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Association Between Ankle Dorsiflexion and Frontal Projection Angle in PFPS

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ClinicalTrials.gov Identifier: NCT03897569
Recruitment Status : Completed
First Posted : April 1, 2019
Last Update Posted : July 30, 2019
Sponsor:
Information provided by (Responsible Party):
Karima Abdelaty Hassan, Cairo University

Brief Summary:
The study will investigate an association between ankle dorsiflexion and altered frontal knee kinematics during step down test in patients with PFPS.

Condition or disease Intervention/treatment
Patellofemoral Pain Syndrome Other: frontal projection angle, ankle dorsiflexion

Detailed Description:

Altered frontal and transverse plane hip kinematics during single leg weight-bearing tasks are thought to be important contributors to patellofemoral pain (PFP). The closed chain nature of single leg tasks means that hip kinematics can be influenced by more distal mechanics, such as foot pronation.

One of the often-studied distal movements theorized to cause PFPS is pronation of the subtalar joint. Pronation is a tri-planar movement that includes dorsiflexion, eversion, and abduction of the foot. Many studies have examined eversion characteristics of PFPS patients, but the dorsiflexion aspect of the movement has been shown to be a possible risk factor, restricting dorsiflexion was shown to increase medial knee displacement in young healthy adults. Conversely, when available dorsiflexion ROM is increased, medial knee displacement is thought to decrease.

Patients with PFPS were observed to have a decreased DFROM (dorsiflexion range of motion) as compared to normal individuals, though this topic has not thoroughly been investigated.


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Study Type : Observational
Actual Enrollment : 46 participants
Observational Model: Case-Control
Time Perspective: Cross-Sectional
Official Title: Association Between Ankle Dorsiflexion and Frontal Projection Angle During a Functional Task in the Patellofemoral Pain Syndrome
Actual Study Start Date : March 30, 2019
Actual Primary Completion Date : July 1, 2019
Actual Study Completion Date : July 1, 2019

Group/Cohort Intervention/treatment
patellofemoral pain syndrome
twenty subjects with anterior or retropatellar knee pain from at least 2 of the following Activities : (1) prolonged sitting; (2) stair climbing; (3) squatting; (4) running; (5) kneeling; and (6) hopping/jumping.
Other: frontal projection angle, ankle dorsiflexion
Dorsiflexion measurements will be taken in 4 different positions and repeated and recorded 3 times in each position, Prone bent, straight knee and Standing bent, straight knee. Prior to the measurement, the participants completed two 30-second calf stretches The FPPA was determined as the angle at the knee formed by lines connecting the anterior superior iliac spine, the midpoint of the femoral condyles and the midpoint of the malleoli at the deepest part of the squat

control
twenty-six asymptomatic subject will be recruited for this study and should have no pain or other relevant clinical symptoms in the lower quadrant
Other: frontal projection angle, ankle dorsiflexion
Dorsiflexion measurements will be taken in 4 different positions and repeated and recorded 3 times in each position, Prone bent, straight knee and Standing bent, straight knee. Prior to the measurement, the participants completed two 30-second calf stretches The FPPA was determined as the angle at the knee formed by lines connecting the anterior superior iliac spine, the midpoint of the femoral condyles and the midpoint of the malleoli at the deepest part of the squat




Primary Outcome Measures :
  1. Frontal knee kinematic [ Time Frame: 20 minutes ]
    The knee kinematic will be measured by using digital video camera using single leg squat during functional step down test


Secondary Outcome Measures :
  1. Ankle mobility [ Time Frame: 20 minutes ]
    Ankle dorsiflexion ROM will be assessed by bubble inclinometer during weight-bearing and non-weight-bearing positions.



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Ages Eligible for Study:   18 Years to 35 Years   (Adult)
Sexes Eligible for Study:   All
Sampling Method:   Non-Probability Sample
Study Population
Subjects between 18 to 35 years old with symptomatic patellofemoral pain syndrome and healthy control.
Criteria

Inclusion Criteria:

  1. Anterior or retropatellar knee pain from at least 2 of the following Activities : (1) prolonged sitting; (2) stair climbing; (3) squatting; (4) running; (5) kneeling; and (6) hopping/jumping.
  2. Insidious onset of symptoms unrelated to a traumatic incident and persistent for at least 6weeks.
  3. VAS equal to or greater than 3.
  4. Age of the subject 18-35 years to limit the possibility that PFPS over age 35 may have been complicated by arthritic changes, and also the subjects should have closed epiphyseal growth plates.
  5. BMI under 30 kg/m2, both gender

For the control group, subjects were recruited to this study if they had:

  1. No previous history or diagnosis of knee pathology.
  2. No pain with any of the above-mentioned provocative activities.
  3. No history of lower limb or spinal pathology.

Exclusion Criteria:

  1. A history of any of the following condition: meniscal or other intraarticular pathologic conditions; cruciate or collateral ligament involvement.
  2. A history of traumatic patellar subluxation or dislocation.
  3. Previous surgery in the lower extremities within the 12 months prior to participation in the study.
  4. Any balance impairments are secondary to a vestibular or neurological disorder or secondary to the use of medication.
  5. Any lower limb bony/congenital deformity

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03897569


Locations
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Egypt
Faculty of Physical therapy, Cairo University
Cairo, Egypt, egypt
Sponsors and Collaborators
Cairo University
Investigators
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Principal Investigator: karima A Hassan, PhD Cairo University

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Responsible Party: Karima Abdelaty Hassan, principal investigator, Cairo University
ClinicalTrials.gov Identifier: NCT03897569     History of Changes
Other Study ID Numbers: PFPS kinematics
First Posted: April 1, 2019    Key Record Dates
Last Update Posted: July 30, 2019
Last Verified: July 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Karima Abdelaty Hassan, Cairo University:
Patellofemoral Pain Syndrome
knee kinematics
frontal projection angle
ankle motion
Additional relevant MeSH terms:
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Patellofemoral Pain Syndrome
Syndrome
Disease
Pathologic Processes
Joint Diseases
Musculoskeletal Diseases