The study purpose is to investigate the effectiveness of a program combining biomechanical taping with lower extremity neuromuscular exercises for runners with patellofemoral pain syndrome (PFPS) and hallux valgus
This will be a single-blind, experimental study with two treatment groups. A total of 30 college athletes with PFPS and hallux valgus and majoring in long distance running or soccer, or recreational runners in Taipei metropolitan area will be recruited. A set of clinical examination will be conducted to rule out abnormal knee structures, pathologies, or injuries apart from PFPS. The lower extremity alignment as well as hip and knee kinematics during a step down test will be tracked using Noraxon's myoMOTION system. Muscle activation of the muscles controlling the hip and knee movements during the step down test will be recorded using TELEmyo DTS of Noraxon. Hallux valgus angle will be measured with surface markers on photographs. Knee pain level will be rated in a visual analog scale. The investigators will analyze the data with Statistical Product and Service Solutions (SPSS) for Windows. Repeated-measure ANOVAs will be used to examine group-by-time interaction on all the outcome variables. All significance level will be set at 0.05.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
The whole intervention period will last for 6 weeks, 2 visits per week, 1 hour per visit in the Research Building Room 630 of National Yang Ming University. All programs will be under the supervision of a physiotherapist with 2-year experience individually. 1. Hallux valgus correction: 1.1 Joint alignment correction (Grade II joint mobilization, 10 times/set, 3 sets/visit) - 1st MTP joint distraction - Proximal talofibular joint anteroposterior glide - (Grade III joint mobilization if any restriction being found) 1.2 Biomechanical taping (using Dynamic taping, 1 time/ visit, keep the taping for 2 days minimum) 1.3 Foot intrinsic muscle strengthening (10 times/set for each exercise, 3 sets/visit): - Short foot exercise - Toespread out exercise - Heel-rise exercises 2. Lower extremity neuromuscular exercises: (10-15 times/set, 3 sets/visit) 2.1 Single lunge 2.2 Stepping down 2.3 Vertical squat 2.4 Vertical jumping
1\. Lower extremity neuromuscular exercises: (10-15 times/set, 3 sets/visit) 1.1 Single lunge 1.2 Stepping down 1.3 Vertical squat 1.4 Vertical jumping All exercises will first start on firm surface without additional resistance/weight. Later, settings will be gradually shifted into on firm surface with resisted band from random direction, on a cushion with/ without resisted band, on a BOSU balance trainer. Progression are made every 2 weeks ideally, while adjustments may be taken into concern due to individual differences.
National Yng Ming University
Taipei, 北投區, Taiwan
Displacement of femur in step-down test
displacement recorded in cm/BMI
Time frame: changes from baseline and after 6 weeks of intervention
Displacement of tibia in step-down test
displacement recorded in cm/BMI
Time frame: changes from baseline and after 6 weeks of intervention
Knee pain level
The level of knee pain during daily activities will be quantified with visual analogue scale.
Time frame: changes from baseline and after 6 weeks of intervention
Changes of pain-free running distance
The changes of pain-free running distance will be recorded in kilometers.
Time frame: changes from baseline and after 6 weeks of intervention
EMG amplitude of knee extensor
amplitude recorded in %MVC
Time frame: changes from baseline and after 6 weeks of intervention
EMG amplitude of knee flexor
amplitude recorded in %MVC
Time frame: changes from baseline and after 6 weeks of intervention
EMG amplitude of hip external rotator
amplitude recorded in %MVC
Time frame: changes from baseline and after 6 weeks of intervention
changes of the muscle activation time between vastus medialis oblique and vastus lateralis
changes of the muscle activation time recorded in second
Time frame: changes from baseline and after 6 weeks of intervention
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Tibiofemoral angle in relaxed standing
recorded in degree
Time frame: changes from baseline and after 6 weeks of intervention
Hallux valgus angle in relaxed standing
recorded in degree
Time frame: changes from baseline and after 6 weeks of intervention
Navicular drop
navicular position changes between sitting and relaxed standing, recording in cm
Time frame: changes from baseline and after 6 weeks of intervention
Arch height index
arch height in one leg standing, recording in the ratio of arch height and truncated foot length
Time frame: changes from baseline and after 6 weeks of intervention
Hip rotation angle in relaxed standing
recorded in degree
Time frame: changes from baseline and after 6 weeks of intervention
Knee rotation angle in relaxed standing
recorded in degree
Time frame: changes from baseline and after 6 weeks of intervention