The influence of objective monitoring on unsupervised homebased treatment in people with Patellofemoral Pain: A randomized clinical trial

• Grant number: 24/10121-4
• Support Opportunities: Scholarships in Brazil - Master
• Start date: November 01, 2024
• End date: May 31, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Fábio Mícolis de Azevedo
• Grantee: Gleison Gustavo Moraes da Silva
• Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil
• Associated scholarship(s): 25/05899-9 - Influence of external focus of attention on hop performance, trunk and lower limb biomechanics of people with and without patellofemoral pain, BE.EP.MS

Abstract

Introduction: Patellofemoral Pain (PFP) is a common and chronic musculoskeletal condition, characterized by pain around or behind the patella during daily and functional activities. PFP affects around 23% of the general adult population, and is associated with clinical and functional impairments. Its main rehabilitation guidelines recommend therapies based on physical exercise (PE). PE as a form of treatment can be carried out both in a supervised clinical environment and in an unsupervised home environment. Although unsupervised home PE is more accessible and less costly to the patient, its effectiveness depends on patient adherence. In this sense, self-reported (ie, self-reported diary) and objective tools (ie, triaxial accelerometer) can be used to monitor the adherence of patients with musculoskeletal disorders to unsupervised treatment programs. However, self-reported diaries may have limitations, be less accurate, and discourage patients from continuing with treatment. The use of triaxial accelerometers, in turn, can exert a certain influence on patient adherence, since they are aware of the monitoring. However, to date, no study has investigated the effect of objective monitoring on PFP patients' adherence to unsupervised home exercise programs. Therefore, the objective of this project is to determine the influence of monitoring by triaxial accelerometers on the adherence of individuals with PFP to unsupervised home PE. Materials and methods: 60 individuals with PFP will be included, subdivided into two groups with different monitoring tools (i.e., triaxial accelerometer and self-reported diary). Both groups will undergo the same unsupervised home PE protocol and be monitored over twelve weeks, returning to the laboratory every 2 weeks for follow-up. The objective monitoring group will be monitored using a triaxial accelerometer, while the self-reported monitoring group will be monitored using an exercise diary. Both groups will receive shin guards with hidden accelerometers, with the pretext that they must be used during PE. Participants will not be informed about this hidden accelerometer. An analysis of covariance (ANCOVA) controlled for EF-related motivation will be used to compare data from hidden accelerometers between both groups. For this analysis, the group x time interaction and main effects of time will be investigated. In case of significant interaction or effect, Bonferroni post hoc tests will be performed. The effect size will be calculated using Cohen's d. The level of statistical significance (±) will be set at 0.05. For statistical analysis, Statistical Software for Social Sciences (SPSS Inc. Chicago, IL) version 29.0 will be used.