Effectiveness of telerehabilitation intervention to improve pain and physical function in people with patellofemoral pain syndrome: study protocol for a randomized controlled trial.

Exercise therapy Face-to-face physical therapy Patellofemoral pain syndrome Randomized controlled trial Smartphone application Telerehabilitation

Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
19 Mar 2024
Historique:
received: 27 09 2023
accepted: 08 03 2024
medline: 20 3 2024
pubmed: 20 3 2024
entrez: 20 3 2024
Statut: epublish

Résumé

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition in young and active adults. Exercise therapy is an essential part of rehabilitation in people with PFPS (PwPFPS). Telerehabilitation is an innovative treatment approach that has been used in several musculoskeletal conditions. This study aims to investigate the non-inferiority of telerehabilitation through a smartphone application, the Vito App, compared to face-to-face physical therapy on reducing pain and improving physical function, quality of life, and psychological factors. This randomized controlled trial will include 60 PwPFPS. to a control group (face-to-face physical therapy) or an experimental group (telerehabilitation). The intervention for both groups consists of stretching, strengthening, balance, and functional exercises for 6 weeks and three sessions per week. The primary outcomes are pain intensity by visual analog scale (VAS), physical function by the Kujala questionnaire and functional tests including the bilateral squat, anteromedial lunge, and step down, and quality of life by the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire quality of life subscale. Secondary outcomes are psychological factors such as anxiety and depression assessed with the Hospital Anxiety and Depression Scale (HADS) questionnaire, kinesiophobia assessed with the Tampa scale, and pain catastrophizing assessed with the Pain Catastrophizing Scale (PCS). Assessments will be held in 3 phases: pre-test (before the intervention), post-test (after the 6 weeks of intervention), and follow-up (1 month after the end of the intervention). We expect that both the control group and experimental group will show similar improvements in clinical and psychological outcome measures. If our hypothesis becomes true, PwPFPS can use telerehabilitation as a practical treatment approach. Telerehabilitation can also enhance accessibility to rehabilitation services for active adults and for people living in remote and rural areas. Iranian Registry of Clinical Trials (IRCT) IRCT20201112049361N1. Registered on 29 October 2022.

Sections du résumé

BACKGROUND BACKGROUND
Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition in young and active adults. Exercise therapy is an essential part of rehabilitation in people with PFPS (PwPFPS). Telerehabilitation is an innovative treatment approach that has been used in several musculoskeletal conditions. This study aims to investigate the non-inferiority of telerehabilitation through a smartphone application, the Vito App, compared to face-to-face physical therapy on reducing pain and improving physical function, quality of life, and psychological factors.
METHODS METHODS
This randomized controlled trial will include 60 PwPFPS. to a control group (face-to-face physical therapy) or an experimental group (telerehabilitation). The intervention for both groups consists of stretching, strengthening, balance, and functional exercises for 6 weeks and three sessions per week. The primary outcomes are pain intensity by visual analog scale (VAS), physical function by the Kujala questionnaire and functional tests including the bilateral squat, anteromedial lunge, and step down, and quality of life by the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire quality of life subscale. Secondary outcomes are psychological factors such as anxiety and depression assessed with the Hospital Anxiety and Depression Scale (HADS) questionnaire, kinesiophobia assessed with the Tampa scale, and pain catastrophizing assessed with the Pain Catastrophizing Scale (PCS). Assessments will be held in 3 phases: pre-test (before the intervention), post-test (after the 6 weeks of intervention), and follow-up (1 month after the end of the intervention).
DISCUSSION CONCLUSIONS
We expect that both the control group and experimental group will show similar improvements in clinical and psychological outcome measures. If our hypothesis becomes true, PwPFPS can use telerehabilitation as a practical treatment approach. Telerehabilitation can also enhance accessibility to rehabilitation services for active adults and for people living in remote and rural areas.
TRIAL REGISTRATION BACKGROUND
Iranian Registry of Clinical Trials (IRCT) IRCT20201112049361N1. Registered on 29 October 2022.

Identifiants

pubmed: 38504365
doi: 10.1186/s13063-024-08047-3
pii: 10.1186/s13063-024-08047-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

195

Subventions

Organisme : Ahvaz Jundishapur University of Medical Sciences
ID : PHT/0127

Informations de copyright

© 2024. The Author(s).

