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- Essai clinique NCT07705945
Using Telehealth to Improve Musculoskeletal Care Through Expanded Physical Therapy Access (TELE-MC)
10 juillet 2026 mis à jour par: Dan Rhon, Brooke Army Medical Center
Using Telehealth to Improve Musculoskeletal Care Through Expanded Physical Therapy Access: The TELE-MC Trial
The purpose of this study is to explore and compare the effectiveness of in-person versus remote physical therapy (PT) for the treatment of musculoskeletal (MSK) pain within the Military Health System (MHS).
Aperçu de l'étude
Statut
Pas encore de recrutement
Les conditions
Intervention / Traitement
Description détaillée
This study will explore the effect of remote two-way video conference telehealth physical therapy sessions compared to standard of care in-person physical therapy.
Eligible participants will be randomized into one of the 2 treatment arms.
Specific aims will compare the effectiveness of physical therapy delivery strategies on the primary outcome of Pain, Enjoyment, and General Activity (PEG-3) Scale, which measures pain interference, and secondary outcomes of PROMIS short forms (mood, physical function, fatigue, sleep disturbance, and prescription medication misuse), patient global impression of change, and pain self-efficacy.
Type d'étude
Interventionnel
Inscription (Estimé)
210
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Coordonnées de l'étude
- Nom: Tina Greenlee, PhD
- Numéro de téléphone: 210-539-9638
- E-mail: sammc@militaryclinicalresearch.org
Sauvegarde des contacts de l'étude
- Nom: Cedar Sexton
- Numéro de téléphone: 210-916-8634
- E-mail: militaryclinicalresearch@gmail.com
Lieux d'étude
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Hawaii
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Tripler AMC, Hawaii, États-Unis, 96859
- Tripler Army Medical Center
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Contact:
- Kaitlyn Foster, PT, DPT, PhD, SCS, FAAOMPT
- Numéro de téléphone: 808-433-5963
- E-mail: researchschofield@gmail.com
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Texas
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Fort Hood, Texas, États-Unis, 76544
- Carl R. Darnall Army Medical Center
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Contact:
- Cedar Sexton
- E-mail: sammc@militaryclinicalresearch.org
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Fort Sam Houston, Texas, États-Unis, 78234
- Brooke Army Medical Center
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Contact:
- Taylor Rossi, PT, DPT, FAAOMPT
- Numéro de téléphone: 210-539-9638
- E-mail: militaryclinicalresearch@gmail.com
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Washington
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Joint Base Lewis McChord, Washington, États-Unis, 98431
- Madigan Army Medical Center
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Contact:
- Jeremy Steiner, PT, DPT
- Numéro de téléphone: 253-448-2453
- E-mail: jblmresearch@gmail.com
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
Accepte les volontaires sains
Non
La description
Inclusion Criteria:
- Ages 18-64
- TRICARE Beneficiary (active duty, retiree, dependent)
- Health care visit for their MSK condition in the past 6 weeks
- Diagnosed with an MSK condition that has persisted for at least 2 weeks
- Has a computer (either smartphone, tablet or laptop), with video and audio capabilities for telehealth, including access to internet
- Able to speak and read English well enough to provide informed consent, follow study instructions and independently answer the questionnaires
- Available to attend treatment sessions over the next 2 months
Exclusion Criteria:
- Surgery for any MSK condition in the past 6 months
- Currently known to be pregnant
- Medical contraindication to exercise
- Currently receiving or scheduled to receive invasive or other nonpharmacologic interventions for any MSK condition (e.g., chiropractic, injections, etc.) with the exception of a physical therapy referral, an issued profile or duty restriction, or other related patient education
- Anyone separating from the military within 9 months (other than normal military retirement), pending a medical or physical evaluation board, discharge from the military for medical reasons, or pending or undergoing any litigation for an injury
- Signs of serious or systemic pathology that could be responsible for the musculoskeletal pain (i.e. ankylosing spondylitis, rheumatoid arthritis, gout, lupus, vertebral osteomyelitis, or psoriatic arthritis), currently receiving treatment for cancer other than skin cancer or acute fracture (in the last 3 months) of the musculoskeletal region.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: In-person physical therapy (PT)
Participants will receive individual treatment sessions provided in-person based on the preference and clinical expertise of the clinician.
