Effect of Functional Strength Training of Hip Abductors in Runners With Medial Tibial Stress Syndrome
NCT ID: NCT05637476
Last Updated: 2024-01-16
Study Results
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Basic Information
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ACTIVE_NOT_RECRUITING
NA
40 participants
INTERVENTIONAL
2022-12-01
2024-06-30
Brief Summary
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Detailed Description
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The selected participants will be randomly assigned to two groups using a simple randomization method to allocate participants to the groups through the available online website www.randomization.com considering the control group as active control group. A flow diagram according to the Consolidated Standards of Reporting Trials (CONSORT) statement will be presented to illustrate the progression of this clinical trial .
Sample size calculation was performed using G\*POWER statistical software (version 3.1.9.2; Franz Faul, Universitat Kiel, Germany) based on data of knee valgus angle derived from Pourahmad et al., (2021) who investigated the effect of strengthening the abductor and external rotator on lower limb kinematics in volleyball players with patellofemoral complications. The sample size required for this study was approximately 15 subjects in each group. Calculation is made with α=0.05, power = 80% and effect size = 1.1. The sample size increased to 18 subjects per group for possible dropout of 20%.
For statistical analysis:
* Unpaired t-test will be conducted for comparison of the subject characteristics between groups.
* Chi- squared test will be conducted for comparison of sex distribution between groups.
* Mixed MANOVA will be conducted to investigate the effect of treatment on pain, function, contralateral pelvic drop angle and dynamic knee valgus.
* Post-hoc tests using the Bonferroni test were carried out for subsequent multiple comparison.
* Statistical measures will be performed through the statistical package for social studies (SPSS) version 25 for windows.
* The level of significance for all statistical tests will be set at p \< 0.05.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
SINGLE
Study Groups
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Group A (Active control group)
Group A (number=20): which is the control group with medial tibial stress syndrome, they will receive a selected physical therapy exercise program.
A selected physical therapy exercise program
Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises:
1. Strength dorsiflexors of the ankle-using rubber band.
2. Eccentric calf exercise (calf raise) .
3. Balance and proprioceptive exercise using wobble boards.
4. Stretch planter flexors (three sets of thirty repetitions, thirty seconds rest in between, three times per week)
Group B (Experimental group)
Group B (number=20): which is the experimental group with Medial tibial stress syndrome, they will receive the same physical therapy exercise program as group A in addition to, functional strength training of hip abductors.
Functional strength training of hip abductors
Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises:
1. Pelvic drop.
2. Single leg -bridge.
3. Side-lying hip abduction with hip internal rotation.
4. Lateral step-up.
5. Standing hip abduction on stance or swing leg with extra resistance .
A selected physical therapy exercise program
Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises:
1. Strength dorsiflexors of the ankle-using rubber band.
2. Eccentric calf exercise (calf raise) .
3. Balance and proprioceptive exercise using wobble boards.
4. Stretch planter flexors (three sets of thirty repetitions, thirty seconds rest in between, three times per week)
Interventions
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Functional strength training of hip abductors
Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises:
1. Pelvic drop.
2. Single leg -bridge.
3. Side-lying hip abduction with hip internal rotation.
4. Lateral step-up.
5. Standing hip abduction on stance or swing leg with extra resistance .
A selected physical therapy exercise program
Every participant will perform three sets of fifteen repetitions, fifteen seconds rest in between, three times per week for the following exercises:
1. Strength dorsiflexors of the ankle-using rubber band.
2. Eccentric calf exercise (calf raise) .
3. Balance and proprioceptive exercise using wobble boards.
4. Stretch planter flexors (three sets of thirty repetitions, thirty seconds rest in between, three times per week)
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Participants with bilateral affection, the most affected limb will be included in measurements.
* Body mass index range between (18.5-25 kg /m2 )
Exclusion Criteria
* Neurological problems that will affect lower extremity function
* Recent or old fractures at lower limbs
* Cognitive impairment
* Medications (anti-inflammatory/muscle relaxant)
* Tumours
25 Years
35 Years
ALL
No
Sponsors
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Cairo University
OTHER
Responsible Party
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Shreen Lashien
Senior musculoskeletal physiotherapist ,faculty of physical therapy
Principal Investigators
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Ebtessam F Gomaa, Doctorate
Role: STUDY_CHAIR
Cairo University
Locations
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Orthopedic out clinic of the faculty of Physical therapy, Cairo, University,and Gezira Youth Center.
Cairo, , Egypt
Countries
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References
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Robinson RL, Nee RJ. Analysis of hip strength in females seeking physical therapy treatment for unilateral patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2007 May;37(5):232-8. doi: 10.2519/jospt.2007.2439.
