Patellofemoral pain syndrome (PFPS) is a multifactorial musculoskeletal condition that is common particularly among young and physically active individuals, negatively affecting activities of daily living and physical performance. Although exercise therapy is considered the gold standard in the management of PFPS, there is limited evidence regarding the effectiveness of motor learning strategies applied during exercise. This study aims to shed light on how motor learning approaches can be optimized in clinical rehabilitation by comparing the effects of internal and external focus strategies used during exercise on muscle activation, functional performance, and pain. This research will make a methodological contribution to the literature through the objective evaluation of muscle mechanical properties using isokinetic assessment and the MyotonPRO device. The findings are expected to clarify the effects of attentional focus strategies on therapeutic outcomes in PFPS rehabilitation and have the potential to provide an evidence-based guide for physiotherapy practice. In this way, the study may contribute to the development of new approaches aimed at improving both clinical effectiveness and patient adherence.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
Internal focus refers to directing attention to one's own body movements or muscle activity while performing a task (e.g., focusing on contracting a specific muscle). During isokinetic strength exercises, this group is instructed with commands such as: "Tighten your quadriceps" and "Straighten your knee."
External focus refers to directing attention to the effect of a movement on the environment or an external object, rather than on the body itself. During isokinetic exercise, this group is given the instruction: "Increase and maintain the performance indicator on the screen."
Istanbul University-Cerrahpasa
Istanbul, Turkey (Türkiye)
RECRUITINGKujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Time frame: baseline
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Time frame: Week 3 of the Treatment
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Time frame: Week 6 of the Treatment
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Time frame: baseline
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Time frame: Week 3 of the Treatment
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Time frame: Week 6 of the Treatment
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
Time frame: baseline
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
Time frame: Week 3 of the Treatment
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
Time frame: Week 6 of the Treatment
Muscle Tone
Muscle tone was assessed using the MyotonPRO device, expressed in Hertz (Hz), with higher values indicating increased resting muscle tone.
Time frame: baseline
Muscle Tone
Muscle tone was assessed using the MyotonPRO device, expressed in Hertz (Hz), with higher values indicating increased resting muscle tone.
Time frame: Week 3 of the Treatment
Muscle Tone
Muscle tone was assessed using the MyotonPRO device, expressed in Hertz (Hz), with higher values indicating increased resting muscle tone.
Time frame: Week 6 of the Treatment
Muscle Stiffness
Muscle stiffness was measured using the MyotonPRO device, expressed in Newton per meter (N/m), with higher values indicating greater muscle stiffness.
Time frame: baseline
Muscle Stiffness
Muscle stiffness was measured using the MyotonPRO device, expressed in Newton per meter (N/m), with higher values indicating greater muscle stiffness.
Time frame: Week 3 of the Treatment
Muscle Stiffness
Muscle stiffness was measured using the MyotonPRO device, expressed in Newton per meter (N/m), with higher values indicating greater muscle stiffness.
Time frame: Week 6 of the Treatment
Muscle Elasticity
Muscle elasticity was evaluated using the MyotonPRO device, expressed as logarithmic decrement, with lower values indicating better elastic properties.
Time frame: baseline
Muscle Elasticity
Muscle elasticity was evaluated using the MyotonPRO device, expressed as logarithmic decrement, with lower values indicating better elastic properties.
Time frame: Week 3 of the Treatment
Muscle Elasticity
Muscle elasticity was evaluated using the MyotonPRO device, expressed as logarithmic decrement, with lower values indicating better elastic properties.
Time frame: Week 6 of the Treatment
Step-Down Test
Step-Down Test was used to assess lower-extremity control and functional performance. Participants were instructed to perform as many step-down repetitions as possible within 30 seconds. Performance was recorded as the number of completed repetitions, with higher scores indicating better functional capacity and dynamic knee stability.
Time frame: baseline
Step-Down Test
Step-Down Test was used to assess lower-extremity control and functional performance. Participants were instructed to perform as many step-down repetitions as possible within 30 seconds. Performance was recorded as the number of completed repetitions, with higher scores indicating better functional capacity and dynamic knee stability.
Time frame: Week 3 of the Treatment
Step-Down Test
Step-Down Test was used to assess lower-extremity control and functional performance. Participants were instructed to perform as many step-down repetitions as possible within 30 seconds. Performance was recorded as the number of completed repetitions, with higher scores indicating better functional capacity and dynamic knee stability.
Time frame: Week 6 of the Treatment
Single-Leg Hop Test
Single-Leg Hop Test was used to assess functional performance and dynamic knee stability. Participants were instructed to perform a maximal forward hop on the affected limb. The hop distance was measured in centimeters (cm), with greater distances indicating better functional performance.
Time frame: baseline
Single-Leg Hop Test
Single-Leg Hop Test was used to assess functional performance and dynamic knee stability. Participants were instructed to perform a maximal forward hop on the affected limb. The hop distance was measured in centimeters (cm), with greater distances indicating better functional performance.
Time frame: Week 3 of the Treatment
Single-Leg Hop Test
Single-Leg Hop Test was used to assess functional performance and dynamic knee stability. Participants were instructed to perform a maximal forward hop on the affected limb. The hop distance was measured in centimeters (cm), with greater distances indicating better functional performance.
Time frame: Week 6 of the Treatment
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