Clinical Research Directory

Vasti Control of Patellofemoral Kinematics in Asymptomatic Volunteer

Background: * Patellofemoral pain syndrome is one of the most common knee problems. It is characterized by pain in the front of the knee that is aggravated by deep knee flexion, prolonged sitting, and repetitive movement. The most widely accepted theory regarding the source of this pain is that a force imbalance around the knee puts extra stress on the area, leading to pain. * Researchers are interested in learning more about the muscle groups around the knee to better understand the causes of knee pain. Objectives: \- To obtain more information on how muscles, tendons, and bones work together to cause motion in the knee, both in the normal state and after immobilizing certain muscles around the knee. Eligibility: \- Healthy individuals between the ages of 18 and 55, who have no current or chronic muscle, bone, or joint problems and who have no implants or other problems that would prevent them from receiving a magnetic resonance imaging (MRI) scan. Design: * This protocol will be carried out over two visits, both of which will involve using standard MRI sequences to look at the knee at rest and in motion. * The first part will examine the knee under its natural state, with a standard MRI scan of the knee both at rest and in motion. * The second part will involve temporarily reducing the force producing capabilities of one of the extensor muscles in the knee. To do so, study doctors will inject lidocaine into the muscle, which will temporarily (for approximately 2 hours) block the force producing capacity of this muscle, and then perform the MRI scan....

Stabilization vs Corrective Exercise in PFP

The purpose of this study is to investigate the effects of a Functional Stabilization training program (FST) and a comprehensive corrective exercise program in PF pain and DKV.

Muscle Strength Loss and Its Effect on Knee Cap Motion in Volunteers With Anterior Knee Pain

Background: \- Researchers are interested in how the muscles affect the movement of the knee cap. These muscles may be related to different kinds of knee pain that are not caused by an injury or a disease. Imaging studies such as magnetic resonance imaging (MRI) can be used to look at these muscles. To study these muscles and how they move, researchers will use MRI to look at healthy individuals and individuals with knee cap pain. Objectives: \- To study how changes to the muscles around the knee can influence knee pain. Eligibility: * Individuals between 18 to 55 years of age who have knee cap pain that cannot be explained by a specific injury or disease. * Healthy volunteers between 18 and 55 years of age. Design: * Participants will be screened with a physical exam and medical history. * This study requires two visits. Each visit will use standard MRI sequences to take images of the knee in motion and at rest. * On the first visit, the MRI scan will look at the knee in its natural state. Participants will move the knee up and down for 1 to 3 minutes at a time during the scan. * On the second visit, a local anesthetic agent will be injected into the muscle of the thigh. The anesthetic will block this muscle from generating force for 2 or 3 hours. Participants will move the knee up and down for 1 to 3 minutes at a time during the MRI scan.

MRI Study of Musculoskeletal Function

This study will use magnetic resonance imaging (MRI) and ultrasound images to study how muscles, tendons, and bones work together to cause motion. The procedure is one of several tools being developed to characterize normal and impaired musculoskeletal function, with the goal of developing improved methods of diagnosis and treatment of movement disorders. Healthy normal volunteers must be age 5 to unlimited, with or without joint impairment, may be eligible for this study. Volunteers with joint impairment may not have serious injury to the joint being studied, previous surgery on the joint being studied, or extreme pain at the joint being studied. MRI uses a strong magnet and radio waves to create images of the inside of the body. The subject lies on a long narrow couch inside a metal cylinder (the scanner) for up to 3 hours while the scanner gathers data. Earplugs are worn to muffle loud noises caused by electrical switching of radiofrequency circuits used in the scanning process. A special pad or tube may be placed over or around the region being scanned to improve the quality of the data. The subject will be asked to repeatedly move a specific joint, such as the knee, for brief periods, usually less than 5 minutes. The subject can communicate via intercom with the person performing the study at all times during the procedure, and may request to stop the study at any time.

A Confirmatory Trial of Multidisciplinary Digital Therapeutics for Patellofemoral Pain Syndrome

This randomized controlled confirmatory study will be evaluating an mobile application, MORA Cure (ETH-01K), owned by EverEx, Inc., to examine safety and effectiveness in individuals with patellofemoral pain syndrome.

Comparing the Outcome of Electrical Stimulation and Physical Therapy in Patellofemoral Pain Syndrome

The purpose of study is to evaluate the efficacy of the electrical muscle stimulation (EMS) device in patients with patellofemoral pain known as anterior knee pain. Usual treatment for it is physical therapy (PT). We want to evaluate and see if adding the electrical muscle stimulation will fasten the recovery and improved outcome in patellofemoral pain syndrome. Half of participants will receive EMS and PT while other half will receive PT only.

