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Effect of Hip Adduction Combination With Knee Extension Exercise on Morphology of Quadriceps Muscles, Pain and Functional Outcomes in Patients With PFPS

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified August 2005 by National Taiwan University Hospital.
Recruitment status was:  Recruiting
Information provided by:
National Taiwan University Hospital Identifier:
First received: September 11, 2005
Last updated: September 7, 2006
Last verified: August 2005

Quadriceps retraining, especially the vastus medialis oblique muscle strengthening, plays an important role in clinical management of patellofemoral pain syndrome. Vastus medialis oblique muscle roles as a dynamic stabilizer during the functional knee movement. It can generate a medial pulling force to patella against the lateral pulled by vastus lateralis. Thus it improves the patellofemoral joint compression force, reduces the knee pain, increases functional abilities, and patients’ quality of life.

Could vastus medialis oblique be isolation by way of specific exercise without or minimize the recruitment of vastus lateralis? According to human anatomy, vastus medialis oblique muscle origin from hip adductor magnus tendon, thus if incorporate hip adduction with knee extension as a selective means of training needs more researches. However, literature search shows that there are only a lot of EMG studies, so we need further clinical research to prove the treatment effect of this kind of strategy.

The purpose of the study is to investigate the treatment effects of hip adduction combine knee extension exercise in patients with patellofemoral pain syndrome. We use muscle morphology of quadriceps muscle, pain, and functional abilities as the main outcome measures. Besides, we will make further compare with traditional knee extension exercise. The first hypothesis of the study is that patients with patellofemoral pain syndrome will get improvement in muscle morphology of quadriceps muscle, pain, and functional abilities after hip adduction combine knee extension exercise training . The second hypothesis is that patients with patellofemoral pain syndrome who receive hip adduction combine knee extension exercise training will get more improvement in muscle morphology of quadriceps muscle, pain, and functional abilities than patients who receive traditional knee extension exercise training.

90 patients with patellofemoral pain syndrome who less than 50 years old will be included in this study, and randomly distributed to hip adduction combine knee extension exercise group, knee extension exercise group, and control group. Following 8 weeks exercise training by an experimental physical therapist, ultrasound measurement of muscle thickness and cross-sectional area of vastus medialis oblique muscle, vastus lateralis muscle, and rectus femoris muscle component of quadriceps, 10cm-VAS patellofemoral joint pain evaluation, including VAS-U, VAS-W, and VAS-activity, and Lysholm scale scores will be measured. A two-way mixed ANOVA will be used to compare the mean differences between theses three groups.

The study is aimed to provide an clinical evidence for evidence-based practice of rehabilitation in patients with patellofemoral pain syndrome.

Condition Intervention Phase
Patellofemoral Syndrome
Procedure: exercise training
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double-Blind
Primary Purpose: Educational/Counseling/Training

Resource links provided by NLM:

Further study details as provided by National Taiwan University Hospital:

Primary Outcome Measures:
  • muscle morphology of quadriceps
  • pain serverity
  • functional ability

Estimated Enrollment: 90
Study Start Date: September 2005
Estimated Study Completion Date: June 2006

Ages Eligible for Study:   20 Years to 50 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • patients with unilateral or bilateral patellofemoral pain syndrome:

    1. age <50 y/o
    2. have anterior or retropatellar knee pain on at least 2 of the following activities: prolonged sitting, ascending or descending stairs, squatting, running, kneeling, hopping/jumping
    3. have anterior or retropatellar knee pain on at least 2 of the following evaluations: patellar palpation, resisted knee extension, patellar compression
    4. have symptoms for at least 1 month, and pain level >3cm on a VAS scale

Exclusion Criteria:

  1. have severe knee pain (>8cm on a VAS scale) or referred pain
  2. recent history (within 3 months) of medical therapy for pain relief
  3. have history of knee surgery
  4. have central or peripheral neurological pain
  5. have severe knee deformity or malalignment of lower extremities
  6. have regular exercise habits (15-20 mins/time, >3times/week)
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Please refer to this study by its identifier: NCT00166777

NTU Recruiting
Taipei, Taiwan
Contact: MH Jan, master    886233228138   
Sponsors and Collaborators
National Taiwan University Hospital
Study Chair: MH Jan, master National Taiwan Uneversity Hospital
  More Information Identifier: NCT00166777     History of Changes
Other Study ID Numbers: 9461700808
Study First Received: September 11, 2005
Last Updated: September 7, 2006

Additional relevant MeSH terms:
Patellofemoral Pain Syndrome
Joint Diseases
Musculoskeletal Diseases processed this record on May 25, 2017