Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain?A randomised clinical trial

2017 ◽  
Vol 52 (10) ◽  
pp. 659-666 ◽  
Author(s):  
Jean-Francois Esculier ◽  
Laurent Julien Bouyer ◽  
Blaise Dubois ◽  
Pierre Fremont ◽  
Lynne Moore ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Functional Limitations ◽  
Randomised Clinical Trial ◽  
Exercise Programme ◽  
Patellofemoral Pain ◽  
Primary Component ◽  
Gait Retraining ◽  
Significant Group ◽  
Vertical Loading ◽  
Group Time

DesignSingle-blind randomised clinical trial.ObjectiveTo compare the effects of three 8-week rehabilitation programmes on symptoms and functional limitations of runners with patellofemoral pain (PFP).MethodsSixty-nine runners with PFP were randomly assigned to one of three intervention groups: (1) education on symptoms management and training modifications (education); (2) exercise programme in addition to education (exercises); (3) gait retraining in addition to education (gait retraining). Symptoms and functional limitations were assessed at baseline (T0), and after 4, 8 and 20 weeks (T4, T8 and T20) using the Knee Outcome Survey of the Activities of Daily Living Scale (KOS-ADLS) and visual analogue scales (VASs) for usual pain, worst pain and pain during running. Lower limb kinematics and kinetics during running, and isometric strength were also evaluated at T0 and T8. The effects of rehabilitation programmes were assessed using two-way analysis of variance.ResultsNo significant group × time interactions (p<0.447) were found for KOS-ADLS and VASs. All three groups showed similar improvements at T4, T8 and T20 compared with T0 (p<0.05). Only the exercises group increased knee extension strength following rehabilitation (group × time: p<0.001) and only the gait retraining group (group × time: p<0.001) increased step rate (+7.0%) and decreased average vertical loading rate (−25.4%).ConclusionEven though gait retraining and exercises improved their targeted mechanisms, their addition to education did not provide additional benefits on symptoms and functional limitations. Appropriate education on symptoms and management of training loads should be included as a primary component of treatment in runners with PFP.Trial registration numberClinicalTrials.gov (NCT02352909).

scholarly journals Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: A randomised clinical trial

2008 ◽  
Vol 9 (1) ◽  
Author(s):  
Bill Vicenzino ◽  
Natalie Collins ◽  
Kay Crossley ◽  
Elaine Beller ◽  
Ross Darnell ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Syndrome ◽  
Randomised Clinical Trial ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Foot Orthoses

scholarly journals Movement pattern training compared with standard strengthening and flexibility among patients with hip-related groin pain: results of a pilot multicentre randomised clinical trial

2020 ◽  
Vol 6 (1) ◽  
pp. e000707 ◽  
Author(s):  
Marcie Harris-Hayes ◽  
Karen Steger-May ◽  
Allyn M Bove ◽  
Stefanie N Foster ◽  
Michael J Mueller ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Muscle Strength ◽  
Groin Pain ◽  
Physical Therapist ◽  
Movement Pattern ◽  
Randomised Clinical Trial ◽  
Exercise Programme ◽  
Home Exercise ◽  
Treatment Protocols ◽  
Patient Reported

Study designPilot, multicentre randomised clinical trial (RCT).ObjectivesAssess viability of performing a definitive RCT and compare preliminary effects of movement pattern training (MoveTrain) and strengthening/flexibility (Standard) to improve function in people with chronic hip-related groin pain (HRGP).BackgroundTo determine the best physical therapist-led intervention for patients with HRGP, we must understand treatment effects of different treatment modes.MethodsForty-six patients (17M:29F; 29±5.3 years; body mass index 25.6±6.3 kg/m2) with HRGP were randomised. MoveTrain included task-specific training to optimise biomechanics during daily tasks. Standard included strengthening/flexibility. Treatment included 10 visits/12 weeks and home exercise programme (HEP). Primary outcomes for feasibility were recruitment, retention, treatment adherence and treatment fidelity. Secondary outcomes were patient-reported function (Hip disability and Osteoarthritis Outcome Score (HOOS)), lower extremity kinematics and hip muscle strength.ResultsWe achieved target recruitment, and retention was excellent (91%). Patient session attendance was high (93%); however, reported HEP adherence (62%) was lower than expected. Physical therapists’ adherence to treatment protocols was high (90%). Patients demonstrated high treatment receipt; 91% of exercises performed were rated independent. Both groups demonstrated clinically important improvements in function (HOOS) and muscle strength; however, there were no between-group differences (HOOS subscales, p≥0.13, strength, p≥0.34). Compared with Standard, MoveTrain demonstrated greater reductions in hip adduction (p=0.016) and pelvic drop (p=0.026) during a single leg squat. No adverse events were noted.ConclusionOur experience in completing this RCT confirmed that a larger, multicentre RCT is feasible and highlighted modifications we will implement to optimise the future RCT.Trial registration numberNCT02913222.

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