Do Power Exercises Result in Superior Benefits for People With Patellofemoral Pain?

Universidade Federal de Sao Carlos

Status: Unknown

Conditions: Patellofemoral Pain Syndrome

Treatments: Other: Strength and Power Training Group (SPTG); Other: Strength Training Group (STG)

Study type: Interventional

Funder types: Other

Identifiers

NCT03985254

LaiotUFSCAR

Details and patient eligibility

About

Patellofemoral pain (PFP) is one of the most common forms of knee pain and has a negative impact on the level of physical activity and quality of life of patients. Although strengthening of the hip and knee muscles has good clinical effects in the treatment of PFP, most exercise protocols do not follow the American College of Sports Medicine (ACSM) guidelines and are not clearly described, making it difficult to apply them in practice clinical and research. In addition, recent studies have shown that these patients also have a power deficit of these muscles. However, it is not known whether the addition of power exercises to a muscle strengthening program would result in superior benefits, especially in relation to pain and physical function. Therefore, the objective of this study is to verify if the improvement in pain intensity, physical function, kinesiophobia, self perception of improvement, quality of life and muscle function variables after a training program of strength and muscular power is superior to that observed in an isolated muscle strength training. This study will be randomized and controlled, developed with individuals with DPF, allocated in one of two groups: Strength Training Group (STG) and Strength and Power Training Group (SPTG). The primary outcomes will be intensity of pain and physical function, while the secondary outcomes will be kinesiophobia; self perception of improvement; quality of life; the peak of isometric abductor and hip extensor torque, and knee extensor; and the rate of development of torque of the abductors and extensors of hip, and extensors of knee at 30% and 90% of maximum isometric torque. Participants in both groups will be evaluated before the intervention (pre), after the end of the intervention (post) and three, six and twelve months after the intervention. Data analysis will follow the intention-to-treat principle. To compare the groups at different times (pre, post and after three, six and twelve months of the intervention) will be used two-way analysis of variance (GROUP X MOMENT) with mixed model, with Bonferroni post hoc to identify specific differences. The significance level will be 0.05.

Enrollment: 74 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• men and women with bilateral or unilateral patellofemoral pain

Exclusion criteria

• history of knee surgery
• history of hip or lumbar spine injury or pain
• patellar instability
• pain on palpation of the patellar tendon, iliotibial band, Hoffa fat, goose paw tendons or knee joint line
• signs or symptoms of meniscal or knee ligament injuries
• presence of Osgood-Schlatter syndrome or Sinding-Larsen-Johansson syndrome
• any vestibular, neurological or musculoskeletal alterations that interfere or contraindicate the procedures of this study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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74 participants in 2 patient groups

Strength Training Group (STG)

Active Comparator group

Description:

The strength training program will consist of applying resistance and progressive exercises for strength gain and will be based on the training principles recommended by the American College of Sport Medicine. The exercises were chosen based on a pilot study that successfully applied the protocol to 10 participants with FPD (data to be published) and other strength training studies (MASCALL et al, 2003; DISTEFANO et al, 2009; REIMAN et al, 2012; BALDON et al, 2014; SILVA et al, 2015). Initially, the goal will be the development of neuromotor control and resistance (load \<50% of the one repetition maximum test \[1RM\]), and in subsequent weeks the goal will be the development of muscle strength (load\> 70% 1RM). In addition, the protocol will initially focus on strengthening the hip and trunk muscles and after four weeks of training, exercises for the knee muscles will be included.

Treatment:

Other: Strength Training Group (STG)

Strength and Power Training Group (SPTG)

Experimental group

Description:

Participants who are allocated to this group will perform the same exercise program performed by the STG, but with the addition of exercises that emphasize power gain. As in the other group, initially, the objective will be the development of neuromotor control and resistance (load \<50% of the one repetition maximum test \[1RM\]). However, in subsequent weeks the goal will be to develop strength (load\> 70% 1RM) and muscle power (load between 40-60% 1RM).

Treatment:

Other: Strength and Power Training Group (SPTG)