Effects of Telerehabilitation Versus Supervised Rehabilitation Protocol on Pain, Range of Motion and Functional Recovery in Patients With Patellofemoral Pain Syndrome.

Participants receive a structured 6-week telerehabilitation exercise program delivered remotely under live, real-time video call supervision by a licensed physical therapist (3 sessions per week, total 18 sessions, for 40 mins.

Baseline Protocol (Pre-Exercise):5-10 minutes warm-up walk.10-15 minutes self-applied moist hot pack over anterior knee. Self-stretching exercises for Hamstrings, Quadriceps, Gastrocnemius-Soleus, and Iliotibial band (3 repetitions of 30-second holds each).Pain-free active knee range of motion (flexion and extension) exercises. Exercise Progression Protocol: Week 1 (Muscle Activation & Pain Relief). Week 2 (Subacute Phase - Closed Kinetic Chain & Hip Stability)Week 3 (Intermediate Phase - Dynamic Stability),Week 4 (Advanced Phase - Eccentric Control),Week 5 (Functional Integration),Week 6 (High-Level Function & Discharge Prep): Full depth controlled squats , Stair negotiation drills, Unassisted single-leg squats, and Multi-planar step agility drills.

The telerehabilitation intervention consists of a structured rehabilitation program delivered remotely through virtual communication platforms. The program includes therapeutic exercises, stretching, strengthening, and functional training designed to reduce pain, improve knee range of motion, and enhance functional recovery in patients with Patellofemoral Pain Syndrome. Participants will receive regular guidance, monitoring, and progression of exercises through remote sessions. Participants receive a structured 6-week telerehabilitation exercise program delivered remotely under live, real-time video call supervision by a licensed physical therapist (3 sessions per week, total 18 sessions, for 40 mins.

Baseline Protocol 5-10 minutes warm-up walk.10-15 minutes self-applied moist hot pack over anterior knee. Self-stretching exercises for Hamstrings, Quadriceps, Gastrocnemius-Soleus, and Iliotibial band (3 repetitions of 30-second holds each).Pain-free active knee range of motion exercises

• Tele-rehab Protocol, Digital Physical Therapy Program , Remote Supervised Exercise Program

Participants receive face-to-face, in-clinic supervised physical therapy delivered directly by a licensed physical therapist (3 sessions per week ,40 min,total 18 sessions).

Baseline Protocol (Pre-Exercise):

5-10 minutes warm-up walk. 10-15 minutes hot pack surrounding patella). Therapist-assisted passive/active-assisted stretching for Hamstrings, Quadriceps, Gastrocnemius-Soleus, and Iliotibial band (3 repetitions of 20-second holds each).

Pain-free active and active-assisted knee range of motion (flexion and extension) exercises.

Exercise Progression Protocol:

Identical exercise progression framework as the Telerehabilitation group (Weeks 1 to 6 covering SLR, hip abduction, clamshells, squats, lunges, step-ups, step-downs, and single-leg balance), performed in-clinic under direct hands-on physical supervision and guidance.

Participants receive face-to-face, in-clinic supervised physical therapy delivered directly by a licensed physical therapist (3 sessions per week ,40 min,total 18 sessions).

Baseline Protocol (Pre-Exercise):

5-10 minutes warm-up walk. 10-15 minutes hot pack surrounding patella). Therapist-assisted passive/active-assisted stretching for Hamstrings, Quadriceps, Gastrocnemius-Soleus, and Iliotibial band (3 repetitions of 20-second holds each).

Pain-free active and active-assisted knee range of motion (flexion and extension) exercises.

Exercise Progression Protocol:

Identical exercise progression framework as the Telerehabilitation group (Weeks 1 to 6 covering SLR, hip abduction, clamshells, squats, lunges, step-ups, step-downs, and single-leg balance), performed in-clinic under direct hands-on physical supervision and guidance.

• In-Clinic Physiotherapy, Face-to-Face Supervised Rehabilitation

The NPRS was utilized to assess the patient's pain level. Patients were asked to rate the intensity of their current pain level on an 11-point scale ranging from 0 (no pain) to 10 (the worst discomfort possible).

The Kujala score was originally designed to assess symptoms and functional disability in patients with Patellofemoral dysfunction. The grading system consists of 13 questions about functional features, such as limping, support, walking, stair descending and climbing, squatting, running, jumping, prolonged sitting with knees flexed, pain, swelling, kneecap movement, thigh atrophy, and flexion deficit. The maximum score is 100, and a higher number indicates a better result.

The universal goniometer is the most often used clinical equipment for measuring ROM. Goniometer demonstrates good intra-rater and inter-rater reliability when used consistently with proper technique. The whole range of joint mobility can be measured in degrees by aligning the goniometer's fixed and moveable arms to specific bony landmarks on either side of the joint, and a universal goniometer is used to measure joint range of motion (ROM).