Clinical Trial: The Addition of Dry Needling in the Treatment of Patients With Patellofemoral Pain Syndrome

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: The Addition of Dry Needling in the Treatment of Patients With Patellofemoral Pain Syndrome

Brief Summary: Subjects between 14 and 40 years of age referred to physical therapy with a diagnosis of PFPS will be randomly assigned to one of two groups. The first group (PFPS) will be treated pragmatically. The second group (PFPS+DN) will receive the same pragmatic approach with the addition of dry needling intervention. The dry needling intervention will be delivered based on the treating physical therapist's examination of the patient's soft tissue mobility deficits, muscle activation deficits, or referred pain patterns.

Detailed Summary: All interventions delivered to both study groups will be provided by licensed physical therapists at Duke Sports Medicine. The frequency of visits and duration of physical therapy care will be determined on an individual basis. Both groups will be expected to perform an individualized home exercise program to supplement formal therapy visits. The PFPS group will receive a pragmatic treatment approach reflective of currently accepted interventions. The clinician will have the ability to select appropriate interventions based on the presentation/need of each patient. These interventions may include: stretching (iliotibial band, hip flexor, lateral retinaculum); patellar taping; kinesiology taping; bracing; joint mobilization (patella, ankle, hip); orthotics/footwear recommendations; pain modalities such as Ice, electric stimulation, laser; soft tissue mobilization (manual or instrument assisted) for restricted tissues such as peri-patellar tissues, iliotibial band, tensor fasciae latae, hamstrings, calf, quadriceps, hip flexors, and gluteals. The PFPS+DN group will be treated in the same manner described above with the addition of the dry needling intervention. The dry needling intervention will be prescriptive in that each provider will assess patient for the presence of a trigger point that may be contributing either directly or indirectly to the patient's symptoms and perform the intervention per the following guidelines. First, the presence of a trigger point must be verified by locating a palpable taught band, a hypersensitive tender area, referred pain of the MTrP in response to compression, a Jump Sign - response from patient who winces, may cry out, or withdraw, or a local twitch response provoked by manually snapping the taut band. Second, a muscle may be selected for dry needling if that muscle is assumed to be contributing to tissue extensibility restriction, motor control dysfunction, or hyperactivity.
Sponsor: Duke University

Current Primary Outcome: Change in Lower Extremity Functional Scale [ Time Frame: Baseline, 2 weeks, 1 month, at completion of treatment (average of 10 weeks), 3 months, 6 months ]

20 Item Survey - Self report of difficulty with 20 lower extremity common tasks


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Change in Pain [ Time Frame: Baseline, Days 1-15, 1 month, at completion of treatment (average of 10 weeks), 3 months, 6 months ]
    Subjective Report of Pain on a Scale from 0-10
  • Change in Global Function Rating [ Time Frame: Baseline, Days 1-15, 1 month, at completion of treatment (average of 10 weeks), 3 months, 6 months ]
    Subjective Rating for Physical Function on a Scale from 0-100%
  • Change in Global Rating of Change [ Time Frame: Baseline, Days 1-15, 1 month, at completion of treatment (average of 10 weeks), 3 months, 6 months ]
    Subjective Rating of Change since starting treatment scale of -7 (much worse) to +7 (much better)


Original Secondary Outcome: Same as current

Information By: Duke University

Dates:
Date Received: May 15, 2017
Date Started: July 2017
Date Completion: March 2019
Last Updated: May 16, 2017
Last Verified: May 2017