Références

Davis IS, Powers CM. Patellofemoral pain syndrome: proximal, distal, and local factors, an international retreat, April 30-May 2, 2009, Fells Point, Baltimore. MD J Orthop Sports Phys Ther. 2010;40(3):A1-16.
pubmed: 20195028 doi: 10.2519/jospt.2010.0302
Post WR. Clinical evaluation of patients with patellofemoral disorders. Arthroscopy. 1999;15(8):841–51.
pubmed: 10564862 doi: 10.1053/ar.1999.v15.015084
Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, et al. Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS ONE. 2018;13(1):e0190892.
pubmed: 29324820 pmcid: 5764329 doi: 10.1371/journal.pone.0190892
Glaviano NR, Kew M, Hart JM, Saliba S. Demographic and epidemiological trends in patellofemoral pain. Int J Sports Phys Ther. 2015;10(3):281–90.
pubmed: 26075143 pmcid: 4458915
Eijkenboom JFA, Waarsing JH, Oei EHG, Bierma-Zeinstra SMA, van Middelkoop M. Is patellofemoral pain a precursor to osteoarthritis?: Patellofemoral osteoarthritis and patellofemoral pain patients share aberrant patellar shape compared with healthy controls. Bone Joint Res. 2018;7(9):541–7.
pubmed: 30294426 pmcid: 6168714 doi: 10.1302/2046-3758.79.BJR-2018-0112.R1
Silva Dde O, Briani RV, Pazzinatto MF, Ferrari D, Aragão FA, Azevedo FM. Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain. Clin Biomech (Bristol, Avon). 2015;30(9):971–5.
pubmed: 26169602 doi: 10.1016/j.clinbiomech.2015.06.021
Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. Br J Sports Med. 2019;53(5):270–81.
pubmed: 30242107 doi: 10.1136/bjsports-2017-098890
Dierks TA, Manal KT, Hamill J, Davis I. Lower extremity kinematics in runners with patellofemoral pain during a prolonged run. Med Sci Sports Exerc. 2011;43(4):693–700.
pubmed: 20798656 doi: 10.1249/MSS.0b013e3181f744f5
Van Cant J, Pineux C, Pitance L, Feipel V. Hip muscle strength and endurance in females with patellofemoral pain: a systematic review with meta-analysis. Int J Sports Phys Ther. 2014;9(5):564–82.
pubmed: 25328820 pmcid: 4196322
Maclachlan LR, Collins NJ, Matthews MLG, Hodges PW, Vicenzino B. The psychological features of patellofemoral pain: a systematic review. Br J Sports Med. 2017;51(9):732–42.
pubmed: 28320733 doi: 10.1136/bjsports-2016-096705
van der Heijden RA, Lankhorst NE, van Linschoten R, Bierma-Zeinstra SM, van Middelkoop M. Exercise for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015;1:Cd010387.
pubmed: 25603546
Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med. 2016;50(14):844–52.
pubmed: 27247098 doi: 10.1136/bjsports-2016-096268
Wallis JA, Roddy L, Bottrell J, Parslow S, Taylor NF. A systematic review of clinical practice guidelines for physical therapist management of patellofemoral pain. Phys Ther. 2021;101(3):pzab021.
pubmed: 33533400 doi: 10.1093/ptj/pzab021
Van Der Heijden RA, Lankhorst NE, Van Linschoten R, Bierma-Zeinstra SM, Van Middelkoop M. Exercise for treating patellofemoral pain syndrome: an abridged version of Cochrane systematic review. Eur J Phys Rehabil Med. 2016;52(1):110–33.
pubmed: 26158920
Brennan DM, Mawson S, Brownsell S. Telerehabilitation: enabling the remote delivery of healthcare, rehabilitation, and self management. Stud Health Technol Inform. 2009;145:231–48.
pubmed: 19592797
Gaikwad R, Warren J. The role of home-based information and communications technology interventions in chronic disease management: a systematic literature review. Health Informatics J. 2009;15(2):122–46.
pubmed: 19474225 doi: 10.1177/1460458209102973
Hamine S, Gerth-Guyette E, Faulx D, Green BB, Ginsburg AS. Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. J Med Internet Res. 2015;17(2):e52.
pubmed: 25803266 pmcid: 4376208 doi: 10.2196/jmir.3951
Agostini M, Moja L, Banzi R, Pistotti V, Tonin P, Venneri A, et al. Telerehabilitation and recovery of motor function: a systematic review and meta-analysis. J Telemed Telecare. 2015;21(4):202–13.