Pain and Movement Responses to Resistance Training to Muscular Failure in Patients With Patellofemoral Pain

This study aims to investigate the effect of training to muscular failure in patients with patellofemoral pain (PFP). In a cross-sectional observational design, participants with PFP will be be performing a knee exercise to voluntarily muscular failure. The participants will throughout the exercise trial report pain levels and continue until 1) not being able to perform the exercise as instructed or 2) reaching a pain level of 5/10 (which is a common threshold for acceptable pain within rehabilitation). During this trial, the participants will be filmed and a biomechanical analysis will be performed to see if/how compensatory movements occur.

High-Intensity Laser Acupuncture for Treating Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is among the most prevalent forms of knee discomfort. The main complaint is typically anterior knee pain, which gets worse while jumping, bending knee, going up or down stairs, or sitting for long periods of time with bent knee. Teens and early adulthood are commonly affected by patellofemoral pain syndrome, with a higher frequency in females. In healthy general populations, the prevalence of patellofemoral pain syndrome is 22.7%, and in teens, it is 28.9%.

Effects of Mc Connell Versus Kinesio Taping; Combined With Hip and Knee Strengthening in Patients With Patellofemoral Pain Syndrome

Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retro-patellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (e.g. squatting, prolonged sitting, ascending/descending stairs, jumping, or running). This randomized controlled trial compares the effects of McConnell taping and Kinesio taping, each combined with a standardized hip and knee strengthening exercise program, in patients with Patellofemoral Pain Syndrome (PFPS). A total of 34 participants (17 per group), aged 26-44 years, will be randomly allocated into two groups. Both groups will undergo a 4-week intervention, consisting of supervised sessions on alternate days. Outcomes will be assessed at baseline and after the intervention. Group A will receive conventional physical therapy, hip and knee strengthening exercises, and McConnell taping. The intervention includes TENS, heating pad application, progressive strengthening exercises, functional training, stretching, and rigid McConnell taping applied before each session to provide medial patellar glide and improve patellar alignment. Group B will receive the same conventional physical therapy and strengthening program but with Kinesio taping. Elastic Kinesio tape will be applied using standardized I-strip and Y-strip techniques to facilitate patellar alignment, improve proprioception, and provide neuromuscular support. The tape may remain in place for 1-2 days, if tolerated. The primary outcomes include pain (Numeric Pain Rating Scale), range of motion (universal goniometer), and functional disability (KOOS-Patellofemoral questionnaire), measured at baseline and after the 4-week intervention.

Elite Athletes: Trunk Mobility, Lower Extremity Flexibility, and Functional Balance Across Sports

This cross-sectional observational study investigated the relationships among dynamic Q angle, core muscle endurance, hip flexibility, and lower extremity functional status in elite adolescent athletes with and without patellofemoral pain syndrome (PFPS). A total of 75 track-and-field athletes aged 15-18 years were included, 42 with PFPS and 33 healthy controls. Dynamic Q angle was assessed using a digital goniometric analysis of the step-down test, core endurance was measured with the McGill endurance tests, flexibility was evaluated using the Straight Leg Raise, Modified Thomas, and Ober tests, and functional status was assessed with the Lower Extremity Functional Scale (LEFS). The study found that athletes with PFPS demonstrated a higher dynamic Q angle, lower core extension and lateral endurance, reduced hip flexor and iliotibial band flexibility, and lower functional scores compared with controls. Regression analyses indicated that hip flexor tightness and functional capacity were significant predictors of the dynamic Q angle in the PFPS group. These findings suggest that PFPS in adolescent athletes is a multidimensional condition influenced by proximal endurance, flexibility, and dynamic alignment rather than isolated knee-level factors.

Isokinetic Training With Blood Flow Restriction for Patellofemoral Pain Syndrome

This randomized controlled trial aims to investigate the effects of isokinetic training combined with blood flow restriction (BFR) in individuals with patellofemoral pain syndrome (PFPS).

