Hip Strengthening Versus Quadriceps Based Training for Patellofemoral Pain Syndrome
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ClinicalTrials.gov Identifier: NCT02114294 |
Recruitment Status :
Active, not recruiting
First Posted : April 15, 2014
Last Update Posted : February 12, 2021
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Condition or disease | Intervention/treatment | Phase |
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Patellofemoral Pain Syndrome | Other: Isolated hip strengthening Other: Quadriceps based training Other: Active control | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 112 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Double (Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Does Isolated Hip Strengthening for Patellofemoral Pain Syndrome Give Better Long Term Results Than Traditional Quadriceps Based Training? A Randomised Controlled Trial. |
Study Start Date : | September 2014 |
Actual Primary Completion Date : | January 2019 |
Estimated Study Completion Date : | December 2023 |
Arm | Intervention/treatment |
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Experimental: Isolated hip strengthening
Isolated hip strengthening (abduction, external rotation, extension)
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Other: Isolated hip strengthening
Exercise program that is carried out by subjects under supervision once a week and then performed at home 2 additional times without supervision for a total of 6 weeks. Hip strengthening group will train hip abduction, hip external rotation and hip extension. |
Active Comparator: Quadriceps based training
Quadriceps based training (mini-squat, straight leg raising, terminal extensions)
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Other: Quadriceps based training
Exercise program that is carried out by subjects under supervision once a week and then performed at home 2 additional times without supervision for a total of 6 weeks. Quadriceps group will train mini-squat, straight leg raising, terminal extensions. |
Active control
Patients receive standardised information concerning patellofemoral pain syndrome, but receive no prescribed exercise regime. They are encouraged to remain active.
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Other: Active control
Patients receive standardised information concerning patellofemoral pain syndrome, but receive no prescribed exercise regime. They are encouraged to remain active. |
- Anterior knee pain score [ Time Frame: 3 months ]Anterior Knee Pain Score (AKPS) is a measurement of subjective symptoms and functional limitations in patellofemoral pain, and has been validated for use in this patient population. The AKPS consists of a 13-point questionnaire with categories related to different levels of function in the knee. The categories within each question are weighted, and the responses are summed for an overall index where 100 represents perfect function. The mean clinically important difference (MCID) has been determined to be 10 points. This questionnaire will be translated to Norwegian and validated according to standard scientific procedures with approval from Kuala et al.
- Visual Analog Scale (VAS) [ Time Frame: 3 months ]Visual Analog Scale (VAS) for pain (0-10cm)
- Global Score Global Score [ Time Frame: 3 months ]An 18-point likert scale for measuring patients' global assessment of change compared with baseline will be carried out at 3 and 12 months. The scale ranges from -9 (maximum deterioration) to +9 (maximum improvement).
- Step-down test [ Time Frame: 3 months ]The step down as performed according to standardised instruction will be used to quantify changes in patients' function. The measure is number of repetitions in 30 seconds.
- Hip abduction, external rotation and knee extension strength [ Time Frame: 3 months ]Isometric strength will be measured for hip abduction, hip external rotation and knee extension.
- Hip abduction endurance [ Time Frame: 3 months ]Testing is carried out in side-lying position with a 5kg weight around the ankle of the upper leg, which is abducted to 30 degrees above the horizontal plane. Time successfully held in target area is measured in seconds.
- EQ 5D 5L [ Time Frame: 3 months ]EQ-5D-5L is calculated on the basis of five questions about daily activities, pain and psychological status with five possible answers for each question. In addition the subject scores his/her overall health on a 1-100 scale. The results are translated to a single summary index value through the use of a table
- Tampa scale for kinesiophobia [ Time Frame: 3 months ]The Tampa scale for kinesiophobia (TSK) is a 13 -item questionnaire aimed at the assessment of fear of movement/re-injury. Each item is scored on a 4-point Likert scale with alternatives ranging from "strongly disagree" (0) to "strongly agree". This gives a possible total score range from 0 to 52.
- HSCL-10 [ Time Frame: 3 months ]The Hopkins Symptom Checklist (HSCL) is a symptom inventory which measures symptoms of anxiety and depression.
- Knee self-efficacy score (K-SES) [ Time Frame: 3 months ]K-SES is a self-administered instrument consisting of in total four sections in which patients score how certain they are about specific activities currently and in the future.
- Pain drawing with number of painful regions [ Time Frame: 3 months ]An adaptation of the Standardised Nordic Questionnaire will be used to register the number of painful areas.

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Ages Eligible for Study: | 16 Years to 40 Years (Child, Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 16-40 years
- Insidious onset of symptoms not related to trauma
- Symptoms more than 3 months
- A minimum of VAS 3 on VAS-W
- Peri- or retropatellar pain during or after at least two of the following: Stair ascent or descent, hopping, running, prolonged sitting, squatting, kneeling.
- Pain on one of the following: Compression of the patella, palpation of the patellar facets
Exclusion Criteria:
- Clinical findings indicative of meniscal or other intraarticular injury
- Clinical findings indicative of injury to or increased laxity of cruciate or collateral ligaments
- Findings on MRI indicative of other intraarticular pathology.
- Clinical and/or x-ray findings (plain anterior-posterior, lateral and skyline view) indicative of osteoarthritis, Osgood-Schlatter or Sinding-Larsen-Johanssen syndrome
- Clinical findings indicative of knee joint effusion
- Significant pain from hip or lumbar spine on clinical evaluation, with potential for causing referred pain to the knee or hindering the patient's ability to perform the prescribed exercises.
- Recurrent patellar subluxation or dislocation.
- Previous surgery to the knee joint
- NSAID or cortisone use over an extended period of time
- Having suffered trauma to the knee joint judged during clinical evaluation to have a significant effect on the presenting clinical condition.
- Physiotherapy or other similar treatment for patellofemoral pain syndrome within the previous 3 months

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02114294
Norway | |
Sorlandet hospital | |
Kristiansand, Vest Agder, Norway, 4633 |
Study Director: | Sigurd Liavaag, MD, PhD | Sørlandet sykehus HF | |
Principal Investigator: | Alexandra C Hott, MD | Sørlandet sykehus HF |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Sorlandet Hospital HF |
ClinicalTrials.gov Identifier: | NCT02114294 |
Other Study ID Numbers: |
2013/1860REK |
First Posted: | April 15, 2014 Key Record Dates |
Last Update Posted: | February 12, 2021 |
Last Verified: | February 2021 |
Patellofemoral pain syndrome Anterior knee pain Randomised controlled trial Exercise intervention |
Hip strengthening Quadriceps based training Anterior knee pain score |
Patellofemoral Pain Syndrome Syndrome Somatoform Disorders Disease |
Pathologic Processes Mental Disorders Joint Diseases Musculoskeletal Diseases |