Comparison of IASTM and Muscle Energy Technique in Patellofemoral Pain Syndrome.

NCT ID: NCT06598618

Last Updated: 2025-02-21

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 48 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-10-02
• Study Completion Date: 2025-09-28

Brief Summary

The aim of this randomized controlled trial is to compare the effect of Instrument Assisted Soft Tissue Mobilization (IASTM) and muscle energy technique on iliotibial band tightness on pain, range of motion and functional mobility in patients with patellofemoral pain syndrome.

Detailed Description

Patellofemoral pain syndrome (PFPS) is termed as anterior knee pain and is characterized by peripatellar or retro patellar pain as a result of changes in the physical and biochemical components of the patellofemoral joint due to increased load during activities such as running, squatting, going up and down stairs, cycling and jumping. Patellofemoral syndrome is one of the most common knee conditions seen by clinicians. In active individuals, it may account for 25% to 40% of all knee problems The iliotibial band is a lateral thickening of the fascia which attaches to the tensor fascia lata proximally. Most of the lateral retinaculum (superficial oblique and deep transverse portion) arises from the ITB, therefore the ITB indirectly provides lateral stabilisation and acts as a passive restraint to medial patella glide. A tight ITB could theoretically lead to lateral patella tracking, lateral patella tilt and lateral patella compression. Several authors have suggested that tightness in the iliotibial band may contribute to patellofemoral syndrome and knee pain by pulling the patella laterally, thereby causing abnormal tracking of the patella in the trochlear groove.

The Instrument-Assisted Soft Tissue Mobilization (IASTM) technique is the most frequent soft tissue mobilization techniques. It involves the use of a tool that causes mechanical micro-traumatic injury to the treated area. As a result, an inflammatory reaction is elicited, speeding up the healing process and restoring the flexibility and integrity of the tissue and cartilage healing. The therapeutic effects of this approach appear to include decreasing tissue adhesion, enhancing the number of fibroblasts, and stimulating collagen synthesis.

Muscle energy technique is a soft tissue technique designed to improve musculoskeletal function through stretching tight muscles and fascia, to reduce pain and improve circulation. MET is characterized by a patient-induced skeletal muscle contraction against physiotherapist resistance in a controlled direction and position. The pathological barrier of a muscle is located through joint positioning which is followed by active muscle contraction by the patient moving away from the resistance followed by relaxation of the muscle. A new pathological barrier is located through passive movement and the process is repeated.

The rationale for the use of these techniques is to compare the effects of IASTM and MET of iliotibial band tightness in improving pain, range of motion and functional mobility in patients with patellofemoral pain syndrome.

Conditions

Patellofemoral Pain Syndrome

Study Design

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

Study Groups

Graston technique+ Conventional PT

Group Type: ACTIVE_COMPARATOR

Graston technique+ Conventional PT

Intervention Type: OTHER

IASTM technique (graston technique) on iliotibial band. Frequency 2 sessions of stroking with 20 seconds rest in between 3 times/week for 3 consecutive weeks Intensity as tolerated by patient. Conventional PT including 1- Therapeutic ultrasound at frequency of 3.5 MHZ for 10 minutes. 2- Stretching exercise of hamstrings. 3-Isometric exercises of Quadriceps

Muscle energy technique + Conventional PT

Group Type: OTHER

Muscle energy technique + Conventional PT

Intervention Type: OTHER

Muscle energy technique (post facilitation stretch) on iliotibial band. Frequency 10 repetitions 3 times/week for 3 consecutive weeks Intensity starting from 50 percent resistance across barrier provided by physiotherapist.. Conventional PT including 1- Therapeutic ultrasound at frequency of 3.5 MHZ for 10 minutes. 2- Stretching exercise of hamstrings. 3-Isometric exercises of Quadriceps.

Interventions

Graston technique+ Conventional PT

IASTM technique (graston technique) on iliotibial band. Frequency 2 sessions of stroking with 20 seconds rest in between 3 times/week for 3 consecutive weeks Intensity as tolerated by patient. Conventional PT including 1- Therapeutic ultrasound at frequency of 3.5 MHZ for 10 minutes. 2- Stretching exercise of hamstrings. 3-Isometric exercises of Quadriceps

Intervention Type: OTHER

Muscle energy technique + Conventional PT

Muscle energy technique (post facilitation stretch) on iliotibial band. Frequency 10 repetitions 3 times/week for 3 consecutive weeks Intensity starting from 50 percent resistance across barrier provided by physiotherapist.. Conventional PT including 1- Therapeutic ultrasound at frequency of 3.5 MHZ for 10 minutes. 2- Stretching exercise of hamstrings. 3-Isometric exercises of Quadriceps.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• • Age between 18 and 35 years

• Both Genders.
• Anterior or retro patellar knee pain for at least the past 3 months.
• Knee pain during at least 3 of the following activities: ascending/descending stairs, squatting, hopping/ running, and prolonged sitting.
• Retro patellar pain in patellar grind test (positive clarke's sign).
• A score of at least 3 on the visual analog scale (VAS).
• Positive Ober's test.

Exclusion Criteria

• • Any meniscal or ligament tears of knee.

• Knee osteoarthritis.
• Any previous surgery of lower limb.
• Patellar fracture or fracture of lower extremity.
• Having received knee injections of corticosteroids or hyaluronic acid.
• Osteoporosis of knee joint.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

KINZA ANWAR, MS-OMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Pakistan Railway hospital

Rawalpindi, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

KINZA ANWAR, MS-OMPT

Role: CONTACT

kinza.anwar@riphah.edu.pk

+92-3239735427

Facility Contacts

KINZA ANWAR, MS-OMPT

Role: primary

kinza.anwar@riphah.edu.pk

+92-3239735427

ALEEZAE SHAMIM, MS-OMPT*

Role: backup

Other Identifiers

REC/01872 Aleezae Shamim

Identifier Type: -

Identifier Source: org_study_id