This is a Randomized Controlled Trial (RCT) regarding the conservative treatment of patellofemoral pain (PFP) with an impairment based rehabilitation program. Those with PFP can have a variety of impairments, such as knee and hip muscle weakness, poor movement patterns, weak core activation and muscle tightness. Several recent RCT trials have looked at treating single impairments, but to date no RCT have address individualized patient impairments during a rehabilitation program. Abnormal muscle firing patterns have also been identified during functional tasks; such as jogging, stair climbing, and performing a single leg squat. Conflicting studies have produced changes to the quadriceps and hip muscle firing patterns with those with PFP. The abnormal activation patterns has been suggested to be why strengthening programs alone do not improve movement patterns during functional tasks for those with PFP. Patterned electrical neuromuscular stimulation (PENS) is a novel form of electrical stimulation that replicates proper firing patterns based off healthy electromyography patterns. The purpose of the study is to investigate the benefits of PENS with a impairment based rehabilitation program for the treatment of PFP. The rationale for this investigation is to assess the benefits of PENS with therapeutic exercise at improving altered firing patterns of the lower extremity muscles during functional tasks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
21
University of Virginia
Charlottesville, Virginia, United States
Changes in Pain Assessed by Visual Analog Scale (VAS)
Current and Worse VAS
Time frame: Pain recorded by the VAS will be collected for 4 weeks
Changes in Quadriceps Muscle Strength
Muscle strength of the quadriceps will be measured by individuals performing a maximum contraction against a small device that will measure force output
Time frame: Up to 4 weeks
Changes in Hamstring Muscle Strength
Muscle strength of the hamstring will be measured by individuals performing a maximum contraction against a small device that will measure force output
Time frame: Up to 4 weeks
Changes in Gluteus Medius Muscle Strength
Muscle strength of the gluteus medius will be measured by individuals performing a maximum contraction against a small device that will measure force output
Time frame: Up to 4 weeks
Changes in Hip Adductor Muscle Strength
Muscle strength of the hip adductors will be measured by individuals performing a maximum contraction against a small device that will measure force output
Time frame: Up to 4 weeks
Changes in Lower Extremity Electromyography during a step down task
EMG activity of six lower extremity muscles during a step down task
Time frame: Up to 4 weeks
Changes in Lower Extremity Electromyography during a single leg squat
EMG activity of six lower extremity muscles during a single leg squat
Time frame: Up to 4 weeks
Changes in Lower Extremity Electromyography during a lunge
EMG activity of six lower extremity muscles during a lunge
Time frame: Up to 4 weeks
Changes in Lower Extremity Electromyography during walking
EMG activity of six lower extremity muscles during walking
Time frame: Up to 4 weeks
Changes in Lower Extremity Electromyography during jogging
EMG activity of six lower extremity muscles during jogging
Time frame: Up to 4 weeks
Changes in Patient reported outcomes
4 patient reported outcomes on pain and function before and after the intervention. These patient reported outcomes are the Anterior Knee Pain Scale, the Activities of Daily Living Scale, the Godin Leisure Scale, and the Fear Avoidance Belief Questionnaire.
Time frame: Up to 4 weeks
Changes in lower extremity kinematics
Trunk, hip, knee and ankle movement during the single leg squat, stair ambulation, lunges, walking and jogging
Time frame: Up to 4 weeks
Changes in core strength
Trunk endurance will be assessed by front and side plank tasks.
Time frame: Up to 4 weeks
Changes in core activation
Core activation will be assessed by real time ultrasound to examine the size of the core muscles
Time frame: Up to 4 weeks
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