- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03784339
Effect of Designated Education Session on Patellofemoral Pain
Feasibility Study: Does a Designated Education Session Change Levels of Catastrophizing, Kinesiophobia and Pain Beliefs in Patients With Patellofemoral Pain?
Feasibility study: Does a designated education session change levels of catastrophizing, kinesiophobia and pain beliefs in patients with patellofemoral pain? Design: Single site feasibility Study Aim: Aims are to identify if a formal education session (intervention) improves patient outcomes and to assess if it is possible to test the intervention for efficacy in a larger study.
Outcome Measures: The primary outcome measure is the Knee Osteoarthritis Outcome Score-Patellofemoral) KOOS-PF. The original KOOS consists of 5 subscales; Pain, other Symptoms, Activities of Daily Living (ADL), Function in sport and recreation (Sport/Rec) and knee related Quality of Life (QOL). The KOOS-PF was developed to evaluate individuals or samples of individuals who present with anterior knee pain/patellofemoral pain and/or patellofemoral osteoarthritis (OA), or who are at risk of developing patellofemoral pain or OA.
Secondary Outcome Measures are Pain Catastrophizing Scale and The Tampa Scale for Kinesiophobia.
Patients who are eligible for inclusion in the study will be identified from the Musculoskeletal Clinical Assessment Service (MCAS) by Band 6's and 7's and approved by a Band 8 Physiotherapist the South Liverpool Treatment Centre.
Intervention: The intervention will comprise a 1:1, 30 minute education session delivered by a specialist musculoskeletal physiotherapist with over ten years' experience who has an interest in patellofemoral pain.
The education session will be based on a schedule formed from the most recent research on patellofemoral pain PFP which considers psychosocial factors (Robertson et al 2017). Crepitus is a word used to describe any grinding, creaking, cracking, grating, crunching or popping that occurs when the patellofemoral joint moves (Robertson et al 2017). The psychological factors, specifically patients' beliefs about crepitus, avoiding crepitus and the influence of others will be discussed.
The intervention will be supported by the leaflet 'managing my patellofemoral pain' developed by Barton and Rathleff (2016) on the basis of international opinion from 21 international experts and subsequent review by 20 patients diagnosed with PFP to ensure clarity.
Duration: Within the time constraints of a Masters Degree, patients will be recruited over a four month period. There will be four months for follow up and a further four months for write up, total study duration 12 months.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Design: A feasibility study to assess if a physiotherapy education session in addition to standard care improves patients scores regarding catastrophizing and kinesiophobia when measured by KOOS-PF, Pain Catastrophizing Scale and Tampa Scale
Objectives:
- To assess if providing a specific education session which reviews patients beliefs about crepitus, causes of pain, joint mechanics and purpose of exercise has an effect on catastrophizing and kinesiophobia.
- To identify if the study is feasible on a larger scale, which would allow the intervention to be assessed for efficacy. If a future study was able to demonstrate that the intervention was effective this would provide an additional evidence based intervention for use in clinical practice.
Recruitment: NHS patients diagnosed in a Musculoskeletal Clinical Assessment Service [MCAS] with patellofemoral pain at the South Liverpool Treatment Centre.
Inclusion criteria:
- Adults aged 18-40
- Be able to understand and converse in English
- Clinical diagnosis of PFP
- Be able to attend for up-to 12 weeks of physiotherapy
Exclusion criteria:
- Patients who present with referred pain from the spine or hip, or have tibiofemoral pathology of any nature on the ipsilateral side.
- A diagnosis of patellofemoral joint (PFJ) OA as confirmed by X-Ray or Magnetic Resonance Imaging (MRI).
Sample size: There is limited published research regarding the use of the questionnaire KOOS-PF in research. As a result it is not possible to do a definitive study to test whether or not the education session effects patient outcome. Therefore it is necessary to do a feasibility study with a small sample size of 24 patients (control n=12, intervention n=12) which will allow any change in the questionnaire scores to be used to calculate how many patients would be needed for a definitive study which would allow researchers to assess whether or not the exercise intervention affected patient outcome, which could improve patient care. The research team are confident that the required number of patients could be recruited as audit data from the service identified that 104 patients in the MCAS service met the criteria for inclusion in this proposed study.
Baseline measures: Participants' characteristics including age, gender and duration of symptoms will be collected alongside baseline measures for the chosen questionnaires - the KOOS-PF, Tampa-scale for Kinesiophobia and Pain Catastrophizing. These questionnaires will be repeated at 12 weeks.
Intervention: Patients recruited into the study will be randomised to either the intervention (n=12) or the control group (n=12). Participants in the control group will undergo standard treatment.
The intervention: Participants in the intervention group will receive standard treatment plus the education session.
The education session will be based on a leaflet produced by other leading researchers in the field and will also explore the causes of pain, beliefs about pain, beliefs about noise that come from the joint, the impact of the pain on activity and the influence of other family members' experience and beliefs about knee pain. At 12 weeks, participants from both groups will be asked to repeat the questionnaires.
Statistical analysis: Descriptive statistical analysis will be performed on the data and the lead researcher will work with the statistics department at MMU to review the change in the chosen questionnaires to identify the sample size required for a definitive study which will assess how effective the education session is on patients' symptoms of PFP.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Merseyside
-
Liverpool, Merseyside, United Kingdom
- Royal Liverpool & Broadgreen University Hospitals Trust
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adults aged 18-40
- Be able to understand and converse in English
- Clinical diagnosis of PFPS
- Be able to attend for up-to 12 weeks of physiotherapy
Exclusion Criteria:
- Patients who present with referred pain from the spine or hip, or have tibiofemoral pathology of any nature on the ipsilateral side.
- A diagnosis of PFJ osteoarthritis as confirmed by X-Ray or MRI.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Physiotherapy
Participants will receive standard physiotherapy care, which will involve strength exercises and taping.
|
Standard physiotherapy care
|
Experimental: Physiotherapy + education
Physiotherapy + education Standard physiotherapy care plus 30 minute education session addressing fear of movement and catastrophizing thoughts.
|
Standard physiotherapy care
Participants will take part in a 30 minute education session surrounding fear of movement and catastrophizing thoughts.
They will then receive standard care, which will involve strength exercises and taping if needed.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Knee Osteoarthritis Outcome Score - Patellofemoral (KOOS-PF)
Time Frame: 12 weeks following baseline visit
|
The KOOS-PF is an 11 item, patient reported outcome measure of pain and function where a maximum score of 100 indicates no problems and a minimum score of 0 indicates extreme problems.
|
12 weeks following baseline visit
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Tampa Scale for Kinesiophobia (TSK)
Time Frame: 12 weeks following baseline visit
|
The TSK is a 17-item patient reported outcome measure of fear of movement.
A score of 17 is the lowest possible score, and indicates no kinesiophobia or negligible.
A score of 68 is the highest possible score and indicates extreme fear of pain with movement.
|
12 weeks following baseline visit
|
Pain Catastrophizing Scale (PCS)
Time Frame: 12 weeks following baseline visit
|
The PCS is a 13 item patient reported outcome measure where the PCS total score is computed by summing the responses to all 13 items.
PCS total scores range from 0 - 52, with higher scores indicating greater pain catastrophizing
|
12 weeks following baseline visit
|
Collaborators and Investigators
Investigators
- Study Chair: James Selfe, Professor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PatellofemoralPain_DEC2018
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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