Adjunctive Effects of Heat vs Contrast Therapy With Otago Exercises on Patellofemoral Pain Syndrome

NCT ID: NCT07293195

Last Updated: 2025-12-19

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-10
• Study Completion Date: 2026-05-24

Brief Summary

The goal of this clinical trial is to determine the adjunctive effects of heat therapy and contrast therapy when combined with the Otago exercise program in individuals with patellofemoral pain syndrome aged 18 to 40 years. The study aims to assess whether these interventions can help reduce pain and swelling, improve knee range of motion, and decrease functional limitations associated with patellofemoral pain syndrome. Researchers will compare two groups one receiving heat therapy with the Otago exercise program and the other receiving contrast therapy with the Otago exercise program to see which approach provides greater improvement in outcomes. Participants will undergo regular supervised sessions that include the assigned thermal therapy and a structured set of Otago exercises targeting lower limb strength, balance, and mobility.

Conditions

Patellofemoral Pain Syndrome

Keywords

Patellofemoral pain syndrome(PFPS), Heat therapy(HT), Contrast therapy(CT),Otago exercise program(OEP)

Study Design

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

Study Groups

Experimental Group: Heat therapy with Otago exercises

1. Heat Therapy:

• Frequency: 3 sessions/week for 4 weeks
• Intensity: Mild to moderate heat (40°C)
• Time: 15 minutes/session
• Type: Passive superficial heat via electrical hot pack

2. Otago Exercise Program:

• Frequency: 3 sessions/week supervised + daily home exercise for 4 weeks
• Intensity: Progressively increasing strength and balance
• Time: 30 minutes/session (includes warm-up and cool-down)
• Type: Functional, strength, and balance exercises for lower limbs

3. Routine Physical Therapy (Medial Patellar Mobilization):

• Frequency: 3 sessions/week for 4 weeks
• Intensity: Gentle grade I/II mobilization
• Time: 3 sets of 10 repetitions
• Type: Passive sustained medial glides of patella

Group Type: EXPERIMENTAL

Heat therapy+Otago exercise program

Intervention Type: OTHER

Heat therapy is a non-surgical technique being recognized for its application in knee pain management. HT enhances blood flow, alleviates pain, and aids tissue repair. It have been effective in knee osteoarthritis but have yet to be fully explored for the treatment of PFPS.

Contrast therapy+ Otago exercise program

Intervention Type: OTHER

Contrast therapy (CT), a commonly used thermal treatment, is gaining attention as a non-invasive option for managing knee pain. By alternating between heat and cold, CT helps stimulate circulation, reduce swelling, and ease joint stiffness. While it has shown benefits in other knee conditions, its potential role in treating patellofemoral pain syndrome (PFPS) is still not well established.

Active Experimental Group: Contrast therapy with Otago exercises

1. Contrast Therapy:

• Frequency: 3 sessions/week for 4 weeks
• Intensity: Heat (38-40°C) and cold (12-14°C)
• Time: 15 minutes/session (4 min heat + 1 min cold cycles)
• Type: Alternating hot/cold packs

2. Otago Exercise Program:

• Frequency: 3 sessions/week supervised + daily home exercise for 4 weeks
• Intensity: Progressively increasing strength and balance
• Time: 30 minutes/session (includes warm-up and cool-down)
• Type: Functional, strength, and balance exercises for lower limbs

3. Routine Physical Therapy (Medial Patellar Mobilization):

• Frequency: 3 sessions/week for 4 weeks
• Intensity: Gentle grade I/II mobilization
• Time: 3 sets of 10 repetitions
• Type: Passive sustained medial glides of patella

Group Type: ACTIVE_COMPARATOR

Heat therapy+Otago exercise program

Intervention Type: OTHER

Heat therapy is a non-surgical technique being recognized for its application in knee pain management. HT enhances blood flow, alleviates pain, and aids tissue repair. It have been effective in knee osteoarthritis but have yet to be fully explored for the treatment of PFPS.

Interventions

Heat therapy+Otago exercise program

Heat therapy is a non-surgical technique being recognized for its application in knee pain management. HT enhances blood flow, alleviates pain, and aids tissue repair. It have been effective in knee osteoarthritis but have yet to be fully explored for the treatment of PFPS.

Intervention Type: OTHER

Contrast therapy+ Otago exercise program

Contrast therapy (CT), a commonly used thermal treatment, is gaining attention as a non-invasive option for managing knee pain. By alternating between heat and cold, CT helps stimulate circulation, reduce swelling, and ease joint stiffness. While it has shown benefits in other knee conditions, its potential role in treating patellofemoral pain syndrome (PFPS) is still not well established.

Intervention Type: OTHER

Other Intervention Names

Hot pack; Electrical Hot pack

Eligibility Criteria

Inclusion Criteria

Participants having age group between 18 and 40 years with anterior, retropatellar, or peripatellar pain with at least severity of 3/10 on the numerical pain rating scale.

Participants who have reported anterior knee pain for at least three months during at least two of the following activities: seating for prolonged periods of time; ascending and descending stairs; squatting; running and jumping, or have had experienced crepitus (popping, or crackling) while walking or running, pain on palpation, insidious pain lasting at least two months.

Positive patellar compression and Grind tests.

Clinical evidence of lateral patellar tracking, given its established role in patellofemoral joint dysfunction.

Pain produced by at least two of the following four tests: (i) isometric muscle contraction with a mild bent knee, (ii) patellofemoral joint line palpation, (iii) compression of patella against the femur and (iv) active resisted knee extension were enrolled in the study.

Exclusion Criteria

Pain lasting less than three months, previous knee operations, meniscal lesions, patellar instability (subluxation/dislocation), clinical evidence of tendinopathy or ligamentous injury, fractures or dislocations involving the pelvis, spinal surgical history, osteoporosis, pregnancy, neurological diseases or radiological findings of chondromalacia beyond grade 2 on MRI, ultrasound, or X-ray.

Recent participation in lower-limb rehabilitation or structured training within six weeks, or prior diagnoses of rheumatoid arthritis, gout, or other rheumatic knee disorders.

Use of NSAIDs in the preceding four weeks, prior history of cancer, infection, psychiatric conditions, cognitive impairment, autoimmune pathology, or neurological dysfunction likely to interfere with walking ability.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Lahore University of Biological and Applied Sciences

OTHER

Sponsor Role: lead

Responsible Party

Umber Nawaz

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Umber Nawaz, PhD Scholar

Role: CONTACT

Phone: +923334888279

Email: dr.umber21@gmail.com

Other Identifiers

U1111-1332-0257

Identifier Type: REGISTRY

Identifier Source: secondary_id

LCPT/DPT/ERB/31

Identifier Type: -

Identifier Source: org_study_id