AI Based Telerehabilitation for Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is a common cause of anterior knee pain in young, active adults and is often aggravated by prolonged sitting, stair use, squatting, and running. Exercise-based physiotherapy is the standard first-line treatment, but access to regular in-person supervision can be limited. This study compares two ways of delivering the same evidence-based exercise programme for PFPS: AI-based telerehabilitation, delivered remotely through the Physitrack platform with AI-assisted movement screening (MediaPipe), and conventional face-to-face physiotherapy. The study aimed to determine whether AI-based telerehabilitation is as effective as, or more effective than, conventional physiotherapy in reducing pain and improving physical function, and to evaluate how usable participants found the telerehabilitation platform

Motor Control Retraining vs Close Kinetic Chain Exercises for Pain, Function and Vastus Medialis Oblique Strength in Patients With Patellofemoral Pain Syndrome

This study compares two treatments - motor control retraining and close kinetic chain exercises - to improves the pain, VMO strength, knee function. Fifty participants out of which 4 dropped out; will be randomly assigned to receive either motor control retraining or close kinetic chain exercises training for 45 minutes per session, three times per week, for six weeks. Pain intensity will be measured using the visual analogue scale. Knee function will be measured using Kujala anterior knee pain scale. Vastus medialis oblique strength will be measured using digital dynamometer. Dynamic knee valgus will be measured using Kinovea-2D video analysis. Q-angle will be measured using manual goniometer. Patellar maltracking will be measured using combined assessment of dynamic knee valgus and q-angle. This study aims to determine which treatment produces greater improvements, which may help physiotherapists choose more effective treatments for patient with patellofemoral pain syndrome in Pakistan.

Effects of Isometric, Isotonic, and Eccentric VMO Exercises in Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition characterized by anterior knee pain, especially during activities such as stair climbing, squatting, running, and prolonged sitting. Weakness or delayed activation of the vastus medialis oblique (VMO) muscle is considered an important contributing factor in the development of PFPS. This study aims to compare the effects of three different types of VMO strengthening exercises (isometric, isotonic, and eccentric) applied within the terminal knee extension range (0-30°) on pain, functional performance, and muscle architecture in individuals with PFPS. Participants will be randomly assigned to one of three exercise groups. All participants will receive a standardized physiotherapy program, including heat therapy, TENS, and therapeutic ultrasound, followed by group-specific VMO strengthening exercises. The intervention will be performed three times per week for 8 weeks. Outcomes will be assessed before and after the intervention and will include pain intensity (Visual Analog Scale), functional performance (WOMAC, 30-second sit-to-stand test, and stair test), and muscle architecture parameters measured by ultrasound imaging. The results of this study are expected to provide evidence for optimizing rehabilitation strategies in individuals with PFPS.

Effect of Adding Inguinal Ligament Mobilization to Talonavicular Joint Mobilization on Patellofemoral Pain Syndrome

This study will be conducted to: * To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain intensity subjects with PFPS * To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS. * To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS . * To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS .

Effects of Clamshell Exercises in Addition to Standardized Physical Therapy in the Management of Patellofemoral Pain Syndrome

This randomized controlled trial aims to evaluate whether adding clamshell exercises to standardized physical therapy provides greater improvements in pain and knee function than standardized physical therapy alone in individuals with patellofemoral pain syndrome (PFPS). PFPS is a common musculoskeletal condition characterized by pain around or behind the kneecap that is aggravated by activities such as stair climbing, squatting, running, and prolonged sitting. Participants aged 18-45 years with clinically diagnosed PFPS will be randomly assigned to one of two groups. The control group will receive standardized physical therapy consisting of warm-up exercises, stretching, quadriceps and lower-limb strengthening exercises, and cool-down activities. The experimental group will receive the same standardized physical therapy program with the addition of clamshell exercises targeting the gluteus medius and hip external rotator muscles. Both groups will participate in supervised treatment sessions lasting approximately 45 minutes, three times per week, for four weeks. Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), and knee function will be assessed using the Kujala Anterior Knee Pain Scale before and after the intervention. The findings of this study may help determine whether incorporating clamshell exercises into routine physiotherapy improves rehabilitation outcomes for patients with PFPS.

Mikhled Knee Exercise Program With and Without Stecco Fascial Manipulation Effect in Patellofemoral Pain Syndrome

To compare the effects of the Mikhled Knee Exercise Program with and without Stecco Fascial Manipulation on pain, range of motion, and functional outcomes Patellofemoral Pain Syndrome.

Dynamic Q Angle and Core Endurance in Adolescent Athletes With Patellofemoral Pain Syndrome

This observational, cross-sectional study aimed to compare dynamic Q-angle, trunk/core endurance, and lower-extremity flexibility between elite adolescent female and male sprinters with and without patellofemoral pain syndrome (PFPS). Participants were classified according to sex and PFPS status. Dynamic Q-angle was assessed during a standardized step-down task, trunk endurance was evaluated using McGill flexion, extension, and lateral endurance tests, and lower-extremity flexibility was assessed using the Straight Leg Raise, Modified Thomas, and Ober tests. The study also examined whether sex and PFPS status were independently associated with dynamic Q-angle. No therapeutic or experimental intervention was administered.

