Strength vs Power Training for Patellofemoral Pain

(STRIPE Trial)

Not currently recruiting at 2 trial locations

Overseen By Neal Glaviano, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Connecticut

Disqualifiers: Other knee pain, Surgery, Subluxation, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 9

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two exercise programs for individuals with patellofemoral pain, a common knee issue. The study evaluates a new strength training plan with power exercises (Strength Training Rehabilitation Incorporating Power Exercises, or STRIPE) against standard rehabilitation methods (Standard of Care Rehabilitation, or SOC) to determine which more effectively reduces pain and improves knee function. Participants will either engage in power-focused exercises or follow the usual care routine, both targeting hip and leg muscles. Ideal candidates have experienced knee pain for over three months, particularly during activities like prolonged sitting or stair use. As an unphased trial, this study allows participants to contribute to innovative research that could enhance future treatment options for knee pain.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these rehabilitation programs are safe for treating patellofemoral pain?

Research has shown that strength training with power exercises, such as the STRIPE program, is generally safe for individuals with patellofemoral pain (knee pain at the front of the knee). Participants who have previously engaged in these exercises found them manageable. Studies indicate that incorporating power exercises into regular strength training does not increase side effects. To date, no serious problems have been reported.

The STRIPE program exercises are performed under guidance to ensure safety. They focus on key muscle groups, including the hips, core, and quadriceps (front thigh muscles). This approach aims to strengthen muscles and reduce knee pain without increasing risk.

Overall, evidence suggests that these exercise programs are safe and could be a promising method for managing knee pain. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the STRIPE approach for treating patellofemoral pain because it adds power exercises to the traditional strength training regimen. Unlike the standard rehabilitation that focuses mainly on strength exercises, STRIPE combines both power and strength exercises, which might enhance muscle performance and speed up recovery. The exercises in STRIPE are designed to work at a higher load (over 60% of the participant's one-repetition maximum) with quicker bursts of effort, potentially improving muscle function more effectively than the slower, moderate efforts used in standard care. This innovative combination could lead to better outcomes for patients by addressing not just muscle strength but also power, which is essential for dynamic movements.

What evidence suggests that this trial's treatments could be effective for patellofemoral pain?

This trial will compare two approaches for managing patellofemoral pain: the Strength Training Rehabilitation Incorporating Power Exercises (STRIPE) program and the Standard of Care (SOC) rehabilitation. Research has shown that strength training programs with power exercises, such as the STRIPE program, can effectively treat patellofemoral pain. Studies have found that these programs lower pain levels and improve physical function more than standard strength training. One study discovered that adding power exercises reduced the chances of pain recurrence over two years. Another source reported better muscle power and fewer problems during activities like squatting. Overall, the STRIPE approach appears promising for effectively managing patellofemoral pain. ^{1 2 4 6 7}

Who Is on the Research Team?

Neal Glaviano, PhD

Principal Investigator

University of Connecticut

Are You a Good Fit for This Trial?

This trial is for people aged 18-40 with patellofemoral pain that started on its own over 3 months ago and hurts at least a bit during activities like sitting long, jumping, or climbing stairs. It's not for those with other knee issues, history of knee cap dislocation, meniscus or ligament injuries, leg surgery, or pain from the lower back.

Inclusion Criteria

My symptoms started slowly over more than 3 months ago.

My worst pain was 3/10 last month when sitting long, jumping, squatting, kneeling, running, or using stairs.

Exclusion Criteria

I have had issues with my kneecap, meniscus, or ligaments.

I have had surgery on my leg or foot.

I have experienced pain that spreads from my lower back.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a 6-week rehabilitation program with either the STRIPE or SOC protocol

6 weeks

3 visits per week (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

24 months

Assessments at 6, 12, 18, and 24 months post-intervention

What Are the Treatments Tested in This Trial?

Interventions

• Standard of Care Rehabilitation (SOC)
• Strength Training Rehabilitation Incorporating Power Exercises (STRIPE)

Trial Overview The study compares two 6-week rehab programs for knee pain: Standard of Care (SOC) vs. Strength Training with Power Exercises (STRIPE). It will check which program better reduces pain and prevents it from coming back while improving leg strength and squatting form.

How Is the Trial Designed?

Group I: Strength Training Rehabilitation Incorporating Power Exercises (STRIPE) Experimental Treatment 1 Intervention

Those in the STRIPE group will complete two power and one strength training sessions a week. All participants will be provided an educational pamphlet and exercises will be divided into four components - hip abductors, hip extensors, core, and quadriceps muscles. The load magnitude will be greater than 60% of the 1RM, with the goal of continually loading against heavy resistance. Participants will complete 4 sets of 6 repetitions, with 3-5 minutes of rest between sets. Time under tension will be prescribed as \<1 second for the concentric phase and 1 second for the eccentric phase of the exercise. The strength training sessions will adhere to same parameters as the SOC. Hip abductor, hip extensor, and core exercises will be initiated during week 1 and continued for the 6-week intervention, while quadriceps focused exercises will be introduced in weeks 3-6.

Group II: Standard of Care (SOC) Active Control 1 Intervention

The SOC rehabilitation group will complete three strength sessions a week. All participants will be provided an educational pamphlet and exercises will be divided into four components - hip abductors, hip extensors, core, and quadriceps muscles. The load magnitude for exercises will be between 60-70% of their 1 repetition max (1RM), with 3 sets of 12 repetitions and a 2-3-minute rest between sets. Time under tension will be prescribed as slow to moderate, with a 2-second concentric phase and 2-second eccentric phase for each exercise. Hip abductor, hip extensor, and core exercises will be initiated during week 1 and continued for the 6-week intervention, while quadriceps focused exercises will be introduced in weeks 3-6.

Who Is Running the Clinical Trial?

University of Connecticut

Lead Sponsor

Trials

194

Recruited

162,000+

University of Central Florida

Collaborator

Trials

101

Recruited

1,191,000+

University of Toledo

Collaborator

Trials

8

Recruited

640+

Citations

1. bmjopensem.bmj.com bmjopensem.bmj.com/content/9/1/e001482

Strength Training Rehabilitation Incorporating Power ... Provides evidence if a rehabilitation programme with power-based exercises reduces the recurrence rates of patellofemoral pain for 2 years ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/36684710/

Strength Training Rehabilitation Incorporating Power ... This protocol details a study evaluating a strength-based rehabilitation programme compared with a strength-based programme incorporating power-based exercises ...

3. researchgate.net researchgate.net/publication/396224285_Strength_Training_Rehabilitation_Incorporating_Power_Exercises_to_Standard_of_Care_for_Individuals_with_Patellofemoral_Pain_A_Randomized_Controlled_Trial

(PDF) Strength Training Rehabilitation Incorporating Power ... OBJECTIVE: To compare the efficacy of strength training rehabilitation incorporating power exercises (STRIPE) with standard of care (SOC) in ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8572497/

Adding muscle power exercises to a strength training ... Primary outcomes will be pain intensity and physical function; and secondary outcomes will be kinesiophobia, self-reported improvement, quality of life, peak ...

5. scholars.unf.edu scholars.unf.edu/en/publications/strength-training-rehabilitation-incorporating-power-exercises-st

Strength Training Rehabilitation Incorporating Power ... Strength Training Rehabilitation Incorporating Power Exercises (STRIPE) for individuals with patellofemoral pain: a randomised controlled trial ...

6. apps.dtic.mil apps.dtic.mil/sti/trecms/pdf/AD1206373.pdf

Optimizing Clinical Outcomes for Patients with Patellofemoral ... This study will compare the effects of standard of care (SOC) intervention to a. SOC that includes power-based exercises (Strength Training ...

7. healthprofessions.ucf.edu healthprofessions.ucf.edu/research/studies/strength-or-power-training-for-kneecap-patellofemoral-pain-stripe/

Strength or Power Training for Kneecap (Patellofemoral) Pain ... The objective of this study is to compare a novel 6-week strength training rehabilitation incorporating power exercises (STRIPE) program to a standard of.