pubmed: 25712109 doi: 10.1177/1357633X15572201
Krpič A, Savanović A, Cikajlo I. Telerehabilitation: remote multimedia-supported assistance and mobile monitoring of balance training outcomes can facilitate the clinical staff’s effort. Int J Rehabil Res. 2013;36(2):162–71.
pubmed: 23337324 doi: 10.1097/MRR.0b013e32835dd63b
Kairy D, Lehoux P, Vincent C, Visintin M. A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disabil Rehabil. 2009;31(6):427–47.
pubmed: 18720118 doi: 10.1080/09638280802062553
Dicianno BE, Parmanto B, Fairman AD, Crytzer TM, Yu DX, Pramana G, et al. Perspectives on the evolution of mobile (mHealth) technologies and application to rehabilitation. Phys Ther. 2015;95(3):397–405.
pubmed: 24925075 doi: 10.2522/ptj.20130534
Boulos MN, Brewer AC, Karimkhani C, Buller DB, Dellavalle RP. Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online J Public Health Inform. 2014;5(3):229.
pubmed: 24683442 pmcid: 3959919
Truijen S, Abdullahi A, Bijsterbosch D, van Zoest E, Conijn M, Wang Y, et al. Effect of home-based virtual reality training and telerehabilitation on balance in individuals with Parkinson disease, multiple sclerosis, and stroke: a systematic review and meta-analysis. Neurol Sci. 2022;43(5):2995–3006.
pubmed: 35175439 pmcid: 9023738 doi: 10.1007/s10072-021-05855-2
Cacciante L, Pietà CD, Rutkowski S, Cieślik B, Szczepańska-Gieracha J, Agostini M, et al. Cognitive telerehabilitation in neurological patients: systematic review and meta-analysis. Neurol Sci. 2022;43(2):847–62.
pubmed: 34822030 doi: 10.1007/s10072-021-05770-6
Amin J, Ahmad B, Amin S, Siddiqui AA, Alam MK. Rehabilitation professional and patient satisfaction with telerehabilitation of musculoskeletal disorders: a systematic review. Biomed Res Int. 2022;2022:7366063.
pubmed: 35958819 pmcid: 9363217 doi: 10.1155/2022/7366063
Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):625–38.
pubmed: 27141087 doi: 10.1177/0269215516645148
Hwang R, Bruning J, Morris N, Mandrusiak A, Russell T. A systematic review of the effects of telerehabilitation in patients with cardiopulmonary diseases. J Cardiopulm Rehabil Prev. 2015;35(6):380–9.
pubmed: 26034937 doi: 10.1097/HCR.0000000000000121
Petersen W, Karpinski K, Backhaus L, Bierke S, Häner M. A systematic review about telemedicine in orthopedics. Arch Orthop Trauma Surg. 2021;141(10):1731–9.
pubmed: 33635399 pmcid: 7907664 doi: 10.1007/s00402-021-03788-1
Latif-Zade T, Tucci B, Verbovetskaya D, Bialkin E, Ng B, Heddon S, et al. Systematic review shows tele-rehabilitation might achieve comparable results to office-based rehabilitation for decreasing pain in patients with knee osteoarthritis. Medicina (Kaunas). 2021;57(8):764.
pubmed: 34440970 pmcid: 8398992 doi: 10.3390/medicina57080764
Chen T, Or CK, Chen J. Effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain: A systematic review and meta-analysis of randomized controlled trials. J Am Med Inform Assoc. 2021;28(2):414–23.
pubmed: 33236109 doi: 10.1093/jamia/ocaa282
Xie SH, Wang Q, Wang LQ, Wang L, Song KP, He CQ. Effect of internet-based rehabilitation programs on improvement of pain and physical function in patients with knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Med Internet Res. 2021;23(1):e21542.
pubmed: 33399542 pmcid: 7815452 doi: 10.2196/21542
Dario AB, Moreti Cabral A, Almeida L, Ferreira ML, Refshauge K, Simic M, et al. Effectiveness of telehealth-based interventions in the management of non-specific low back pain: a systematic review with meta-analysis. Spine J. 2017;17(9):1342–51.
pubmed: 28412562 doi: 10.1016/j.spinee.2017.04.008
Albornoz-Cabello M, Barrios-Quinta CJ, Barrios-Quinta AM, Escobio-Prieto I, Cardero-Durán MLA, Espejo-Antunez L. Effectiveness of Tele-Prescription of Therapeutic Physical Exercise in Patellofemoral Pain Syndrome during the COVID-19 Pandemic. Int J Environ Res Public Health. 2021;18(3):1048.