Effect of Short Foot Exercise Combined With Focused Hip and Knee Exercises on Pain, Q Angle and Functional Outcomes in Female Patients With Patellofemoral Pain Syndrome

This randomized controlled trial aims to evaluate the effectiveness of short foot exercises combined with focused hip and knee strengthening on pain, Q-angle, and functional outcomes in female patients with patellofemoral pain syndrome (PFPS). Thirty-eight participants aged 18-45 years will be randomly assigned to either an experimental group (short foot + hip and knee exercises) or a control group (hip and knee exercises only) for a 6-week supervised rehabilitation program.

Popliteus Muscle Release Versus Patellofemoral Mobilization in Patellofemoral Pain Syndrome

This study will be conducted to compare the effect of popliteus muscle release and patellofemoral mobilization on pain intensity, function, and quadriceps muscle strength in patients with patellofemoral pain syndrome?

Tele-rehabilitation for Recreational Athletes With Patellofemoral Pain Syndrome

This study is a randomized clinical trial designed to evaluate the usability and effectiveness of a tele-rehabilitation program in recreational athletes with Patellofemoral Pain Syndrome (PFPS). A total of 26 participants aged 18-35 years with unilateral PFPS will be randomly allocated into either a conventional physiotherapy group or a tele-rehabilitation group. Both groups will receive the same evidence-based exercise protocol comprising stretching, strengthening, balance, and functional exercises over a four-week period; however, the intervention group will perform the exercises remotely using the Physitrack mobile application with regular virtual supervision and progress monitoring, while the control group will receive face-to-face physiotherapy sessions. Primary outcome measures will include pain intensity assessed by the Numerical Pain Rating Scale (NPRS), knee range of motion measured using a universal goniometer, and quality of life evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS). The usability and patient satisfaction of the tele-rehabilitation platform will be assessed using the Telehealth Usability Questionnaire (TUQ). The findings of this study will determine whether tele-rehabilitation is a feasible, user-friendly, and effective alternative to conventional physiotherapy for improving clinical outcomes and rehabilitation accessibility in recreational athletes with PFPS.

Aquatic Plyometrics for Adolescents With Patellofemoral Pain Syndrome

This study was designed to assess the effect of a 12-week hydro-kinetic plyometric (HK-Plyo) training on pain, muscle strength, disability, and quality of life (QoL) in adolescents with patellofemoral pain syndrome (PFPS). Fifty-six adolescents with PFPS were randomly allocated to the HK-Plyo group (n = 28, received the plyometric-based hydro-kinetic therapy program, twice/week, over 12 weeks) or the control group (n = 28, received standard exercise program). Both groups were assessed for pain, muscle strength, disability, and QoL pre and post-treatment.

Kinematic and Neuromuscular Deficiencies Phenotypes Associated With Patellofemoral Pain Syndrome

The purpose of this study is to describe and compare the kinematic deficiencies specifically associated with each of the 3 main clinical phenotypes of patellofemoral pain syndrome. The prevalence of patellofemoral pain is high with a high rate of chronicity and recurrence and an overrepresentation of young, athletic and female populations. There are multiple classifications of patellofemoral pain syndrome. A pragmatic classification distinguishes 3 main clinical phenotypes of patellofemoral pain syndrome: with objectively displaceable patella, with extra-patellar alignment problems and without alignment problems. The pathophysiology of patellofemoral pain syndrome is multifactorial involving static and dynamic dysfunctions of the hip, knee and foot, which remain incompletely elucidated to date. The links between the clinical and biomechanical aspects are still unclear and the kinematic and neuromuscular deficiencies associated with the 3 main clinical phenotypes are poorly understood. A validated non-invasive device allows the 3D evaluation of femorotibial rotations during walking.

Effects of Kinesio Taping Versus McConnell Taping on Clinical Outcomes in Patients With Patellofemoral Pain Syndrome.

The primary goal of this randomized clinical trial (RCT) is to evaluate whether Kinesio Taping versus McConnell Taping, when integrated into a standardized hip-knee strengthening and neuromuscular control program, produces significant effects in individuals aged 18-50 with patellofemoral pain syndrome (PFPS). The main question it aims to answer is: Does Kinesio Taping compared with McConnell Taping when both combined with a standardized hip-knee exercise program, produce different effects on quadriceps neuromuscular activation (VMO-VL sEMG), pain, functional knee pain, and dynamic knee valgus over a 6 week period intervention? Participants will be divided into three groups for comparison: the control group will receive a structured hip-knee physical therapy exercise program without any taping intervention, Kinesio Taping group with a standardized exercise program, and a McConnell Taping group with a standardized exercise program.