Irawan DS, Huoth C, Sinsurin K, Kiratisin P, Vachalathiti R, Richards J. Concurrent Validity and Reliability of Two-dimensional Frontal Plane Knee Measurements during Multi-directional Cutting Maneuvers. Int J Sports Phys Ther. 2022 Feb 2;17(2):148-155. doi: 10.26603/001c.31651. eCollection 2022.
Almeida GP, Silva AP, Franca FJ, Magalhaes MO, Burke TN, Marques AP. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop. 2016 Feb 9;51(2):181-6. doi: 10.1016/j.rboe.2016.01.010. eCollection 2016 Mar-Apr.
Cashman GE. The effect of weak hip abductors or external rotators on knee valgus kinematics in healthy subjects: a systematic review. J Sport Rehabil. 2012 Aug;21(3):273-84. doi: 10.1123/jsr.21.3.273.
Chuter VH, Janse de Jonge XA. Proximal and distal contributions to lower extremity injury: a review of the literature. Gait Posture. 2012 May;36(1):7-15. doi: 10.1016/j.gaitpost.2012.02.001. Epub 2012 Mar 21.
Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE. Hip strength in collegiate female athletes with patellofemoral pain. Med Sci Sports Exerc. 2007 Aug;39(8):1227-32. doi: 10.1249/mss.0b013e3180601109.
Craig DI. Medial tibial stress syndrome: evidence-based prevention. J Athl Train. 2008 May-Jun;43(3):316-8. doi: 10.4085/1062-6050-43.3.316.
Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. J Orthop Sports Phys Ther. 2008 Aug;38(8):448-56. doi: 10.2519/jospt.2008.2490. Epub 2008 Aug 1.
Ferber R, Davis IM, Williams DS 3rd. Gender differences in lower extremity mechanics during running. Clin Biomech (Bristol). 2003 May;18(4):350-7. doi: 10.1016/s0268-0033(03)00025-1.
Franklyn M, Oakes B. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World J Orthop. 2015 Sep 18;6(8):577-89. doi: 10.5312/wjo.v6.i8.577. eCollection 2015 Sep 18.
Galbraith RM, Lavallee ME. Medial tibial stress syndrome: conservative treatment options. Curr Rev Musculoskelet Med. 2009 Oct 7;2(3):127-33. doi: 10.1007/s12178-009-9055-6.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. doi: 10.1002/acr.20543. No abstract available.
Hreljac A, Marshall RN, Hume PA. Evaluation of lower extremity overuse injury potential in runners. Med Sci Sports Exerc. 2000 Sep;32(9):1635-41. doi: 10.1097/00005768-200009000-00018.
Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003 Nov;33(11):671-6. doi: 10.2519/jospt.2003.33.11.671.
Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004 Jun;36(6):926-34. doi: 10.1249/01.mss.0000128145.75199.c3.
Mehta SP, Fulton A, Quach C, Thistle M, Toledo C, Evans NA. Measurement Properties of the Lower Extremity Functional Scale: A Systematic Review. J Orthop Sports Phys Ther. 2016 Mar;46(3):200-16. doi: 10.2519/jospt.2016.6165. Epub 2016 Jan 26.
Menendez C, Batalla L, Prieto A, Rodriguez MA, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. Int J Environ Res Public Health. 2020 Oct 13;17(20):7457. doi: 10.3390/ijerph17207457.
Fredericson M, Bergman AG, Hoffman KL, Dillingham MS. Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. Am J Sports Med. 1995 Jul-Aug;23(4):472-81. doi: 10.1177/036354659502300418.
Willson JD, Davis IS. Utility of the frontal plane projection angle in females with patellofemoral pain. J Orthop Sports Phys Ther. 2008 Oct;38(10):606-15. doi: 10.2519/jospt.2008.2706.
Skouras AZ, Kanellopoulos AK, Stasi S, Triantafyllou A, Koulouvaris P, Papagiannis G, Papathanasiou G. Clinical Significance of the Static and Dynamic Q-angle. Cureus. 2022 May 11;14(5):e24911. doi: 10.7759/cureus.24911. eCollection 2022 May.
Lashien SA, Abdelnaeem AO, Gomaa EF. Effect of hip abductors training on pelvic drop and knee valgus in runners with medial tibial stress syndrome: a randomized controlled trial. J Orthop Surg Res. 2024 Oct 29;19(1):700. doi: 10.1186/s13018-024-05139-3.
Other Identifiers
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Medial tibial stress syndrome
Identifier Type: -
Identifier Source: org_study_id
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