A Study on the Effectiveness of Ankle Dorsiflexion Range of Motion Training in Patients With Patellofemoral Joint Pain.

N/ANot Yet RecruitingNCT06958757

Tianjin University of Sport64 enrolled

Overview

Patellofemoral Pain (PFP) is a common knee condition causing pain around the kneecap during activities like running or squatting. Limited ankle flexibility ("dorsiflexion" - how far participants can lift their toes toward the shin) may worsen PFP by altering leg movements. This study investigates whether adding ankle flexibility exercises to standard knee-strengthening programs improves outcomes for young adults with PFP. Active adults aged 18-30 with PFP and limited ankle flexibility (measured with a simple tool) are eligible, excluding those with prior knee/ankle surgeries, fractures, or conditions like arthritis. Sixty-four participants will be randomly assigned to either an Exercise + Ankle Training group (standard knee exercises plus targeted ankle training) or an Exercise-Only group for 8 weeks under physiotherapist guidance. Outcomes include improvements in knee pain scores (Kujala Scale), ankle flexibility changes, and muscle coordination measured with non-invasive sensors. If effective, ankle flexibility training could provide a low-cost addition to current treatments, helping patients resume activities with less pain. The study follows international ethical guidelines and has received preliminary ethics approval (No. TJUS-2025-054).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Patellofemoral Pain, PFP

Standard Exercise Therapy + Ankle Dorsiflexion TrainingOTHER

The experimental group receives: Standard Exercise Therapy (30 min/session, 3x/week for 8 weeks): Quadriceps eccentric exercises (e.g., slow step-downs), Hip abductor strengthening (e.g., side-lying leg lifts), and Neuromuscular control drills (e.g., single-leg balance on unstable surfaces). Ankle Dorsiflexion Training (15 min/session, 3x/week for 8 weeks): Mobilization techniques (posterior glides of the talus), Resistance band exercises (dorsiflexion against elastic bands), Progressive Achilles tendon stretching (weight-bearing calf stretches). Exercise progression (resistance/intensity) is adjusted biweekly based on functional assessments.

Standard Exercise Therapy OnlyOTHER

Standard Exercise Therapy (30 min/session, 3x/week for 8 weeks): Quadriceps eccentric exercises (e.g., slow step-downs), Hip abductor strengthening (e.g., side-lying leg lifts), and Neuromuscular control drills (e.g., single-leg balance on unstable surfaces). Exercise progression (resistance/intensity) is adjusted biweekly based on functional assessments.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 30 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18-30 years * Diagnosed with patellofemoral pain (PFP) per clinical guidelines (anterior knee pain aggravated by ≥2 activities: running, squatting, stair climbing) * Ankle dorsiflexion range of motion (ROM) \<10° (measured via goniometer in weight-bearing) * BMI 18.5-28 kg/m² * Engage in regular physical activity (≥3 sessions/week) Exclusion Criteria: * Ankle fractures * Achilles tendon rupture * Rheumatoid arthritis * Gout, or systemic diseases * Prior knee/ankle surgeries * Concurrent lower limb injuries (e.g., ligament tears, meniscal pathology) * Neurological disorders affecting mobility * Participation in other lower limb rehabilitation programs within 3 months

Outcomes

Primary Outcomes

Kujala Anterior Knee Pain Scale

Time frame: Assess all outcome measures at baseline (pre-intervention) and immediately after the completion of the 8-week intervention program (post-intervention).

Ankle dorsiflexion range of motion

Time frame: Assess all outcome measures at baseline (pre-intervention) and immediately after the completion of the 8-week intervention program (post-intervention).

Secondary Outcomes

sEMG co-contraction ratios

Time frame: All outcome measures (sEMG co-contraction) ratios are assessed at baseline (pre-intervention) and immediately after completing the 8-week intervention program (post-intervention).