Relation Between Femoral Nerve Conduction Velocity and Its Mechanosensitivity Changes Among Patellofemoral Pain Syndrome

NCT ID: NCT04624542

Last Updated: 2020-11-12

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 60 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2020-12-01
• Study Completion Date: 2021-08-01

Brief Summary

1. to investigate the relation between NCV of femoral nerve and other dependent variables such as ( pain & limited hip extension ROM )in patients with PFPS .

2. to predict using the NCV as a method for assessment femoral nerve mechanosensitivity in those with PFPS

Detailed Description

Patellofemoral pain syndrome (PFPS) is considered one of the most common condition affecting young active populations, it accounts for about 40% of individuals complaining from knee pain.PFPS is the anterior or retro patellar pain that can be precipitated by some daily activities such as ascending and descending stairs, kneeling, squatting or performing everyday tasks. Individuals with PFPS can experience a history of cracking or popping sounds when changing position or climbing stairs and also experience pain during repeated knee flexion. In a previous study conducted by Jensen et al .(2008),they observed that individuals with PFPS experienced symptoms that are related to neural compromise like patellar numbness and reduced ability to differentiate between different thermal stimulus .so PFPS may be related to neurological impairments or dysfunction.

Femoral slump test can be used in examining the neurodynamic responses in individuals with anterior knee pain which has a specificity of more than 75% in testing neural mechanosensitivity In a study conducted by Lin et al (2014) that examine the hip extension range of motion (ROM) and mechanical sensitivity of femoral nerve as a neurodynamic response in individuals with PFPS , they proposed that 30% of them have decrease hip extension ROM and increased mechanosensitivity comparison with healthy individuals. The current management of the patellofemoral pain support using open- and closed-chain exercises, strengthening, stretching, aerobic exercise, patellofemoral and tibiofemoral mobilizations, patellar taping, highintensity NMES, neuromuscular training, and gait retraining as a multi modal treatment for PFPS. Despite these methods result in significant improvement, other few patients reported some residual symptoms Hung et al .,(2015) have encouraged that using the femoral nerve mobilization as a neurodynamic management for treating PFPS patients especially those with postive femoral slump test , and testing the hip extension range of motion as a reference of improvement previous studies reported the presence of neurogenic dysfunction model to PFPS but most of these scientific researches lack the presence of the gold standard and objective method for identifying the neurogenic patellofemoral pain

Conditions

Patello Femoral Syndrome

Keywords

femoral nerve conduction velocity

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

group 1

Thirty individuals diagnosed with unilateral chronic PFPS from both genders and age between 18-35 years who will be referred from an orthopedic surgeon.

Electromyographic device

Intervention Type: DEVICE

the EMG machine will be used to measure NCV of femoral nerve within individuals with PFPS

control group

-30 healthy active individuals ranging from 18-36 yrs as a controlled group

Electromyographic device

Intervention Type: DEVICE

the EMG machine will be used to measure NCV of femoral nerve within individuals with PFPS

Interventions

Electromyographic device

the EMG machine will be used to measure NCV of femoral nerve within individuals with PFPS

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

1. Patient reporting symptoms of insidious onset and duration of at least 1 month (de Oliveira et al .,2016)

2. Peri- or retropatellar pain during at least 2 of the following activities: squatting, prolonged sitting, kneeling, running, jumping and climbing stairs (Vegstein et al., 2019)

3. Worst pain level in the previous month of up to 3cm on a 10cm numerical rating scale (NRS). (de Oliveira et al .,2016)

4. BMI 25-30 kg/cm2 (Nouri F et al .,2019)

5. Showing 2 or more positive signs on the following clinical tests:

Clarke's sign, Waldron test, active patellar grind test, patellar compression test ,and palpation of the medial/lateral articular border of the patella.(hung et al., 2015) To be included in the control group CG, participants could not present any signs or symptoms of PFP or other musculoskeletal conditions

Exclusion Criteria

• 1) inflammatory process of lower limb (Lin et al., 2014 ) 2) patellar tendon or meniscus tears (hung et al., 2015) 3) bursitis and ligament tears (hung et al., 2015) 4) Those who had undergone knee surgery, oral steroids and knee injection were excluded from this study (Vegstein et al., 2019) 5) lower back dysfunction such as disc lesion , sciatica or spondylolisthesis (Lin et al., 2014 ) 6) participants that had undergone physiotherapy during the preceding 6 months (de Oliveira et al .,2016)

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 36 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Nabil Abdo Abdellah Mohamed

lecturer of orthopedic physiotherapy /faculty of physical therapy cairo university

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

nabil ab abdo

Role: STUDY_DIRECTOR

PHD faculty of physical therapy Cairo university

Central Contacts

ramez fd fahim, Bachelor

Role: CONTACT

Phone: 201211553069

Email: ramezfahim1993@gmail.com

nabil ab abdo, PHD

Role: CONTACT

Phone: 201144259011

References

Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006 Mar;85(3):234-43. doi: 10.1097/01.phm.0000200390.67408.f0.

Reference Type: BACKGROUND

PMID: 16505640 (View on PubMed)

Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med. 2002 Jan;12(1):36-8. doi: 10.1097/00042752-200201000-00010. No abstract available.

Reference Type: BACKGROUND

PMID: 11854587 (View on PubMed)

Jensen R, Kvale A, Baerheim A. Is pain in patellofemoral pain syndrome neuropathic? Clin J Pain. 2008 Jun;24(5):384-94. doi: 10.1097/AJP.0b013e3181658170.

Reference Type: BACKGROUND

PMID: 18496302 (View on PubMed)

Jensen R, Hystad T, Kvale A, Baerheim A. Quantitative sensory testing of patients with long lasting Patellofemoral pain syndrome. Eur J Pain. 2007 Aug;11(6):665-76. doi: 10.1016/j.ejpain.2006.10.007. Epub 2007 Jan 3.

Reference Type: BACKGROUND

PMID: 17204440 (View on PubMed)

Eliav E, Benoliel R, Tal M. Inflammation with no axonal damage of the rat saphenous nerve trunk induces ectopic discharge and mechanosensitivity in myelinated axons. Neurosci Lett. 2001 Sep 21;311(1):49-52. doi: 10.1016/s0304-3940(01)02143-7.

Reference Type: BACKGROUND

PMID: 11585565 (View on PubMed)

Sanchis-Alfonso V, Rosello-Sastre E. Immunohistochemical analysis for neural markers of the lateral retinaculum in patients with isolated symptomatic patellofemoral malalignment. A neuroanatomic basis for anterior knee pain in the active young patient. Am J Sports Med. 2000 Sep-Oct;28(5):725-31. doi: 10.1177/03635465000280051801.

Reference Type: BACKGROUND

PMID: 11032232 (View on PubMed)

Heintjes E, Berger MY, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW. Exercise therapy for patellofemoral pain syndrome. Cochrane Database Syst Rev. 2003;(4):CD003472. doi: 10.1002/14651858.CD003472.

Reference Type: BACKGROUND

PMID: 14583980 (View on PubMed)

Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, Rathleff MS, Smith TO, Logan P. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS One. 2018 Jan 11;13(1):e0190892. doi: 10.1371/journal.pone.0190892. eCollection 2018.

Reference Type: RESULT

PMID: 29324820 (View on PubMed)

Other Identifiers

NCV for PFPS

Identifier Type: -

Identifier Source: org_study_id