Effects of Posterior Oblique Sling Strengthening Exercises on Pain & Flexibility Among Runners With

NCT ID: NCT05915754

Last Updated: 2023-06-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-23

Study Completion Date

2023-07-10

Brief Summary

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The popularity of recreational running and rate of running related injuries are increasing. Research has shown that iliotibial band syndrome (ITBS) is one of the most common knee injuries among runners alongside plantar fasciitis, meniscal injuries, patellar tendinopathy, and patelleofemoral pain (PFP). ITBS is twice as common in female runners as compared to male long distance runners due to biomechanical variations. Literature supports the use of gluteal strengthening and IT band stretching as an effective treatment for iliotibial band syndrome. Posterior oblique sling is activated during running and its weakness is thought to be the predisposing factor of iliotibial band syndrome among long distance runners. The purpose of this study is to evaluate the effectiveness of posterior oblique sling exercises in decreasing lateral knee pain and improving flexibility of iliotibial band among female runner compared to gluteal strengthening and IT band stretching alone.

Data will be collected by using non-probability purposive sampling method. Sample size will be 26. 13 Female runners with average running of 15 kilometers per week and chronic iliotibial band syndrome will be employed in two different study groups A and B randomly. Both groups will get treatment for four weeks four times per week. Control group A will get conventional treatment of hip abductors strengthening and Iliotibial band stretching and Experimental group B will get posterior oblique sling strengthening exercises plus conventional hip abductors strengthening and IT band stretching. Pain and flexibility will be measured before treatment after every week and by the end of the month to note progression. Numeric Pain Rating Scale (NPRS) will be used to rate pain and modified Ober's test using digital inclinometer will be used to rate flexibility of iliotibial band. Statistical analysis will be done using SPSS latest version

Detailed Description

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The purpose of this study is to compare the two different treatment protocols for Iliotibial band syndrome and help create an effective treatment option for long distance runners who suffer lateral knee pain due to IT band tightness.

The study will be Randomized control trial. Non-probability purposive sampling method will be used.Subjective and objective data of all the participants will be taken by using NPRS, Modified Ober's test using Digital inclinometer, Noble's compression test and ITB Questionnaire.

Researcher will take careful history of the participant with proper assessment and examination of the knee.

At baseline, weekly and by the end of 4th week of treatment objective and subjective measurements of participants will be taken using NPRS, Modified Ober's test using Digital inclinometer, Noble's Compression test and ITB Questionnaire.

All the participants will receive equal treatment of 4 weeks. The Data will be analyzed using SPSS for windows software version 25. Statistical significance P=0.05. After assessing the normality of current data by shapiro wilk test. it will be decided whether parametric or non parametric test will be used within the groups or between 2 groups.

Conditions

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Iliotibial Band Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Hip abductors stretching and strengthening exercises

Patients will get the hip abductor stretching and strengthening exercise treatment for four weeks four times per week and will consist of four sets of 15 repetitions.

Group Type EXPERIMENTAL

Hip abductors stretching and strengthening exercises

Intervention Type OTHER

Treatment consist of four stretches for the ITB including: ITB stretch with trunk side bend, ITB stretch with trunk side bend and upward lateral reach, trunk side bend with downward lateral reach and side lying leg adduction and Strengthening exercise plan involving the gluteal muscle groups. These exercises include clams, side-lying abduction, reverse clams and supine bridge

Posterior oblique sling strengthening exercises

Patients will get treatment plan of Hip abductors stretching and strengthening exercises plus a posterior oblique sling strengthening program for four weeks, four times per week and will consist of four sets of 15 repetitions.

Group Type EXPERIMENTAL

Posterior oblique sling strengthening exercises

Intervention Type OTHER

Treatment consists of treatment A plus the intervention program of POSS consisted of four different exercises utilizing activation of the POSS. The intervention program focuses on one specific exercise each week that will progress in difficulty over the 4 weeks. The equipment used in the exercise progression included a blue, latex-free, medium-resistance theraband (TB), and the final exercise of the progression will include the use of a step stool. The TB will be used to increase the activation of the latissimus dorsi while simultaneously performing lower-extremity exercise to increase gluteal muscle involvement. The exercises are to be used in the 4-week progression.

Interventions

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Hip abductors stretching and strengthening exercises

Treatment consist of four stretches for the ITB including: ITB stretch with trunk side bend, ITB stretch with trunk side bend and upward lateral reach, trunk side bend with downward lateral reach and side lying leg adduction and Strengthening exercise plan involving the gluteal muscle groups. These exercises include clams, side-lying abduction, reverse clams and supine bridge

Intervention Type OTHER

Posterior oblique sling strengthening exercises

Treatment consists of treatment A plus the intervention program of POSS consisted of four different exercises utilizing activation of the POSS. The intervention program focuses on one specific exercise each week that will progress in difficulty over the 4 weeks. The equipment used in the exercise progression included a blue, latex-free, medium-resistance theraband (TB), and the final exercise of the progression will include the use of a step stool. The TB will be used to increase the activation of the latissimus dorsi while simultaneously performing lower-extremity exercise to increase gluteal muscle involvement. The exercises are to be used in the 4-week progression.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Female Treadmill runners of age 18 to 35 years.
* Perform running of average 15 running kilometers per week and Experience of burning lateral knee pain after 2nd-3rd kilometer of running
* Localized point tenderness over the femoral condyle about 2-4 cm above joint line on palpation
* Positive Noble's Compression test
* Positive modified Ober's Test

