Patellofemoral pain syndrome (PFPS) is a common knee condition causing pain and dysfunction. This study aims to compare the effectiveness of two physical therapy treatments for PFPS: Mulligan mobilization with movement technique versus phonophoresis with chitosan gel.
Forty-five participants with patellofemoral pain syndrome will be randomly assigned to one of three groups: (1) Mulligan technique group, (2) Phonophoresis with chitosan gel group, or (3) Control group receiving standard physical therapy exercises. Each group will receive treatment 3 times per week for 4 weeks.
The researchers want to determine which treatment is more effective in improving neuromuscular control, reducing pain, and improving function in patients with patellofemoral pain syndrome. Participants will be assessed before and after the treatment period.
This study may help physical therapists and healthcare providers choose the most effective treatment approach for patients with patellofemoral pain.
Insidious onset of anterior knee pain
Retro patellar or peripatellar pain
Pain duration more than four weeks (chronic/subacute)
Pain severity ≥ 3/10 on Visual Analog Scale (VAS)
Traumatic injury (e.g., dislocation, fracture, ligament or meniscus pathology)
Inflammatory arthritis (e.g., rheumatoid arthritis, gout)
Prior knee surgery
Current use of NSAIDs or corticosteroids
Parallel
Mulligan technique
Procedure/SurgeryEach mobilization with movement (MWM) is performed in three sets of 10 repetitions, with a 30-second rest interval between sets, 3 times per week for 6 weeks, before hip and knee strengthening exercises.
Phonophoresis with Chitosan Gel
Procedure/SurgeryPhonophoresis (ultrasound with chitosan gel) is applied at 1 MHz, 1.0 W/cm², continuous mode, for 5 minutes, 3 times per week for 6 weeks before hip and knee exercises.
Standard Physical Therapy Exercise Program
BehavioralParticipants attend 3 sessions per week for 6 weeks. Each session includes stretching and hip and knee focused exercises. Progression involves weekly increases in repetitions and resistance based on pain levels (less than 3/10).
Maximal rate of force development (RFD)
Calculated from the slope of force- or torque-time curves obtained during rapid, explosive voluntary contractions also termed ballistic or rapid actions has become a key metric for assessing explosive strength in diverse populations, including athletes, older adults, and clinical patients
Pain at patella
Pain measured using the Kujala Anterior Knee Pain Scale (AKPS). The scale ranges from 0 to 100 points, with 0 indicating maximum disability and 100 indicating no disability. Higher scores indicate better outcome (less pain and better function)
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