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

NCT ID: NCT03985254

Last Updated: 2019-08-28

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 74 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-08-01
• Study Completion Date: 2021-07-01

Brief Summary

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.

Conditions

Patellofemoral Pain Syndrome

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Strength Training Group (STG)

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.

Group Type: ACTIVE_COMPARATOR

Strength Training Group (STG)

Intervention Type: OTHER

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.

Strength and Power Training Group (SPTG)

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).

Group Type: EXPERIMENTAL

Strength and Power Training Group (SPTG)

Intervention Type: OTHER

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).

Interventions

Strength Training Group (STG)

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.

Intervention Type: OTHER

Strength and Power Training Group (SPTG)

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).

Intervention Type: OTHER

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Universidade Federal de Sao Carlos

OTHER

Sponsor Role: lead

Responsible Party

Gabriela Souza de Vasconcelos

Post graduate

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Gabriela Souza de Vasconcelos

São Carlos, São Paulo, Brazil

Site Status: RECRUITING

Countries

Brazil

Central Contacts

Gabriela S de Vasconcelos, MsC

Role: CONTACT

vasconcelosgs@gmail.com

+5551995372276

Facility Contacts

Gabriela S de Vasconcelos

Role: primary

vasconcelosgs@gmail.com

51995372276

References

Vasconcelos GS, Nunes GS, Munhoz RF, da Silva MECB, Pisani GK, Luz BC, Serrao FV. Is strength and power training targeting hip and knee muscles superior to strength training in individuals with patellofemoral pain? Proof of concept study. Sci Rep. 2024 Nov 10;14(1):27450. doi: 10.1038/s41598-024-78074-2.

Reference Type: DERIVED

PMID: 39523423 (View on PubMed)

de Vasconcelos GS, Nunes GS, Barton CJ, Munhoz RF, da Silva MECB, Pisani GK, Luz BC, Serrao FV. Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial. Trials. 2021 Nov 6;22(1):777. doi: 10.1186/s13063-021-05748-x.

Reference Type: DERIVED

PMID: 34742328 (View on PubMed)

Other Identifiers

LaiotUFSCAR

Identifier Type: -

Identifier Source: org_study_id