- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03798483
INDividualised EXercise for Kneecap Dislocations (INDEX-KD)
January 12, 2021 updated by: City, University of London
Individualised Exercise for Adults With an Acute Lateral Patellar Dislocation: a Feasibility Study
This study is a feasibility study.
It will assess areas of uncertainty relating to the implementation of an individualised exercise programme for patients with a recent kneecap dislocation.
This will help determine if a future larger study is feasible, and inform the design and conduct of future research that would aim to optimise outcomes after a kneecap dislocation.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The investigators aim to recruit 15 adult participants with a recent, first-time or recurrent kneecap dislocation, from an acute hospital.
Participants will receive up to 6 physiotherapy sessions over 3 months.
The investigator's exercise programme aims to improve leg muscle strength and facilitate a return to the participant's usual activities.
This may include activities such as hopping and changing direction which differentiates it from other programmes.
Participants will be required to perform the exercise programme 3 times a week independently.
Strategies to increase adherence to the exercise programme will also be used.
This study is part of a Masters in Clinical Research funded by the National Institute for Health Research
Study Type
Interventional
Enrollment (Actual)
15
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Oxford, United Kingdom, OX3 9DU
- John Radcliffe Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Child, Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- First time or recurrent lateral patella dislocation meeting the diagnostic criteria of 1) requiring reduction by paramedics or 2) diagnosed by a member of the trauma and orthopaedic team.
Exclusion Criteria:
- Concurrent anterior cruciate ligament or posterior cruciate ligament injury confirmed by negative Lachman's and posterior drawer test or confirmed by Magnetic Resonance Imagery (MRI); medial collateral and lateral collateral ligament injury requiring application of a hinged knee brace or surgical repair; concomitant injury that would prohibit participation in the exercise intervention
- > 4 weeks from injury to presentation to acute care (ED or trauma services)
- Unable to give written informed consent
- Previous surgery on the affected knee
- Presence of fracture on plain radiograph including osteochondral fractures
- Medial patellar dislocation
- Considered inappropriate for referral to physiotherapy (by member of trauma and orthopaedic team assessing the patient)
- History of severe neuromuscular or congenital disorders
- Patients referred for orthopaedic opinion who are subsequently listed for surgery prior to completion of the study intervention
- Unable to understand written or spoken English
- Unable to attend physiotherapy sessions at the John Radcliffe trauma outpatient physiotherapy department
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Individualized exercise
Participants after a lateral kneecap dislocation will be enrolled into an individualized exercise intervention supervised by a physiotherapist
|
The intervention will be comprised of up to 6, one-to-one physiotherapy sessions, over a maximum duration of 3 months.
1 or 2 extra sessions are allowed if deemed essential by the participant's physiotherapist.
Less than 6 physiotherapy sessions can be agreed with the participant if they have achieved their goals.
Throughout this time participants will be required to perform an exercise programme a minimum of 3 times per week.
The exercise programme aims to increase leg muscle strength and facilitate a return to the participant's usual activities.
It may include hopping and change of direction tasks if these are activities the participant would normally do.
Behavioural change techniques to increase participant adherence to the exercise programme will also be used.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Eligibility Rate
Time Frame: 15 weeks
|
Percentage of patients with a diagnosed lateral patellar dislocation, screened for eligibility, who satisfied the eligibility criteria
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15 weeks
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Recruitment Rate
Time Frame: 15 weeks
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Percentage of eligible participants who consented to participate in the study
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15 weeks
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Attrition
Time Frame: 12 weeks
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Percentage (0-100%) of participants enrolled in the study who failed to provide any 12 week follow-up data
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12 weeks
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Acceptability [Participant Satisfaction]: Questionnaire
Time Frame: 12 weeks
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Participant response to an internally designed patient questionnaire.
This will measure several domains of of intervention acceptability: satisfaction with treatment, self-efficacy, burden of treatment, and intention to adhere.
6 questions will assess satisfaction with treatment, 3 questions will assess self-efficacy,1 question will assess burden of treatment and 1 question will assess intention to adhere.
Each question will use a 5 point likert scale (0-4) with lower scores indicating higher satisfaction, self-efficacy, and intention to adhere.
Each question will be reported individually.
