Adjunctive Effects of Heat vs Contrast Therapy With Otago Exercises on Patellofemoral Pain Syndrome (PFPS OEP CT HT)

Lahore University of Biological and Applied Sciences

Status: Not yet enrolling

Conditions: Patellofemoral Pain Syndrome

Treatments: Other: Heat therapy+Otago exercise program; Other: Contrast therapy+ Otago exercise program

Study type: Interventional

Funder types: Other

Identifiers

NCT07293195

LCPT/DPT/ERB/31

U1111-1332-0257 (Registry Identifier)

Details and patient eligibility

About

The goal of this clinical trial is to determine the adjunctive effects of heat therapy and contrast therapy when combined with the Otago exercise program in individuals with patellofemoral pain syndrome aged 18 to 40 years. The study aims to assess whether these interventions can help reduce pain and swelling, improve knee range of motion, and decrease functional limitations associated with patellofemoral pain syndrome. Researchers will compare two groups one receiving heat therapy with the Otago exercise program and the other receiving contrast therapy with the Otago exercise program to see which approach provides greater improvement in outcomes. Participants will undergo regular supervised sessions that include the assigned thermal therapy and a structured set of Otago exercises targeting lower limb strength, balance, and mobility.

Enrollment: 40 estimated patients

Sex: All

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Participants having age group between 18 and 40 years with anterior, retropatellar, or peripatellar pain with at least severity of 3/10 on the numerical pain rating scale.

Participants who have reported anterior knee pain for at least three months during at least two of the following activities: seating for prolonged periods of time; ascending and descending stairs; squatting; running and jumping, or have had experienced crepitus (popping, or crackling) while walking or running, pain on palpation, insidious pain lasting at least two months.

Positive patellar compression and Grind tests.

Clinical evidence of lateral patellar tracking, given its established role in patellofemoral joint dysfunction.

Pain produced by at least two of the following four tests: (i) isometric muscle contraction with a mild bent knee, (ii) patellofemoral joint line palpation, (iii) compression of patella against the femur and (iv) active resisted knee extension were enrolled in the study.

Exclusion criteria

Pain lasting less than three months, previous knee operations, meniscal lesions, patellar instability (subluxation/dislocation), clinical evidence of tendinopathy or ligamentous injury, fractures or dislocations involving the pelvis, spinal surgical history, osteoporosis, pregnancy, neurological diseases or radiological findings of chondromalacia beyond grade 2 on MRI, ultrasound, or X-ray.

Recent participation in lower-limb rehabilitation or structured training within six weeks, or prior diagnoses of rheumatoid arthritis, gout, or other rheumatic knee disorders.

Use of NSAIDs in the preceding four weeks, prior history of cancer, infection, psychiatric conditions, cognitive impairment, autoimmune pathology, or neurological dysfunction likely to interfere with walking ability.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

Experimental Group: Heat therapy with Otago exercises

Experimental group

Description:

1. Heat Therapy: * Frequency: 3 sessions/week for 4 weeks * Intensity: Mild to moderate heat (40°C) * Time: 15 minutes/session * Type: Passive superficial heat via electrical hot pack 2. Otago Exercise Program: * Frequency: 3 sessions/week supervised + daily home exercise for 4 weeks * Intensity: Progressively increasing strength and balance * Time: 30 minutes/session (includes warm-up and cool-down) * Type: Functional, strength, and balance exercises for lower limbs 3. Routine Physical Therapy (Medial Patellar Mobilization): * Frequency: 3 sessions/week for 4 weeks * Intensity: Gentle grade I/II mobilization * Time: 3 sets of 10 repetitions * Type: Passive sustained medial glides of patella

Treatment:

Other: Contrast therapy+ Otago exercise program

Other: Heat therapy+Otago exercise program

Active Experimental Group: Contrast therapy with Otago exercises

Active Comparator group

Description:

1. Contrast Therapy: * Frequency: 3 sessions/week for 4 weeks * Intensity: Heat (38-40°C) and cold (12-14°C) * Time: 15 minutes/session (4 min heat + 1 min cold cycles) * Type: Alternating hot/cold packs 2. Otago Exercise Program: * Frequency: 3 sessions/week supervised + daily home exercise for 4 weeks * Intensity: Progressively increasing strength and balance * Time: 30 minutes/session (includes warm-up and cool-down) * Type: Functional, strength, and balance exercises for lower limbs 3. Routine Physical Therapy (Medial Patellar Mobilization): * Frequency: 3 sessions/week for 4 weeks * Intensity: Gentle grade I/II mobilization * Time: 3 sets of 10 repetitions * Type: Passive sustained medial glides of patella

Treatment:

Other: Heat therapy+Otago exercise program