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IRCT20221030056342N1 IRCT 2023-01-28 Mashhad University of Medical Sciences Comparison of dry needling and functional joint mobilization with functional joint mobilization only on pain, disability and quality of life in patients with patellofemoral pain syndrome Comparison of dry needling and functional joint mobilization with functional joint mobilization only on pain, disability and quality of life in patients with patellofemoral pain syndrome 2022-12-01 anticipated 56 Complete https://irct.ir/trial/66592 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Blocked randomization will be done using random block method. Using the Sealedenvelope.com website, a sequence of 28 letters consisting of letters a and b will be placed in opaque, sealed envelopes, respectively. When the patients visit, the envelopes are taken from the collection of envelopes and according to the order determined by the number on the back of the envelopes, the sample allocator (department secretary) after obtaining informed consent, opens the envelope and assigns the patient to the relevant group. The secretary of the department is also unaware of how to code, Blinding description: The allocator is the secretary of the physiotherapy department and does not know how to code. Also, the evaluator and statistical analyst are not aware of the way of grouping. Allocation Concealment method: closed, opaque, and sealed envelopes and numbered in order. N/A Patella Femoral Pain Syndrome. Intervention 1: Intervention group: At first, they receive conventional physiotherapy. Exercises are applied in 3 sets with 10 repetitions. The cold pack is applied for 15 minutes after the sessions. Physiotherapy takes place for 12 sessions and 3 times a week. Patients will be taught knee and thigh strengthening exercises at home and exercise brochures will be provided to them. In addition to these, neuromuscular electrical stimulation is used for patients, in which the patient contracts his quadriceps muscle simultaneously with the electrical current. Two surface adhesive electrodes are attached to the movement points of the quadriceps: on the vestus medialis and the vestus lateralis. During the application of neuromuscular electrical stimulation, the patient performs two types of movements: 1. Isometric quadriceps strengthening (30 isometric exercises) 2. Then Terminal knee extension from zero to 30 degrees (30 isotonic exercises). Intervention 2: Intervention group: Functional mobilization is the second intervention, which includes movement of the patella and movement of internal rotation of the tibia in relation to the femur, first in a less functional and non-weight bearing state, then in a weight bearing state, while bending and straightening the knee, standing, squatting, and on the stairs. Intervention 3: Intervention group: The third intervention is the use of dry needling for the quadriceps muscles in the trigger pain points that are detected by the physiotherapist during the manual examination. Intervention 4: Control group: At first, they receive conventional physiotherapy. Exercises are applied in 3 sets with 10 repetitions. The cold pack is applied for 15 minutes after the sessions. Physiotherapy takes place for 12 sessions and 3 times a week. Patients will be taught knee and thigh strengthening exercises at home and exercise brochures will be provided to them. In addition to these, neuromuscular electrical stimulation is used for patients, in which the patient contracts his quadriceps muscle simultaneously with the electrical current. Two surface adhesive electrodes are attached to the movement points of the quadriceps: on the vestus medialis and the vestus lateralis. During the application of neuromuscular electrical stimulation, the patient performs two types of movements: 1. Isometric quadriceps strengthening (30 isometric exercises) 2. Then Terminal knee extension from zero to 30 degrees (30 isotonic exercises). Intervention 5: Control group: Functional mobilization is the second intervention, which includes movement of the patella and movement of internal rotation of the tibia in relation to the femur, first in a less functional and non-weight bearing state, then in a weight bearing state, while bending and straightening the knee, standing, squatting, and on the stairs. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no further information.
public Zohre Khorshidi
Faculty of Paramedical Sciences, University campus, East entrance of Ferdowsi University of Mashhad, Azadi Square, Mashhad.
Mashhad Iran (Islamic Republic of) 9177948964 +98 51 3869 8719 Zohreh.khorshidi7@gmail.com Mashhad University of Medical Sciences scientific Zohreh Khorshidi
Faculty of Paramedical Sciences, University campus, East entrance of Ferdowsi University of Mashhad, Azadi Square, Mashhad.