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12 weeks
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Adherence
Time Frame: 12 weeks
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Percentage (0-100%) of scheduled physiotherapy sessions attended
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12 weeks
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Adherence [Participant-reported Adherence to Home Exercise Using a Likert Scale]
Time Frame: 12 weeks
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Participant response at follow-up to the question 'how often did you perform your exercises at least three times a week?' using a five-point Likert scale (0-4) anchored at 'always' (0) and 'never' (4)
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12 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Acceptability of Outcome Data Collection
Time Frame: 12 weeks
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Percentage (0-100%) of questions completed in the following patient-reported outcome measures: Lysholm Knee Scoring Scale, Tegner Activity Scale, EQ-5D-5L, completed at baseline and returned at 3-month follow-up
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12 weeks
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Number of Treatment Related Adverse Events Experienced by Participants
Time Frame: Through 12 weeks after first physiotherapy session
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The total number and type of treatment related adverse events experienced by participants will be recorded.
This will be recorded from commencement of the intervention to 12 week follow-up.
Treatment related adverse events will be recorded by physiotherapists at each physiotherapy session and by participant self report at 12 week follow up.
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Through 12 weeks after first physiotherapy session
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Presence/Absence of Common Lateral Patella Dislocation Diagnostic Criteria
Time Frame: Baseline
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Following diagnosis of a lateral patellar dislocation by an orthopaedic surgeon or physiotherapist, the clinician will be asked which of the following proposed assessment findings to include in the eligibility criteria for future studies, were present/absent during their clinical examination: positive patella apprehension test, visible knee joint effusion or haemarthrosis, medial patellofemoral ligament tenderness on palpation, and a convincing patient history of a visible deformity on the lateral aspect of the knee or a sensation of the patella 'popping' out of joint followed by spontaneous reduction
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Baseline
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Tegner Activity Scale Questionnaire
Time Frame: 12 weeks
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This measures activity on a scale from 0-10, with higher scores indicating higher activity.
It will be administered as a patient completed questionnaire.
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12 weeks
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Lyhsolm Knee Scoring Scale Questionnaire
Time Frame: 12 Weeks
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It is scored from 0-100 with lower scores indicating higher pain and disability.
It will be administered as a patient completed questionnaire.
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12 Weeks
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Quality of Life Using the EQ-5D-5L Questionnaire
Time Frame: 12 weeks
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This assess quality of life using 5 domains: mobility, self-care, usual activities, pain/discomfort and anxiety/depress, each containing 5 options.
These domains are combined to give a single score ranging from -0.594 to 1 for UK populations, with higher scores indicating higher quality of life.
Participants rate their overall health on a visual analogue scale from 0 (worst health you can imagine) to 100 (the best help you can imagine).
It will be administered as a patient completed questionnaire.
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12 weeks
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Assess Delivery of the Intervention [Duration From Injury to Commencing Physiotherapy]
Time Frame: From date of injury until date of the first physiotherapy session, assessed up to 6 weeks
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Treatment logs will be analysed to record the duration (number of days) from injury to commencing the intervention
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From date of injury until date of the first physiotherapy session, assessed up to 6 weeks
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Assess Delivery of the Intervention [Number of Physiotherapy Sessions Received by Participants]
Time Frame: 12 weeks
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Treatment logs will be analysed to assess the number of physiotherapy sessions received by participants
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12 weeks
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Assess Delivery of the Intervention [Duration of Intervention]
Time Frame: 12 weeks
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Treatment logs will be analysed to assess the duration (days) of the study intervention
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12 weeks
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Assess Delivery of the Intervention [Types of Exercises Prescribed by Physiotherapists]
Time Frame: 12 weeks
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Treatment logs will be analysed to assess the types of exercise prescribed by physiotherapists to participants
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12 weeks
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Assess Delivery of the Intervention [Dose of Exercises Prescribed by Physiotherapists]
Time Frame: 12 weeks
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Treatment logs will be analysed to assess the dose of exercise prescribed by physiotherapists to participants
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12 weeks
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Assess Delivery of the Intervention [Initial Injury Management]
Time Frame: From date of review by trauma and orthopaedic team until date of the first physiotherapy session, assessed up to 6 weeks
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Treatment logs will be analysed to assess how participants are initially managed by trauma and orthopaedic team
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From date of review by trauma and orthopaedic team until date of the first physiotherapy session, assessed up to 6 weeks
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Mark Haddad, PhD, City, University of London
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
January 24, 2019
Primary Completion (Actual)
October 8, 2019
Study Completion (Actual)
October 15, 2019
Study Registration Dates
First Submitted
December 11, 2018
First Submitted That Met QC Criteria
January 8, 2019
First Posted (Actual)
January 10, 2019
Study Record Updates
Last Update Posted (Actual)
February 1, 2021
Last Update Submitted That Met QC Criteria
January 12, 2021
Last Verified
December 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MRes/18-19/04/2
- 251913 (Other Identifier: Health Research Authority - IRAS ID)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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