Effect of Specific Versus General Hamstring Stretch on Clinical Outcomes in Patellofemoral Pain Syndrome (PFPS)

Condition(s) studied

Investigational drug(s) / intervention(s)

Transcutaneous Electrical Nerve Stimulation Device: Each participant will receive 20 minutes of TENS, Electrodes will be positioned around the patella with a 5 - 7 cm distance in between, The TENS settings include a continuous asymmetric biphasic square-pulse wave, a pulse width of 120 microseconds, and a pulse rate of 180 Hz.

Strength exercises for lower limb: Each participant will receive progressive strengthening program targeting the hip and knee, begin with 3 sets of 10 repetitions and progress to 3 sets of 20 repetitions.

Hamstring Stretch Muscle Energy Technique(MET) (General ): The participant will be supine and the leg will be taken into hip flexion until a tightness is felt then patient will be asked to push down with his lower leg and hold the contraction for 10 seconds then relax for 2 to 3 seconds then the therapist will take the patient's leg into further flexion for 30 seconds this will be repeated for 3 times each session .

Medial Hamstring Muscle energy technique(MET) stretch: The Participant will be supine' then the therapist will take his leg in flexion, abduction and external rotation at the same time until he feels tightness then he will ask the patient to push his leg down and in or toward him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more abduction 'external rotation and flexion for 30 seconds, this will be repeated for 3 times each session

Lateral hamstring Muscle Energy Technique(MET)Stretch: The Participant will be supine' then the therapist will take his leg in flexion, adduction and internal rotation at the same time until he feels a tightness then he will ask the patient to push his leg down and out or away from him him and hold the contraction for 10 seconds then relax for 2 to 3 seconds then therapist will take the patient's leg in more adduction 'internal rotation and flexion for 30 seconds, this will be repeated for 3 times each session

Study summary

This randomized, Single-blind, parallel-group trial will compare the effects of three hamstring stretching interventions-general hamstring Muscle Energy Technique (MET), medial hamstring MET, and lateral hamstring MET-each combined with standardized TENS and progressive hip/knee strengthening, on hamstring flexibility (knee-extension ROM), anterior knee pain (Arabic Kujala score), pain intensity visual analogue scale (VAS), and lower-limb strength (hand-held dynamometer) in adults with patellofemoral pain syndrome (PFPS).

Eligibility

Primary outcome measure(s)

• hamstring flexibility (knee extension range of motion ) — 4 weeks
  measuring knee extension range of motion(hamstring flexibility) by active knee extension test using kinovea software
• Arabic Kujala Anterior knee pain score — 4 weeks
  Arabic Kujala Anterior knee pain score is used to measure pain and functional activities in anterior knee pain patients consisting of 13 questions, the Patient will be asked to mark the most suitable answer for him. Each answer has points up to 5 or 10, and the total score is 100. The higher the score, the better for the patient.

Trial sites (1)

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