Clinical Trial: Early Intervention for Adolescents With Patellofemoral Pain Syndrome

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Early Intervention for Adolescents With Patellofemoral Pain Syndrome - a Cluster Randomized Trial

Brief Summary:

Self-reported, unspecific knee pain is highly prevalent among adolescents. A large proportion of the unspecific knee pain can be attributed to Patellofemoral Pain Syndrome (PFPS). There are a number of treatment options for PFPS. Physical therapy has been advocated as one of the cornerstones in rehabilitation of patients with PFPS. Twenty-five years ago, McConnell proposed a multimodal approach that combined several treatment options. The regimen included retraining of the vastus medialis oblique muscle through functional weight bearing activities. This exercise is combined with patellar taping, patellar mobilization, and stretching to improve patellar tracking, reduce pain, and enhance vastus medialis oblique muscle activation. Short term results (<12 months) indicates that multimodal physiotherapy is more effective than placebo treatment.

While treatment for PFPS may be successful for the short-term, long-term results are less promising. A recent review covering the long term prognosis for patients diagnosed with PFPS, reported that only 1/3 of those diagnosed with PFPS and treated conservatively were pain free 12 months after diagnosis. Further ¼ stopped participating in sports because of knee pain.

Predictors of long term outcome (>52weeks) indicate that a long symptom duration, higher age and greater severity at baseline are associated to poorer outcome after treatment. These prognostic factors suggest that an early initiation of treatment might lead to a better long-term prognosis. The purpose of this study is to examine the short and long-term effectiveness of multi-modal physiotherapy compared to standard wait-and-see treatment applied at a very early state of disease among adolescents. The investigators hypothesized a significantly larger proportion of completely recovered patients at three-month follow

Detailed Summary:
Sponsor: Mogens Berg Laursen

Current Primary Outcome: Change in perception of recovery after 12 months measured on a 7-point likert scale ranging from "completely recovered" to "worse than ever". [ Time Frame: Baseline, 3, 6, 12 and 24months ]

Perception of recovery after 12 months measured on a 7-point likert scale ranging from "completely recovered" to "worse than ever".


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Knee Injury and Osteoarthritis Outcome Score [ Time Frame: Baseline, 3, 6, 12 and 24months ]
  • EQ5D [ Time Frame: Baseline, 3, 6, 12 and 24months ]
  • Neuromuscular function [ Time Frame: Baseline and 3 months ]
    Each subjects will undergo quadriceps strength measurements and two basic tests of neuromuscular function of m. vastus medialis and m. vastus lateralis. EMG will be collected during two different conditions: Walking and semi-squat at 90 degrees flexion at the knee joint.


Original Secondary Outcome: Same as current

Information By: Northern Orthopaedic Division, Denmark

Dates:
Date Received: August 2, 2011
Date Started: June 2011
Date Completion:
Last Updated: March 23, 2016
Last Verified: March 2016