Effect of Adding Blood Flow Restriction to Strengthening Exercise in Patients With Patellofemoral Pain Syndrome

NCT ID: NCT06565754

Last Updated: 2024-08-22

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-01

Study Completion Date

2026-04-01

Brief Summary

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To study the effect of adding BFRT to strengthening exercises and compare it with strengthening exercises alone in improving, muscular strength, pain, function, joint position sense, and dynamic balance test (star excursion test). in patients with PFPS.

Detailed Description

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Background: Patellofemoral Pain Syndrome (PFPS) is a common condition characterized by anterior knee pain, particularly affecting individuals aged 15-30. It often involves lower limb muscle weakness, particularly in the quadriceps, which can exacerbate symptoms and affect functional performance. Blood Flow Restriction Training (BFRT) has shown promise in enhancing muscle strength and functional outcomes with reduced intensity compared to traditional high-intensity training.

Purpose: This study aims to compare the efficacy of combining BFRT with traditional strengthening exercises versus using strengthening exercises alone in improving muscular strength, pain, function, joint position sense, and dynamic balance in patients with PFPS.

Methods: A triple-blinded, randomized controlled trial was conducted at the Almenshawy General Hospital, Tanta, Egypt. Fifty patients with unilateral non-traumatic PFPS, aged 18-35, were randomly assigned to either a strengthening exercises group (SE Group) or a BFRT plus strengthening exercises group (BFRT Group). Both groups underwent a 6-week intervention with three sessions per week. Outcomes assessed included quadriceps and hip abductors strength, pain severity (Visual Analog Scale), functional status (Kujala Patellofemoral Score), joint position sense (measured by digital inclinometer), and dynamic balance (Star Excursion Balance Test).

Conditions

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BFR PFPS Strengthening Exercises Quadriceps Strength Dynamic Balance Joint Position Sense

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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strengthening exercises group (SE Group)

all patients will receive :

1. Isometric quadriceps exercise - 3 sets of 20 repetitions (5 s).
2. Straight leg raise (SLR) with 3 sets - 20 repetitions.
3. Short arc knee extension exercise - 3 sets of 20 repetitions.
4. Hip abduction from side lying - 3 sets of 20 repetitions.

Group Type ACTIVE_COMPARATOR

strengthening exercise

Intervention Type OTHER

Quadriceps strengthening exercises are part of the treatment of PFPS, but the heavy resistance exercises may aggravate knee pain. Blood flow restriction training (BFRT) provides a low-load quadriceps strengthening method to treat PFPS (Giles et al., 2017).

BFRT plus strengthening exercises group (BFRT Group)

all patients will receive the below exercises using BFR cuff :

1. Isometric quadriceps exercise - 3 sets of 20 repetitions (5 s).
2. Straight leg raise (SLR) with 3 sets - 20 repetitions.
3. Short arc knee extension exercise - 3 sets of 20 repetitions.
4. Hip abduction from side lying - 3 sets of 20 repetitions.

Group Type EXPERIMENTAL

BFR

Intervention Type OTHER

Blood flow restriction training is an accessory to a variety of different exercise modes (e.g., resistance exercise, walking, cycling) has recently become a popular research topic. It involves the application of pressurized cuffs to the proximal portion of each lower extremity or upper extremity. It enhance blood pooling in the capillary beds of the limb muscles distal to the tourniquet or cuff.

The 3rd Generation SmartCuffs® pump (SmartCuffs® 3.0 PRO) is Personalized Pressure feature which allows for a fast, hassle-free personalized pressure calculation. With the built-in pressure sensor and on-board computer, it is calculate arterial occlusion pressure and set the optimal pressure for patient's body. There is no need for an external doppler probe or hand pump. This unit will do everything for patient. Smart Cuffs 3rd generation is FDA Approved Listed Class 1 device.

The automatized tourniquet (Smart Tools) contains a ring-shaped single- chamber

strengthening exercise

Intervention Type OTHER

Quadriceps strengthening exercises are part of the treatment of PFPS, but the heavy resistance exercises may aggravate knee pain. Blood flow restriction training (BFRT) provides a low-load quadriceps strengthening method to treat PFPS (Giles et al., 2017).

Interventions

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BFR

Blood flow restriction training is an accessory to a variety of different exercise modes (e.g., resistance exercise, walking, cycling) has recently become a popular research topic. It involves the application of pressurized cuffs to the proximal portion of each lower extremity or upper extremity. It enhance blood pooling in the capillary beds of the limb muscles distal to the tourniquet or cuff.

The 3rd Generation SmartCuffs® pump (SmartCuffs® 3.0 PRO) is Personalized Pressure feature which allows for a fast, hassle-free personalized pressure calculation. With the built-in pressure sensor and on-board computer, it is calculate arterial occlusion pressure and set the optimal pressure for patient's body. There is no need for an external doppler probe or hand pump. This unit will do everything for patient. Smart Cuffs 3rd generation is FDA Approved Listed Class 1 device.

The automatized tourniquet (Smart Tools) contains a ring-shaped single- chamber

Intervention Type OTHER

strengthening exercise

Quadriceps strengthening exercises are part of the treatment of PFPS, but the heavy resistance exercises may aggravate knee pain. Blood flow restriction training (BFRT) provides a low-load quadriceps strengthening method to treat PFPS (Giles et al., 2017).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient referred from Orthopedic surgeon with diagnosis of patellofemoral pain syndrome PFPS.
* Both genders.
* BMI ranges from 18.5 to 29.9.
* Age ranges between 18 and 40 years experienced non-traumatic PFPS onset of anterior knee pain for greater than 2 weeks.
* Pain with any two activities, including running, jumping, squatting, kneeling, stair ascent/descent or prolonged sitting.

Exclusion Criteria

* Coexisting pathology around the knee, including patellar subluxation or dislocation.
* Other sources of anterior knee pain (bursa, fat pad).
* Previous knee surgery.
* Suspicion of patellar tendinopathy, with strong consideration of pain localised to the patellar tendon.
* Any cardiovascular disease.
* Uncontrolled hypertension.
* Any lower limb trauma.
* Hip and ankle pathology.
* BMI more than 30%.
* Pregnancy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Mohamed Mahmoud Abdelaziz Khalil

doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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enas F youssef, Professor

Role: STUDY_CHAIR

Cairo University

abdelgalil A shaaban, PhD

Role: STUDY_DIRECTOR

Cairo University

ahmed S helal, PhD

Role: STUDY_DIRECTOR

Tanta University

ahmed M khalil, PhD

Role: STUDY_DIRECTOR

Pharos University in Alexandria

Locations

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Cairo University

Giza, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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ABDELRAHMAN M HEWID, MSc

Role: CONTACT

9294358403 ext. 9294358403

ahmed M khalil, PhD

Role: CONTACT

9294358403

Facility Contacts

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enas F youssef, Professor

Role: primary

+201127867507

abdelgalil A shaaban, PhD

Role: backup

+201146937036

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Study Documents

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Document Type: Study Protocol

View Document

Related Links

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https://bjsm.bmj.com/content/51/13/1003.abstract

This review found that BFR significantly improves muscle strength but is less effective than heavy-load training . BFR is a viable and tolerable rehab tool, needing personalized

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761718/

The study examines how low-intensity cycling with and without blood flow restriction (BFR) impacts muscle strength, hypertrophy, and aerobic capacity, addressing whether BFR can simultaneously enhance both muscular and cardiovascular fitness.

Other Identifiers

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P.T.REC/012/005148

Identifier Type: OTHER

Identifier Source: secondary_id

P.T.REC/012/005148

Identifier Type: -

Identifier Source: org_study_id

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