the patellofemoral joint alone. However, literature suggests additional manipulative therapy with exercise and soft-tissue treatment may give a better outcome. Further research is needed.

Therefore, this project is a pilot study to inform a future randomized controlled trial to determine if chiropractic adjusting of the full lower extremity (lumbosacral through foot) combined with exercise and soft tissue treatment (Protocol and group A) is superior to chiropractic adjusting of the knee (alone) combined with exercise and soft tissue treatment (Protocol and group B) in the treatment of patellofemoral pain syndrome. We will use the Anterior Knee Pain Scale (AKPS) and Visual Analogue Scale (VAS) as valid and reliable primary outcome measures, a functional measure (step-ups, step-downs and squats) and a Patient Satisfaction Scale (PSS - discharge or refer) as secondary outcome measures. This study will help establish the feasibility of conducting quality research at Cleveland Chiropractic College Los Angeles.

In this pilot study there will be two groups of 10 subjects each

Group A will receive CMT to the knee only, exercise and soft tissue treatment (Graston Instrument Soft Tissue Mobilization hereafter GISTM)
Group B will receive CMT to the lumbosacral, sacroiliac and (all) lower extremity joints, exercise and soft tissue treatment (GISTM).

Enrolled subjects will receive a total of 6 treatments. The primary endpoint will be a 2 month follow-up after the 6th treatment.

Eligibility

Ages Eligible for Study:	18 Years to 45 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

anterior, peri or retropatellar knee pain >3 months from at least two of the following: prolonged sitting, stair-climbing, squatting, running, kneeling, and hopping/jumping or overuse activities. Pain is relieved by rest.
insidious onset of symptoms unrelated to a traumatic incident; and
presence of pain on palpation of the patellar facets, on step down from a 25-cm step, or during a double-legged squat
other disorders such as OA, instability or medial meniscus injury must be ruled out
X-ray or MRI findings not required. There is no clear correlation between severity of complaints and arthroscopic or radiologic findings
A VAS-Worst pain of ≥ 5.0; a AKPS of ≥ 50.This reflects the current probability that less PFPS patients with less severity currently consult chiropractors for this disorder

Exclusion Criteria:

Patellar subluxation/dislocation
meniscal injuries
intra-articular pathology (ACL injury, etc)
ligament laxity
Osgood-Schlatters
Sinding-Larsen-Johanson syndrome
knee joint effusion
previous surgery on patellofemoral joint
illiteracy/inability to understand and answer questionnaires
inability to attend all treatment sessions
true locking of knee joint
a neurological disorder that influences gait
if taking medication, amount will be diarized - otherwise not allowed
foot orthotics allowed if already worn
arthritidies
bursitis
patellar tendonitis
older subjects > 45 years of age
subjects < 18 years of age
those that begin marked ↑ in physical activity during the course of the trial

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00401050

Locations

United States, California
Cleveland Chirpractic College Los Angeles
Los Angeles, California, United States, 90004

Sponsors and Collaborators

Cleveland Chiropractic College

Investigators

Principal Investigator:

James W. Brantingham, D.C., PhD.

Cleveland Chiropractic College Los Angeles

More Information

No publications provided

Study ID Numbers:	06-15-06
Study First Received:	November 16, 2006
Last Updated:	August 29, 2007
ClinicalTrials.gov Identifier:	NCT00401050 History of Changes
Health Authority:	United States: Institutional Review Board

Keywords provided by Cleveland Chiropractic College:

patellofemoral pain syndrome
chiropractic
knee pain
chiropractic manipulation
Graston Instrument Soft Tissue Mobilization(GISTM)

Additional relevant MeSH terms:

Pathologic Processes
Disease
Musculoskeletal Diseases
Mental Disorders

Joint Diseases
Patellofemoral Pain Syndrome
Syndrome
Somatoform Disorders

ClinicalTrials.gov processed this record on November 05, 2009