None listed
Conditions
Brief summary
Background: Knee pain is the second most common musculoskeletal complaint, second only to back pain. Both education and physiotherapist led exercise have been reported to be effective. However, to date, there is little research evaluating the effectiveness of education alone, and how many people still need physiotherapy following receiving appropriate education. Population: 30 young people (18 - 40y/o) with knee pain. Outcome measures: Pain, function, muscle strength, movement pattern, psychosocial factors, knowledge and quality of life. Phase 1 intervention: 6 weeks of online and leaflet based self-directed education to teach how to manage pain including strategies and importance of exercises to improve pain. All outcome measures will be reassessed following the 6 week period. Phase 2: Those who do not rate themselves as completely recovered following phase 1 will receive further 12 weeks tailored education and exercise guidance from a physiotherapist. This treatment will be randomly provided via 1 of 2 protocols: (i) 8 sessions of one on one physiotherapy to allow progression of exercise into a gym program; or (ii) 8 sessions of physiotherapy delivered via Skype to guide home exercises and educate them about their condition. Both groups will be reassessed for all outcome measures at the completion of this 12 week period.
Interventions
This trial will be divided in 2 phases:
For phase 1 and 2 participants will be asked to: avoid taking antiinflamatory or analgesic medications; avoid participating in any additional physiotherapy program; avoid making any drastically changes in their diet. Participants will be asked to report any of these events in their paper diary.
Phase 1 will involve a 6 week period of self-directed education using a purposely created online platform and printed leaflets.
- Self-directed education:
A phy
This trial will be divided in 2 phases: For phase 1 and 2 participants will be asked to: avoid taking antiinflamatory or analgesic medications; avoid participating in any additional physiotherapy program; avoid making any drastically changes in their diet. Participants will be asked to report any of these events in their paper diary. Phase 1 will involve a 6 week period of self-directed education using a purposely created online platform and printed leaflets. - Self-directed education: A physiotherapist (> 5 years' experience) will introduce the content of the website and leaflet for each participant in a 30-minutes session. The website was designed to educate patients with patellofemoral pain how to manage their knee pain by themselves based on the best evidence available. It will consist in 3 main topics: 1 - Understanding patellofemoral pain - Why does it hurt? - Diagnosis - How common is patellofemoral pain? - What pain is ok? - When will my pain stop? - Fear of movement - Manage your load to manage your pain. 2 - Treatment options - What works? - Exercise - Taping/Bracing - Orthotics - Other options? - Surgery - PRP - Ultrasound 3 - Exercise program - Exercise 1 - Bridges - Exercise 2 - Core - Exercise 3 - Hip - Exercise 4 - Squats In addition to the website, we will deliver an education leaflet titled "Managing my patellofemoral pain", which was previous published, also freely available for general public "Barton CJ, Rathleff MS ‘Managing My Patellofemoral Pain’: the creation of an education leaflet for patients BMJ Open Sport & Exercise Medicine 2016;2:e000086. doi: 10.1136/bmjsem-2015-000086" Following this 6 week period, participants who do not consider themselves completely recovered will enter into phase 2: a double blind two arm pilot randomised trial conforming to CONSORT guidelines involving different physiotherapist led exercise and education interventions, provided over 12 weeks. The mode of administration of both interventions will be one-on-one (participant and physiotherapist). The tested intervention will be a Physiotherapist-delivered exercise program. - Physiotherapist-delivered exercise group One physiotherapist (5 years' experience) will deliver a 12-weeks exercise program to the participants of this randomised controlled trial. Participants will attend to 8 sessions in a Physiotherapy Clinic which will be distributed according to the topics below: - Week 1: 1-hour session - Week 2: 1-hour session - Week 3: 1-hour session - Week 4: 1-hour session - Week 6: 1-hour session - Week 8: 1-hour session - Week 10: 1-hour session - Week 12: 1-hour session Besides the sessions with the physiotherapist, participants will be instructed to perform the exercises 2 times a week at home. The adherence to the recommended home-based exercises and physiotherapy sessions will be assessed through the app "Physio Track", available at: http://www.physiotrack.co.uk/our-app/ or paper diary depending on preference The intervention and recommendations will consist in progressive core, hip and knee strengthening exercises, gait retraining in gestures participants report knee pain and gradual exposure to pain exacerbating activities.
Sponsors
Christian John Barton
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
The following inclusion criteria will be applied by a licensed physical therapist (> 5 years of clinical experience): i) anterior knee pain during at least two of the following activities: stair ascent or descent, squatting, prolonged sitting, kneeling, running, and jumping; ii) symptoms for at least one month with an insidious onset; and iv) pain level of at least 20 mm on a 100 mm visual analogue scale in the previous week.
Exclusion criteria
Exclusion criteria will be events of patellar subluxation or dislocation, lower limb inflammatory process, lower limb surgery, patellar tendon or meniscus tears, bursitis, ligament tears, or the presence of neurological diseases. Individuals who had received oral steroids and opiate treatment.
Outcome results
None listed