All sessions will be supervised in a clinic.
A digital exercise prescription and patient education platform will be available for their use.
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Participants assigned to in-person PT will receive individual treatment sessions provided by a licensed, on-site PT.
Participants will receive 1-on-1 sessions based on the preference and clinical expertise of the clinician.
Participants assigned to in-person physical therapy will receive individual treatment sessions provided by a licensed, on-site physical therapist at the participating military treatment facility.
Physical therapists delivering in-person physical therapy will have the option to provide participants a digital home exercise program, however this will not be required.
If you choose to download and use either app, you will have to accept the app's terms of service.
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Expérimental: Telehealth physical therapy (TH-PT)
Participants will receive individual treatment sessions provided remotely via a 2-way video conferencing platform.
The core components of the treatment sessions include: 1) education, particularly on the biopsychosocial aspects of pain, 2) individualized exercise instruction, and 3) pain coping strategies for self-management.
A digital exercise prescription and patient education platform will be available for their use.
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Participants assigned to telehealth physical therapy will use two-way video conferencing with a licensed physical therapist via a secure platform approved for patient care.
Video conferencing will be accessible via a mobile app or web browser on your home computer.
Participants assigned to telehealth physical therapy will be provided a digital home exercise program.
The home exercise program is accessible via a mobile app or web browser on your home computer.
This is an app that some military clinics already use as standard of care for providing home exercise programs to their patients, so there is a chance you would be receiving your exercises by this method even if you didn't participate in this study.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Pain, Enjoyment, and General Activity Scale (PEG-3)
Délai: 12 Weeks
|
The PEG-3 measure includes 3 items evaluating 1) pain severity; and interference of pain with 2) enjoyment and 3) general activity.
Item response options range from 0-10.
The PEG-3 score is expressed as the mean of all item scores ranging from 0-10.
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12 Weeks
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
PROMIS-29
Délai: 12 Weeks
|
The PROMIS-29 assesses additional domains relevant to patients with MSK pain including physical function, fatigue, depression, anxiety, pain intensity, ability to participate in social roles, and sleep disturbance.
The PROMIS-29 can also be used to calculate a physical and mental health summary score and can be used in cost-effectiveness analyses.
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12 Weeks
|
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Pain Self-Efficacy Questionnaire (PSEQ)
Délai: 12 Weeks
|
Because of its role in patients' capacity of selfmanagement, we will use the 10 item Pain Self-Efficacy Questionnaire (PSEQ) to quantify an individual's confidence in performing activities despite pain.
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12 Weeks
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Patient Global Assessment of Change (PGIC)
Délai: 12 Weeks
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Participants' satisfaction with their intervention will be based on the single-item Patient Global Assessment of Change (PGIC).
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12 Weeks
|
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PROMIS Short Form Prescription Pain Medication Misuse
Délai: 26 Weeks
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The PROMIS short form 7a assesses the abuse of prescription pain medication.
The short form uses fixed items from the PROMIS item bank to provide a T-score with population mean = 50 (sd=10).
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26 Weeks
|
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EuroQoL (EQ-5D)
Délai: 12 Weeks
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The EQ-5D is a generic quality of life questionnaire that will assess quality of life on a scale that can be referenced to other disease conditions.
The EQ-5D covers 5 domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Each domain has 3 response categories: level 1, "no problems"; level 2, "some problems"; and level 3, "inability or extreme problems."
Responses are combined to give a 5-digit descriptive health state classification (e.g., 11222).
The EQ-5D yields a total of 243 possible health states.
Valuations for each health state are available.
The EQ-5D is commonly used in economic evaluation of interventions and cost-effectiveness analysis.
