Knee Isometric Exercises for Patellofemoral Pain Syndrome

Overseen By Haley Goble, MHA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The Methodist Hospital Research Institute

Disqualifiers: Neurological, Degenerative musculoskeletal, Surgical, others

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

Compensation: Varies

Number of Visits: 2

Duration: 4-8 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a new set of knee exercises can reduce knee pain more effectively than the usual physical therapy routine. The study will compare two groups: one performing the new Knee Isometric Program (KIP) exercises and the other following standard physical therapy guidelines. Individuals experiencing front knee pain for at least four weeks but less than a year, with a doctor's recommendation for physical therapy, may be suitable candidates. As an unphased trial, this study provides a unique opportunity to explore innovative treatments that could enhance knee health.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the Knee Isometric Program (KIP) is safe for treating patellofemoral pain syndrome?

Research shows that knee exercises, such as the Knee Isometric Program (KIP), are usually manageable for patients. One study with 30 participants experiencing knee pain found that a specific exercise program to strengthen the thigh muscles significantly reduced their pain. The study reported no serious side effects, suggesting that KIP is safe for most people.

Although the study didn't list specific side effects, the absence of major issues provides confidence in the program's safety. Since this trial is not in its early stages, there is already some evidence regarding the treatment’s safety. For those considering participation, it is reassuring to know that exercise-based treatments like KIP generally have a good safety record. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Knee Isometric Program (KIP) because it offers a less time-intensive approach to managing patellofemoral pain syndrome compared to the typical structured physical therapy regimen. Unlike standard care that involves multiple weekly visits over several weeks, KIP streamlines the process, which might make it more convenient and accessible for patients. This program also emphasizes a comprehensive home exercise plan, promoting long-term maintenance of improved muscle strength and function. By potentially reducing the treatment burden while maintaining effectiveness, KIP could enhance patient adherence and outcomes.

What evidence suggests that the Knee Isometric Program (KIP) might be an effective treatment for patellofemoral pain syndrome?

Research shows that isometric exercises, such as those in the Knee Isometric Program (KIP), can reduce knee pain for individuals with patellofemoral pain syndrome. Participants in this trial will follow the KIP protocol, which studies have shown not only lessens knee pain but also improves knee function. Isometric exercises strengthen the thigh muscles without moving the knee, stabilizing the joint and reducing pain. Another study found that individuals in a similar exercise program experienced better muscle function and reduced fear of movement. Overall, KIP shows promise in improving knee pain and function. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

This trial is for individuals experiencing anterior knee pain, known as Patellofemoral Pain Syndrome. Specific eligibility criteria are not provided, but typically participants would need to meet certain health conditions and agree to follow the study's procedures.

Inclusion Criteria

I have been referred for knee physical therapy by the study's doctor.

I have had front knee pain for 4 weeks to 12 months.

Accept all provisions of the study and agree to complete the program in its entirety

Exclusion Criteria

I have a nerve or muscle condition affecting my legs.

I have not had surgery or broken a bone in the affected limb(s) in the past year.

Significant anatomical anomaly or limb alignment disorder as diagnosed by medical professional

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a knee isometric program or standard physical therapy regimen over 4-8 weeks with 1-2 visits per week, supplemented by home exercise programs.

4-8 weeks

1-2 visits per week (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at baseline, 6 weeks, and 12 weeks.

6 weeks

1 visit (in-person) at 12 weeks

Long-term maintenance

Participants continue with a refined comprehensive home exercise program after discharge from formal physical therapy.

What Are the Treatments Tested in This Trial?

Interventions

• Knee Isometric Program (KIP)

Trial Overview The study is testing a Knee Isometric Program (KIP) against the current standard treatment recommended by the Academy of Orthopedic Physical Therapy. The goal is to see if KIP can effectively reduce knee pain.

How Is the Trial Designed?

Group I: Knee Isometric Program (KIP) - Intervention Experimental Treatment 1 Intervention

This group will incorporate the KIP protocol, which is a modified physical therapy regimen that is less time-intensive than the gold standard counterpart. Typical structured/skilled physical therapy occurs over the course of 4-8 weeks with 1-2 visits per week to establish improved lower extremity muscle strength, education, and improve gross function. Home exercise programs (HEP) are utilized in tandem with physical therapy visits so that patients are completing interventions 4-5 days per week. Long-term maintenance is generally provided via a refined comprehensive HEP on completion and discharge from formal physical therapy.

Group II: Patellofemoral Clinical Practice Guideline (CPG) - Control Active Control 1 Intervention

This group will incorporate the standard of care physical therapy regimen which includes a specific and structured combination of quadriceps and gluteal strengthening as defined in the patellofemoral pain clinical practice guideline. Typical structured/skilled physical therapy occurs over the course of 4-8 weeks with 1-2 visits per week to establish improved lower extremity muscle strength, education, and improve gross function. Home exercise programs (HEP) are utilized in tandem with physical therapy visits so that patients are completing interventions 4-5 days per week. Long-term maintenance is generally provided via a refined comprehensive HEP on completion and discharge from formal physical therapy.

Who Is Running the Clinical Trial?

The Methodist Hospital Research Institute

Lead Sponsor

Trials

299

Recruited

82,500+

Published Research Related to This Trial

In a study of 55 young female patients with patellofemoral pain syndrome, those who performed hip-and-knee exercises showed significantly greater improvements in pain relief and functional gain compared to those who only did knee exercises after 12 weeks.

The study suggests that incorporating hip-strengthening exercises into rehabilitation programs can enhance outcomes for patients suffering from patellofemoral pain syndrome.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of hip and knee exercises on pain, function, and strength in patientswith patellofemoral pain syndrome: a randomized controlled trial. Şahin, M., Ayhan, FF., Borman, P., et al.[2022]

A systematic review of 19 randomized controlled trials found that most therapeutic exercises for patellofemoral pain (PFP) primarily focused on simple, non-weight bearing movements, which may not effectively address the complex mechanics of the injury.

The analysis revealed a significant lack of task-specific exercises, such as multiplanar and single limb weight-bearing activities, suggesting that current rehabilitation programs may need to evolve to better target the underlying biomechanical issues associated with PFP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do exercises for patellofemoral pain reflect common injury mechanisms? A systematic review. Dischiavi, SL., Wright, AA., Tarara, DT., et al.[2021]

Patients with patellofemoral pain syndrome exhibited a significant reduction in quadriceps torque (30% to 40%) compared to healthy individuals, indicating a potential impairment in muscle function associated with this condition.

The torque reduction was consistent across different speeds and modes of contraction, suggesting that the impact of patellofemoral pain syndrome on muscle strength is not influenced by these factors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Concentric and eccentric torque variations of the quadriceps femoris in patellofemoral pain syndrome. Dvir, Z., Shklar, A., Halperin, N., et al.[2013]

An isokinetic exercise program significantly improved functional capacity and reduced pain scores in 22 patients with patellofemoral pain syndrome over a 6-week treatment period.

The exercise program helped prevent loss of extensor power, but the improvements in functional capacity were not directly linked to the increase in power, indicating a complex relationship between strength and function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Alaca, R., Yilmaz, B., Goktepe, AS., et al.[2022]

In a pilot study involving 20 patients with patellofemoral pain syndrome, isotonic eccentric training of the quadriceps significantly reduced pain and improved functional status, as measured by various outcome scales.

All outcome measures, including the SF-36 Health questionnaire and patellofemoral pain severity scale, showed significant improvements, indicating that this type of training can be an effective treatment option for managing symptoms of patellofemoral pain syndrome.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of eccentric isotonic quadriceps muscle exercises on patellofemoral pain syndrome: an exploratory pilot study. Eapen, C., Nayak, CD., Pazhyaottyil Zulfeequer, C.[2021]

In a study of 30 patients with patellofemoral pain, a structured isometric quadriceps strengthening program significantly reduced knee pain in both skeletally immature individuals and adults, demonstrating its efficacy as an initial treatment.

Skeletally immature patients showed not only pain reduction but also improved knee alignment, with 8 out of 13 showing significant changes in congruence angles, while adults had less radiographic improvement and some had to limit their activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patellofemoral stress. A prospective analysis of exercise treatment in adolescents and adults. O'Neill, DB., Micheli, LJ., Warner, JP.[2017]

A comprehensive treatment approach for patellofemoral pain syndrome in 40 young women led to significant reductions in pain and improvements in muscle function and physical activity after 12 weeks, with 85% of participants able to engage in sports pain-free at the 12-month follow-up.

Both isometric and eccentric training programs were effective, showing no significant differences in outcomes, suggesting that the overall treatment strategy, including education and gradual progression, played a key role in recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comprehensive treatment approach for patellofemoral pain syndrome in young women. Thomeé, R.[2022]

Citations

1. trials.arthritis.org trials.arthritis.org/trials/NCT06536426

Knee Isometric Program (KIP) Home Exercise Programs (HEP ... The purpose of this study is to evaluate the efficacy of a knee isometric program (KIP) as compared to the current gold standard treatment for anterior knee ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11015899/

Efficacy of Isometric Exercises and Somatosensory Training ... Research has demonstrated that isometric exercises can minimize pain in the anterior aspect of the knee, promote functional capacity, and ...

3. withpower.com withpower.com/trial/phase-patellofemoral-pain-syndrome-7-2024-c0299

Knee Isometric Exercises for Patellofemoral Pain Syndrome Research shows that isometric quadriceps strengthening exercises can reduce knee pain in patients with patellofemoral pain syndrome, as seen in a study where ...

4. jospt.org jospt.org/doi/10.2519/jospt.2012.4184

A Randomized Controlled Clinical Trial With 1-Year Follow ... Knee-stretching and -strengthening exercises supplemented by hip posterolateral musculature- strengthening exercises were more effective than knee exercises ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1466853X21001176

How effective is an evidence-based exercise intervention ... Individuals with PFP showed improved function, kinesiophobia and quadriceps muscle inhibition after the 6-week exercise programme.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12080477/

The effect of patellar taping combined with isometric strength ... The study demonstrates that patellar taping combined with quadriceps -IST at a 60° knee flexion improves pain, muscle strength, and functional performance

7. trialsjournal.biomedcentral.com trialsjournal.biomedcentral.com/articles/10.1186/s13063-025-08787-w

Effectiveness of combining a proximal strengthening exercise ... As established in previous research, strengthening exercises boost performance and ease pain in PFPS patients. However, it has thus far been ...