Exclusion Criteria

* Short distance runners
* People with any other medical condition Including myofacial pain syndrome, early degenerative joint disease, lateral collateral ligament pathology, lateral meniscal injuries, tibiofibular joint sprain, popliteal or biceps femoris tendonitis, or referred pain from lumbar spine. All these conditions will be ruled out with carefully history and examination
* People taking any other form of treatment including corticosteroids, non-steroidal anti-inflammatory drugs or analgesics
* People with previous history of surgical treatment for ITBS
* People with neurological deficits or systemic illness
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dr.Nosheen Manzoor, MS-OMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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SHAPES gymnasium

Lahore, Punjab Province, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Dr. Nosheen Manzoor, MS-OMPT

Role: CONTACT

03236877879

Facility Contacts

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Awais Manzoor

Role: primary

03234446846

References

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Foch E, Reinbolt JA, Zhang S, Fitzhugh EC, Milner CE. Associations between iliotibial band injury status and running biomechanics in women. Gait Posture. 2015 Feb;41(2):706-10. doi: 10.1016/j.gaitpost.2015.01.031. Epub 2015 Feb 7.

Reference Type BACKGROUND
PMID: 25701012 (View on PubMed)

Charles D, Rodgers C. A LITERATURE REVIEW AND CLINICAL COMMENTARY ON THE DEVELOPMENT OF ILIOTIBIAL BAND SYNDROME IN RUNNERS. Int J Sports Phys Ther. 2020 May;15(3):460-470.

Reference Type BACKGROUND
PMID: 32566382 (View on PubMed)

Gordon S. Iliotibial Band Syndrome. Clinical Practice Guidelines. 2018:321.

Reference Type BACKGROUND

Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-9. doi: 10.2165/00007256-200535050-00006.

Reference Type BACKGROUND
PMID: 15896092 (View on PubMed)

van der Worp MP, van der Horst N, de Wijer A, Backx FJ, Nijhuis-van der Sanden MW. Iliotibial band syndrome in runners: a systematic review. Sports Med. 2012 Nov 1;42(11):969-92. doi: 10.2165/11635400-000000000-00000.

Reference Type BACKGROUND
PMID: 22994651 (View on PubMed)

Mouw J. The Effects of Posterior Oblique Sling Exercises on a Runner with Iliotibial Band Syndrome: Azusa Pacific University; 2019.

Reference Type BACKGROUND

McKay J, Maffulli N, Aicale R, Taunton J. Iliotibial band syndrome rehabilitation in female runners: a pilot randomized study. J Orthop Surg Res. 2020 May 24;15(1):188. doi: 10.1186/s13018-020-01713-7.

Reference Type BACKGROUND
PMID: 32448384 (View on PubMed)

Gangat AK. The effectiveness of gluteus medius and iliotibial band stretching, versus strengthening, in the rehabilitation of iliotibial band syndrome in long distance runners. 2005.

Reference Type BACKGROUND

Baker RL, Fredericson M. Iliotibial Band Syndrome in Runners: Biomechanical Implications and Exercise Interventions. Phys Med Rehabil Clin N Am. 2016 Feb;27(1):53-77. doi: 10.1016/j.pmr.2015.08.001.

Reference Type BACKGROUND
PMID: 26616177 (View on PubMed)

SieunNarine-McKay J. Evaluation of outcomes in assessment of iliotibial band syndrome rehabilitation programs: University of British Columbia; 2016

Reference Type BACKGROUND

Rosenthal MD. Clinical testing for extra-articular lateral knee pain. A modification and combination of traditional tests. N Am J Sports Phys Ther. 2008 May;3(2):107-9.

Reference Type BACKGROUND
PMID: 21509133 (View on PubMed)

Kahl C, Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill Pain Questionnaire: an overview of psychometric properties. Physical therapy reviews. 2005;10(2):123-8.

Reference Type BACKGROUND

Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986 Oct;27(1):117-126. doi: 10.1016/0304-3959(86)90228-9.

Reference Type BACKGROUND
PMID: 3785962 (View on PubMed)

Kesminas R, Burbulevičiūtė J. Ober's Test and Modified Ober's Test are Reliable Means of Measuring Iliotibial Band using both Goniometer and Inclinometer. Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija. 2019;2

Reference Type BACKGROUND

Colaco J, Dudley N, Karmacharya N, Holbein-Jenny M. Interrater reliability and validity of Ober's, Noble compression, and modified Thomas tests. Physical therapy. 2002:5-8

Reference Type BACKGROUND

Other Identifiers

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REC/RCR&AHS/23/0420

Identifier Type: -

Identifier Source: org_study_id

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