Patellofemoral Pain, PFPNCT07384858
Effects of Attentional Focus Strategies During Isokinetic Quadriceps Training on Strength and Functional Performance in Individuals With Patellofemoral Pain Syndrome.
A study testing Internal focus group and External focus in people with Patellofemoral Pain, PFP, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).
Trial summary
Patellofemoral pain syndrome (PFPS) is a multifactorial musculoskeletal condition that is common particularly among young and physically active individuals, negatively affecting activities of daily living and physical performance. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Patellofemoral Pain, PFP
- What is being tested?
- Internal focus group and External focus
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 2 Feb 2026to 30 Jul 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Aged between 18 and 45 years.
- Diagnosed with patellofemoral pain syndrome (PFPS).
- Anterior or retropatellar knee pain persisting for at least four weeks with a VAS score > 3.
- Pain exacerbated by at least two functional activities (e.g., squatting, stair climbing, prolonged sitting).
- Willing to regularly participate in the 6-week program throughout the study period.
Who cannot join
- History of patellar subluxation or dislocation.
- Anterior or posterior cruciate ligament insufficiency.
- Lower extremity fractures.
- Neurological or systemic musculoskeletal disorders.
- Rheumatoid arthritis or other inflammatory joint diseases.
- History of knee surgery, meniscal injury, or any other underlying musculoskeletal condition that would prevent the participant from performing the exercises.
Show all 9Show fewer
- Pregnancy or postpartum period.
- Participation in a similar exercise program within the last 3 months.
- Radiographic evidence of osteoarthritis classified as Kellgren-Lawrence grade 2 or higher.
Trial locations and contacts
1 site in 1 country.
About this study
Patellofemoral pain syndrome (PFPS) is a multifactorial musculoskeletal condition that is common particularly among young and physically active individuals, negatively affecting activities of daily living and physical performance. Although exercise therapy is considered the gold standard in the management of PFPS, there is limited evidence regarding the effectiveness of motor learning strategies applied during exercise. This study aims to shed light on how motor learning approaches can be optimized in clinical rehabilitation by comparing the effects of internal and external focus strategies used during exercise on muscle activation, functional performance, and pain.
This research will make a methodological contribution to the literature through the objective evaluation of muscle mechanical properties using isokinetic assessment and the MyotonPRO device. The findings are expected to clarify the effects of attentional focus strategies on therapeutic outcomes in PFPS rehabilitation and have the potential to provide an evidence-based guide for physiotherapy practice. In this way, the study may contribute to the development of new approaches aimed at improving both clinical effectiveness and patient adherence.
- Conditions
- Patellofemoral Pain, PFP
- Being tested
- Internal focus group, External focus
- Medical subject headings
- Patellofemoral Pain Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Internal focus groupOther
Internal focus refers to directing attention to one's own body movements or muscle activity while performing a task (e.g., focusing on contracting a specific muscle). During isokinetic strength exercises, this group is instructed with commands such as: "Tighten your quadriceps" and "Straighten your knee."
External focusOther
External focus refers to directing attention to the effect of a movement on the environment or an external object, rather than on the body itself. During isokinetic exercise, this group is given the instruction: "Increase and maintain the performance indicator on the screen."
| Study group | Role | What they receive |
|---|---|---|
| Internal focus | Experimental | Not described Receives: Other: Internal focus group |
| External focus | Experimental | Not described Receives: Other: External focus |
What is being measured
The primary outcome is the main question the study is designed to answer.
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities.
The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Measured: baseline
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities.
The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Measured: Week 3 of the Treatment
Kujala Patellofemoral Pain Score
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities.
The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Measured: Week 6 of the Treatment
Secondary outcomes (21)
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Measured: baseline
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Measured: Week 3 of the Treatment
Visual Analog Scale
Visual Analog Scale (VAS) is a simple and reliable tool used to assess the intensity of knee pain. Participants rate their pain on a 0 to 10 cm scale, with higher scores indicating greater pain severity. It was used to evaluate changes in pain before and after exercise.
Measured: Week 6 of the Treatment
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
Measured: baseline
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
Measured: Week 3 of the Treatment
Isokinetic Muscle Strength Assessment (Isoforce)
Muscle performance will be objectively evaluated by measuring concentric strength values of the quadriceps muscle.
Measured: Week 6 of the Treatment
Muscle Tone
Muscle tone was assessed using the MyotonPRO device, expressed in Hertz (Hz), with higher values indicating increased resting muscle tone.
Measured: baseline
Muscle Tone
Muscle tone was assessed using the MyotonPRO device, expressed in Hertz (Hz), with higher values indicating increased resting muscle tone.
