Development and validation of a Specific training program for managing mild anterior knee pain in recreational cyclists

The aim of the study was to develop and validate an evidence-based exercise protocol (Specific training program) for managing mild anterior knee pain in recreational cyclists.

• Literature was searched in databases like PubMed, Cochrane Library, Google Scholar, Science direct and Embase to locate original studies and evidence synthesis studies (systematic/integrative/scoping reviews) published from 2015 to 2021. A specific training program (consisting 10 strengthening exercises for knee, hip, pelvic and core muscles and 4 stretching exercises for lower limb muscles) was developed based on literature review. Intensity, duration, and technique for each exercise was described. Experts were invited to go through the exercise protocol and rate each exercise on a 4-point Likert scale from 1 to 4 (from “totally inappropriate” to “very appropriate”) for each exercise of the intervention. Content validation of the developed protocol was performed using these scores. The item-level content validity index (I-CVI), the average of scale-level content validity index (S-CVI/Ave) and modified Kappa was calculated to identify whether the treatment required further refinement. Data was analyzed using Microsoft excel.

8 subject experts having practice and/or research experience in sports field in India accepted the invitation and completed the scoring within 15 working days. All the items of the specific training program were determined to be valid, with I-CVIs ranging from 0.87 to 1 for each items and S-CVI/Ave 0.95 which is identified as an excellent for the whole protocol. Modified Kappa was calculated for each item and result obtained ranged from 0.75 to 1 indicating excellent validity. Experts also suggested to use this protocol for specific condition of anterior knee pain (i.e. patellofemoral pain syndrome) for achieving highest benefits.

An evidence based specific training program for 8-week duration for treatment of mild anterior knee pain in recreational cyclists was developed.  The results showed excellent validity by subject experts. 

It has provided healthcare providers in sports and researchers with an exercise protocol to treat recreational cyclists with mild anterior knee pain specifically those who have patellofemoral pain syndrome.