Mashhad Iran (Islamic Republic of) 9177948964 +98 51 3869 8719 Zohreh.khorshidi7@gmail.com Mashhad University of Medical Sciences Iran (Islamic Republic of) The age of participants is between 18 and 40 years. The diagnosis of this syndrome is based on the pain behind the Patella or around the patella. Presence of at least one active trigger point. Have at least a score of 3 on the VAS pain scale. 18 years 40 years Both History of knee surgery P Patellar tendinopathy or osteoarthritis, any systemic disease Symptoms of pressure on the lumbosacral nerve root If the participants had acupuncture, injection or dry needling treatment of the quadriceps or knee muscles in the last 6 months. knee sports injury such as meniscus tear or cruciate ligament injury If the participants use anticoagulant drugs, or have blood disorders or are pregnant. Any structural problem of the lower limb (such as arthritis or the presence of a prosthesis) Any peripheral or central neurological damage or chronic disease such as diabetes Any Fear of needles resence of bilateral patellofemoral pain syndrome. M22.2X Patellofemoral disorders Rehabilitation Rehabilitation Rehabilitation Rehabilitation Rehabilitation Intervention group: At first, they receive conventional physiotherapy. Exercises are applied in 3 sets with 10 repetitions. The cold pack is applied for 15 minutes after the sessions. Physiotherapy takes place for 12 sessions and 3 times a week. Patients will be taught knee and thigh strengthening exercises at home and exercise brochures will be provided to them. In addition to these, neuromuscular electrical stimulation is used for patients, in which the patient contracts his quadriceps muscle simultaneously with the electrical current. Two surface adhesive electrodes are attached to the movement points of the quadriceps: on the vestus medialis and the vestus lateralis. During the application of neuromuscular electrical stimulation, the patient performs two types of movements: 1. Isometric quadriceps strengthening (30 isometric exercises) 2. Then Terminal knee extension from zero to 30 degrees (30 isotonic exercises). Intervention group: Functional mobilization is the second intervention, which includes movement of the patella and movement of internal rotation of the tibia in relation to the femur, first in a less functional and non-weight bearing state, then in a weight bearing state, while bending and straightening the knee, standing, squatting, and on the stairs. Intervention group: The third intervention is the use of dry needling for the quadriceps muscles in the trigger pain points that are detected by the physiotherapist during the manual examination. Control group: At first, they receive conventional physiotherapy. Exercises are applied in 3 sets with 10 repetitions. The cold pack is applied for 15 minutes after the sessions. Physiotherapy takes place for 12 sessions and 3 times a week. Patients will be taught knee and thigh strengthening exercises at home and exercise brochures will be provided to them. In addition to these, neuromuscular electrical stimulation is used for patients, in which the patient contracts his quadriceps muscle simultaneously with the electrical current. Two surface adhesive electrodes are attached to the movement points of the quadriceps: on the vestus medialis and the vestus lateralis. During the application of neuromuscular electrical stimulation, the patient performs two types of movements: 1. Isometric quadriceps strengthening (30 isometric exercises) 2. Then Terminal knee extension from zero to 30 degrees (30 isotonic exercises). Control group: Functional mobilization is the second intervention, which includes movement of the patella and movement of internal rotation of the tibia in relation to the femur, first in a less functional and non-weight bearing state, then in a weight bearing state, while bending and straightening the knee, standing, squatting, and on the stairs. Pain. Timepoint: Visual Analogue scale. Method of measurement: In this scale, there is a horizontal line of 10 cm. The left end of this line corresponds to the absence of pain and the other end corresponds to the most intense pain that a person experiences. The distance between the two ends is calculated in centimeters and is calculated as the pain intensity. Performance. Timepoint: Persian version of Kujala questionnaire. Method of measurement: It is used to assess the functional activity of the knee during movements that potentially stress the knee joint. This questionnaire contains 13 items that are completed by the participant. The scoring range of this questionnaire is from zero to one hundred. Higher scores indicate lower levels of disability, and zero means the most severe disability. The Persian version of this questionnaire has been localized and validated for patients with patellofemoral pain syndrome. Quality of Life. Timepoint: Before and after of treatment. Method of measurement: Persian questionnaire SF36. The effectiveness of treatment. Timepoint: Before and after of treatment. Method of measurement: Global Rating Scale. Mashhad University of Medical Sciences Approved 2022-07-30 Research Ethics Committees of School of Paramedical Sciences and Health School Khorasan Razavi, Mashhad, Shaheed Fakuri Blvd, between Shahidjovan and Al Shahidi Square, Danesh and Salamat Shahrek Mashhad Razavi Khorasan Iran (Islamic Republic of)