pubmed: 33504042 pmcid: 7908506 doi: 10.3390/ijerph18031048
Arslan T, Gültekin MZ. The effect of a supervised online group exercise program on symptoms associated with patellofemoral pain syndrome in women. Technol Health Care. 2023;31:771–82.
pubmed: 36442169 doi: 10.3233/THC-220533
Lee JH, Shin KH, Lee GB, Son S, Jang KM. Comparison of functional outcomes between supervised rehabilitation and telerehabilitation in female patients with patellofemoral pain syndrome during the COVID-19 pandemic. Int J Environ Res Public Health. 2023;20(3):2233.
pubmed: 36767600 pmcid: 9915527 doi: 10.3390/ijerph20032233
Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.
pubmed: 23295957 pmcid: 5114123 doi: 10.7326/0003-4819-158-3-201302050-00583
Hessam M, Hosseinpour P, Vaezipour A, Mehravar M. Development of an evidence-based progressive web app to promote exercise therapy and telemonitoring for individuals with patello-femoral pain syndrome: a usability study. Shiraz E-Med J. 2022;23(12):e126461.
doi: 10.5812/semj-126461
Negahban H, Pouretezad M, Yazdi MJ, Sohani SM, Mazaheri M, Salavati M, et al. Persian translation and validation of the Kujala Patellofemoral Scale in patients with patellofemoral pain syndrome. Disabil Rehabil. 2012;34(26):2259–63.
pubmed: 22630589 doi: 10.3109/09638288.2012.683480
Loudon JK, Wiesner D, Goist-Foley HL, Asjes C, Loudon KL. Intrarater reliability of functional performance tests for subjects with patellofemoral pain syndrome. J Athl Train. 2002;37(3):256–61.
pubmed: 12937582 pmcid: 164353
Coburn SL, Barton CJ, Filbay SR, Hart HF, Rathleff MS, Crossley KM. Quality of life in individuals with patellofemoral pain: a systematic review including meta-analysis. Phys Ther Sport. 2018;33:96–108.
pubmed: 30059951 doi: 10.1016/j.ptsp.2018.06.006
Salavati M, Mazaheri M, Negahban H, Sohani SM, Ebrahimian MR, Ebrahimi I, et al. Validation of a Persian-version of Knee injury and Osteoarthritis Outcome Score (KOOS) in Iranians with knee injuries. Osteoarthritis Cartilage. 2008;16(10):1178–82.
pubmed: 18411065 doi: 10.1016/j.joca.2008.03.004
Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of Anxiety and Depression Hospital Scales (HADS): Iranian patients with anxiety and depression disorders. Tehran Univ Med J. 2009;67(5):379–85.
Raeissadat SA, Sadeghi S, Montazeri A, editors. Validation of the Pain Catastrophizing Scale (PCS) in Iran. 2013.
Abedi M, Okhovatian F, Heydarpour Meymeh M, Daryabor A, Akbarzadeh BA. Reliability and validity of the tampa scale of kinesiophobia questionnaire in individuals with non-specific low back pain. Middle East J Rehabil Health Stud. 2021;8(4):e115185.
doi: 10.5812/mejrh.115185
Askary-Ashtiani A, Ebrahimi-Takamejani I, Torkaman G, Amiri M, Mousavi SJ. Reliability and validity of the persian versions of the fear avoidance beliefs questionnaire and tampa scale of kinesiophobia in patients with neck pain. Spine. 2014;39(18):E1095–102.
pubmed: 24859572 doi: 10.1097/BRS.0000000000000438
Seron P, Oliveros MJ, Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, et al. Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview. Phys Ther. 2021;101(6):pzab053.
pubmed: 33561280 pmcid: 7928601 doi: 10.1093/ptj/pzab053

Auteurs

Negar Amirabadi (N)

Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Masumeh Hessam (M)

Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. hessam_pt81@yahoo.com.
Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. hessam_pt81@yahoo.com.

Saeideh Monjezi (S)

Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Farshad Molhemi (F)

Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Mohammad Mehravar (M)

Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Pardis Hosseinpour (P)

Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Classifications MeSH