Effect of Specific Versus General Hamstring Stretch on Clinical Outcomes in Patellofemoral Pain Syndrome (PFPS)
NCT ID: NCT07013617
Last Updated: 2025-06-15
Study Results
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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NOT_YET_RECRUITING
NA
60 participants
INTERVENTIONAL
2025-06-14
2025-11-30
Brief Summary
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Detailed Description
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General MET group: standard non-specific hamstring MET stretch
Medial MET group: targeted medial-hamstring MET stretch
Lateral MET group: targeted lateral-hamstring MET stretch
All groups receive:
TENS: 20 min asymmetric biphasic square-pulse, 120 μs pulse width, 180 Hz, electrodes around patella (5-7 cm apart)
Strengthening: 3×/week for 4 weeks; hip/knee exercises, start 3×10 reps → 3×20, progress with weights or resistance bands.
Outcomes are measured pre-intervention and at 4 weeks. Analysis by mixed-design MANOVA (α \< 0.05).
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Arm A (general hamstring stretch group)
* General hamstring Muscle energy technique (MET)
* TENS 20 min
* Hip/knee strengthening program
Transcutaneous Electrical Nerve Stimulation Device
Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.
Strength exercises for lower limb
Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.
Hamstring Stretch Muscle Energy Technique(MET) (General )
The participant will be supine and the leg will be taken into hip flexion until a tightness is felt then patient will be asked to push down with his lower leg and hold the contraction for 10 seconds then relax for 2 to 3 seconds then the therapist will take the patient's leg into further flexion for 30 seconds this will be repeated for 3 times each session .
Arm B (medial hamstring stretch)
* Medial hamstring MET
* TENS 20 min
* Hip/knee strengthening program
Transcutaneous Electrical Nerve Stimulation Device
Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.
Strength exercises for lower limb
Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.
Medial Hamstring Muscle energy technique(MET) stretch
The Participant will be supine' then the therapist will take his leg in flexion, abduction and external rotation at the same time until he feels tightness then he will ask the patient to push his leg down and in or toward him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more abduction 'external rotation and flexion for 30 seconds, this will be repeated for 3 times each session
Arm C (lateral hamstring stretch)
* Lateral hamstring MET
* TENS 20 min
* Hip/knee strengthening program
Transcutaneous Electrical Nerve Stimulation Device
Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.
Strength exercises for lower limb
Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.
Lateral hamstring Muscle Energy Technique(MET)Stretch
The Participant will be supine' then the therapist will take his leg in flexion, adduction and internal rotation at the same time until he feels a tightness then he will ask the patient to push his leg down and out or away from him him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more adduction 'internal rotation and flexion for 30 seconds, this will be repeated for 3 times each session
Interventions
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Transcutaneous Electrical Nerve Stimulation Device
Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.
Strength exercises for lower limb
Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.
Hamstring Stretch Muscle Energy Technique(MET) (General )
The participant will be supine and the leg will be taken into hip flexion until a tightness is felt then patient will be asked to push down with his lower leg and hold the contraction for 10 seconds then relax for 2 to 3 seconds then the therapist will take the patient's leg into further flexion for 30 seconds this will be repeated for 3 times each session .
Medial Hamstring Muscle energy technique(MET) stretch
The Participant will be supine' then the therapist will take his leg in flexion, abduction and external rotation at the same time until he feels tightness then he will ask the patient to push his leg down and in or toward him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more abduction 'external rotation and flexion for 30 seconds, this will be repeated for 3 times each session
Lateral hamstring Muscle Energy Technique(MET)Stretch
The Participant will be supine' then the therapist will take his leg in flexion, adduction and internal rotation at the same time until he feels a tightness then he will ask the patient to push his leg down and out or away from him him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more adduction 'internal rotation and flexion for 30 seconds, this will be repeated for 3 times each session
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Pain reproduced by at least two functional tasks: squatting, kneeling, prolonged sitting, stair climbing, hopping or running
* Pain intensity of ≥3 on a Visual Analog Scale
* positive active knee extension test (inability to achieve greater than 160° of knee extension with the hip at 90° of flexion)
* Body mass index (BMI) \< 30 Kg/m² and \> 18Kg/m²
Exclusion Criteria
* History of knee pathologies, such as meniscal injury' ligament injury, or knee osteoarthritis
* Psychological, cardiovascular' or neurological disorders
* Dizziness or fainting while doing exercises, pregnancy, or any contraindications to exercise
* Physical therapy treatment in the last 3 months
18 Years
37 Years
ALL
No
Sponsors
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Cairo University
OTHER
Responsible Party
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Amna Ibrahim Mahmoud Mohammed Shemila
principal investigator
Locations
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faculty of physical therapy Cairo university
Giza, Giza Governorate, Egypt
Countries
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Central Contacts
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Facility Contacts
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References
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Zahra Rojhani-Shirazi, Mohamad Reza Salimifard, Fatemeh Barzintaj. Comparison of the effects of static stretching and muscle energy technique on Hamstring flexibility, pain, and function in athletes with patellofemoral pain. J Adv Pharm Edu Res 2021;11(S1):33-38.
Lopes HS, Waiteman MC, Priore LB, Glaviano NR, Bazett-Jones DM, Briani RV, Azevedo FM. There is more to the knee joint than just the quadriceps: A systematic review with meta-analysis and evidence gap map of hamstring strength, flexibility, and morphology in individuals with gradual-onset knee disorders. J Sport Health Sci. 2024 Jul;13(4):521-536. doi: 10.1016/j.jshs.2023.08.004. Epub 2023 Sep 3.
Wallis JA, Roddy L, Bottrell J, Parslow S, Taylor NF. A Systematic Review of Clinical Practice Guidelines for Physical Therapist Management of Patellofemoral Pain. Phys Ther. 2021 Mar 3;101(3):pzab021. doi: 10.1093/ptj/pzab021.
Hamdan M, Haddad B, Isleem U, Hamad A, Hussein L, Shawareb Y, Hadidi F, Alryalat SA, Samarah O, Khanfar A, Alzoubi B. Validation of the Arabic version of the Kujala patellofemoral pain scoring system. J Orthop Sci. 2019 Mar;24(2):290-293. doi: 10.1016/j.jos.2018.09.008. Epub 2018 Oct 10.
John Gibbons. (2022). Muscle energy techniques: a practical guide for physical therapists / JOHN GIBBONS (second edition). Lotus publishing / North Atlantic book
Puig-Divi A, Escalona-Marfil C, Padulles-Riu JM, Busquets A, Padulles-Chando X, Marcos-Ruiz D. Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives. PLoS One. 2019 Jun 5;14(6):e0216448. doi: 10.1371/journal.pone.0216448. eCollection 2019.
Hott A, Brox JI, Pripp AH, Juel NG, Liavaag S. Patellofemoral pain: One year results of a randomized trial comparing hip exercise, knee exercise, or free activity. Scand J Med Sci Sports. 2020 Apr;30(4):741-753. doi: 10.1111/sms.13613. Epub 2020 Jan 5.
Constantinou A, Mamais I, Papathanasiou G, Lamnisos D, Stasinopoulos D. Comparing hip and knee focused exercises versus hip and knee focused exercises with the use of blood flow restriction training in adults with patellofemoral pain. Eur J Phys Rehabil Med. 2022 Apr;58(2):225-235. doi: 10.23736/S1973-9087.22.06691-6. Epub 2022 Jan 5.
Other Identifiers
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P.T.REC/012/005812
Identifier Type: -
Identifier Source: org_study_id
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