Measured: Week 3 of the Treatment
Muscle Tone
Muscle tone was assessed using the MyotonPRO device, expressed in Hertz (Hz), with higher values indicating increased resting muscle tone.
Measured: Week 6 of the Treatment
Muscle Stiffness
Muscle stiffness was measured using the MyotonPRO device, expressed in Newton per meter (N/m), with higher values indicating greater muscle stiffness.
Measured: baseline
Muscle Stiffness
Muscle stiffness was measured using the MyotonPRO device, expressed in Newton per meter (N/m), with higher values indicating greater muscle stiffness.
Measured: Week 3 of the Treatment
Muscle Stiffness
Muscle stiffness was measured using the MyotonPRO device, expressed in Newton per meter (N/m), with higher values indicating greater muscle stiffness.
Measured: Week 6 of the Treatment
Muscle Elasticity
Muscle elasticity was evaluated using the MyotonPRO device, expressed as logarithmic decrement, with lower values indicating better elastic properties.
Measured: baseline
Muscle Elasticity
Muscle elasticity was evaluated using the MyotonPRO device, expressed as logarithmic decrement, with lower values indicating better elastic properties.
Measured: Week 3 of the Treatment
Muscle Elasticity
Muscle elasticity was evaluated using the MyotonPRO device, expressed as logarithmic decrement, with lower values indicating better elastic properties.
Measured: Week 6 of the Treatment
Step-Down Test
Step-Down Test was used to assess lower-extremity control and functional performance. Participants were instructed to perform as many step-down repetitions as possible within 30 seconds. Performance was recorded as the number of completed repetitions, with higher scores indicating better functional capacity and dynamic knee stability.
Measured: baseline
Step-Down Test
Step-Down Test was used to assess lower-extremity control and functional performance. Participants were instructed to perform as many step-down repetitions as possible within 30 seconds. Performance was recorded as the number of completed repetitions, with higher scores indicating better functional capacity and dynamic knee stability.
Measured: Week 3 of the Treatment
Step-Down Test
Step-Down Test was used to assess lower-extremity control and functional performance. Participants were instructed to perform as many step-down repetitions as possible within 30 seconds. Performance was recorded as the number of completed repetitions, with higher scores indicating better functional capacity and dynamic knee stability.
Measured: Week 6 of the Treatment
Single-Leg Hop Test
Single-Leg Hop Test was used to assess functional performance and dynamic knee stability. Participants were instructed to perform a maximal forward hop on the affected limb. The hop distance was measured in centimeters (cm), with greater distances indicating better functional performance.
Measured: baseline
Single-Leg Hop Test
Single-Leg Hop Test was used to assess functional performance and dynamic knee stability. Participants were instructed to perform a maximal forward hop on the affected limb. The hop distance was measured in centimeters (cm), with greater distances indicating better functional performance.
Measured: Week 3 of the Treatment
Single-Leg Hop Test
Single-Leg Hop Test was used to assess functional performance and dynamic knee stability. Participants were instructed to perform a maximal forward hop on the affected limb. The hop distance was measured in centimeters (cm), with greater distances indicating better functional performance.
Measured: Week 6 of the Treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Feb 2026
- Study start2 Feb 2026
- Primary completion30 Jul 2026
- Study completion30 Jul 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Patellofemoral Pain, PFPStudies of the same condition, open and under way.
- More trials run by Istanbul University - CerrahpasaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Istanbul University - Cerrahpasa
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Seda Ateş, Istanbul University - Cerrahpasa
- Investigators
- SEZEN KARABÖRKLÜ ARGUT, Assistant Professor, Study director, Istanbul University-Cerrahpaşa, Faculty of Health Science
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07384858
- Sponsor's protocol ID
- 2025/714
- Status last verified
- Aug 2026
- First submitted
- 17 Dec 2025
- Last updated
- 18 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 18 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Attentional Focus Strategies During Isokinetic Quadriceps Training on Strength and Functional Performance in Individuals With Patellofemoral Pain Syndrome.
- ClinicalTrials.gov ID
- NCT07384858
- Acronym / sponsor ID
- 2025/714
- Conditions
- Patellofemoral Pain, PFP
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Istanbul University - CerrahpasaUniversity, hospital or other
- Study start
- 2 Feb 2026 (actual)
- Primary completion
- 30 Jul 2026 (actual)
- Study completion
- 30 Jul 2026 (actual)
- First posted
- 3 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Patellofemoral pain syndrome (PFPS) is a multifactorial musculoskeletal condition that is common particularly among young and physically active individuals, negatively affecting activities of daily living and physical performance. Although exercise therapy is considered the gold standard in the management of PFPS, there is limited evidence regarding the effectiveness of motor learning strategies applied during exercise. This study aims to shed light on how motor learning approaches can be optimized in clinical rehabilitation by comparing the effects of internal and external focus strategies used during exercise on muscle activation, functional performance, and pain.
This research will make a methodological contribution to the literature through the objective evaluation of muscle mechanical properties using isokinetic assessment and the MyotonPRO device. The findings are expected to clarify the effects of attentional focus strategies on therapeutic outcomes in PFPS rehabilitation and have the potential to provide an evidence-based guide for physiotherapy practice. In this way, the study may contribute to the development of new approaches aimed at improving both clinical effectiveness and patient adherence.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Internal focus | Experimental | Other: Internal focus group |
| External focus | Experimental | Other: External focus |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Aged between 18 and 45 years.
- Diagnosed with patellofemoral pain syndrome (PFPS).
- Anterior or retropatellar knee pain persisting for at least four weeks with a VAS score > 3.
- Pain exacerbated by at least two functional activities (e.g., squatting, stair climbing, prolonged sitting).
- Willing to regularly participate in the 6-week program throughout the study period.
Key exclusion criteria (9 listed)
- History of patellar subluxation or dislocation.
- Anterior or posterior cruciate ligament insufficiency.
- Lower extremity fractures.
- Neurological or systemic musculoskeletal disorders.
- Rheumatoid arthritis or other inflammatory joint diseases.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Internal focus groupInternal focus refers to directing attention to one's own body movements or muscle activity while performing a task (e.g., focusing on contracting a specific muscle). During isokinetic strength exercises, this group is instructed with commands such as: "Tighten your quadriceps" and "Straighten your knee." | Other | Internal focus |
| External focusExternal focus refers to directing attention to the effect of a movement on the environment or an external object, rather than on the body itself. During isokinetic exercise, this group is given the instruction: "Increase and maintain the performance indicator on the screen." | Other | External focus |
Primary outcome
Kujala Patellofemoral Pain Score
Time frame: baseline
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Kujala Patellofemoral Pain Score
Time frame: Week 3 of the Treatment
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
Kujala Patellofemoral Pain Score
Time frame: Week 6 of the Treatment
Kujala Patellofemoral Pain Score is a valid and reliable self-reported outcome measure specific to patellofemoral pain syndrome that assesses knee function and pain-related limitations during daily activities. The total score ranges from 0 to 100, with higher scores indicating better knee function and fewer symptoms.
21 secondary outcomes
Visual Analog Scale
Time frame: baseline
Visual Analog Scale
Time frame: Week 3 of the Treatment
Visual Analog Scale
Time frame: Week 6 of the Treatment
Isokinetic Muscle Strength Assessment (Isoforce)
Time frame: baseline
Isokinetic Muscle Strength Assessment (Isoforce)
Time frame: Week 3 of the Treatment
Isokinetic Muscle Strength Assessment (Isoforce)
Time frame: Week 6 of the Treatment
Muscle Tone
Time frame: baseline
Muscle Tone
Time frame: Week 3 of the Treatment
Muscle Tone
Time frame: Week 6 of the Treatment
Muscle Stiffness
Time frame: baseline
Muscle Stiffness
Time frame: Week 3 of the Treatment
Muscle Stiffness
Time frame: Week 6 of the Treatment
Muscle Elasticity
Time frame: baseline
Muscle Elasticity
Time frame: Week 3 of the Treatment
Muscle Elasticity
Time frame: Week 6 of the Treatment
Step-Down Test
Time frame: baseline
Step-Down Test
Time frame: Week 3 of the Treatment
Step-Down Test
Time frame: Week 6 of the Treatment
Single-Leg Hop Test
Time frame: baseline
Single-Leg Hop Test
Time frame: Week 3 of the Treatment
Single-Leg Hop Test
Time frame: Week 6 of the Treatment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Aug 2026.
- Individual participant dataSharing planned: Undecided
Related trials for Patellofemoral Pain, PFP
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Gait Retraining for Runners With Patellofemoral Pain
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Telerehabilitation for Patellofemoral Pain
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Comparison Between Foot Segment Mulligan Mobilization and Ilium Mulligan Mobilization in Treatment Patellofemoral Pain Patients With Flatfeet: a Randomized Controlled Comparative Study
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
SEZEN KARABÖRKLÜ ARGUT, Assistant Professor study director
Istanbul University-Cerrahpaşa, Faculty of Health Science
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Internal focus group and External focus in people with Patellofemoral Pain, PFP, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Kujala Patellofemoral Pain Score (time frame: baseline). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Aug 2026.