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12 Weeks
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Krebs EE, Lorenz KA, Bair MJ, Damush TM, Wu J, Sutherland JM, Asch SM, Kroenke K. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009 Jun;24(6):733-8. doi: 10.1007/s11606-009-0981-1. Epub 2009 May 6.
- Fritz JM, Magel JS, McFadden M, Asche C, Thackeray A, Meier W, Brennan G. Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial. JAMA. 2015 Oct 13;314(14):1459-67. doi: 10.1001/jama.2015.11648.
- Molloy JM, Pendergrass TL, Lee IE, Chervak MC, Hauret KG, Rhon DI. Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact. Mil Med. 2020 Sep 18;185(9-10):e1461-e1471. doi: 10.1093/milmed/usaa027.
- Abiero B, Gliner M, Beamer S, Sackett A, Marshall-Aiyelawo K, Ellison J, McDavid T, de Geus J. Military Medical Readiness and Patient Experience with Access to Care. Med J (Ft Sam Houst Tex). 2022 Jan-Mar;(Per 22-01/02/03):3-10.
- Ojha HA, Wyrsta NJ, Davenport TE, Egan WE, Gellhorn AC. Timing of Physical Therapy Initiation for Nonsurgical Management of Musculoskeletal Disorders and Effects on Patient Outcomes: A Systematic Review. J Orthop Sports Phys Ther. 2016 Feb;46(2):56-70. doi: 10.2519/jospt.2016.6138. Epub 2016 Jan 11.
- Lopez-Marcos JJ, Diaz-Arribas MJ, Valera-Calero JA, Navarro-Santana MJ, Izquierdo-Garcia J, Ortiz-Gutierrez RM, Plaza-Manzano G. The Added Value of Face-to-Face Supervision to a Therapeutic Exercise-Based App in the Management of Patients with Chronic Low Back Pain: A Randomized Clinical Trial. Sensors (Basel). 2024 Jan 16;24(2):567. doi: 10.3390/s24020567.
- Hunter R, Beattie M, O'Malley C, Gorely T. Mobile apps to self-manage chronic low back pain: A realist synthesis exploring what works, for whom and in what circumstances. PEC Innov. 2023 Jun 16;3:100175. doi: 10.1016/j.pecinn.2023.100175. eCollection 2023 Dec 15.
- Chen M, Wu T, Lv M, Chen C, Fang Z, Zeng Z, Qian J, Jiang S, Chen W, Zhang J. Efficacy of Mobile Health in Patients With Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth. 2021 Jun 11;9(6):e26095. doi: 10.2196/26095.
- Madsen C, Poropatich R, Koehlmoos TP. Telehealth in the Military Health System: Impact, Obstacles, and Opportunities. Mil Med. 2023 Mar 6;188(Suppl 1):15-23. doi: 10.1093/milmed/usac207.
- Childs JD, Fritz JM, Wu SS, Flynn TW, Wainner RS, Robertson EK, Kim FS, George SZ. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res. 2015 Apr 9;15:150. doi: 10.1186/s12913-015-0830-3.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Estimé)
1 juillet 2026
Achèvement primaire (Estimé)
1 mars 2028
Achèvement de l'étude (Estimé)
1 juillet 2028
Dates d'inscription aux études
Première soumission
10 juillet 2026
Première soumission répondant aux critères de contrôle qualité
10 juillet 2026
Première publication (Réel)
15 juillet 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
15 juillet 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
10 juillet 2026
Dernière vérification
1 juillet 2026
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- C.2026.052d
- 14256810 (Autre subvention/numéro de financement: HT9425-25-MHSRP (Defense Health Agency))
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
OUI
Description du régime IPD
Study data will be made available upon reasonable request, and pursuant to any Data Sharing Agreement requirements from the US Defense Health Agency.
DSA applications and information can be found at health.mil
Délai de partage IPD
Within one year
Type d'informations de prise en charge du partage d'IPD
- PROTOCOLE D'ÉTUDE
- SÈVE
- CIF
- ANALYTIC_CODE
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .