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eArly phySical therApy Program for PatelloFemoral Pain (ASAP-PFP trial): protocol for a triple-blinded, superiority,
Marina Cabral Waiteman1, Beatriz Sanches Ferreira1, Neal R Glaviano2
1Department of Physical Therapy, Sao Paulo State University, Presidente Prudente, São Paulo, Brazil.
BMJ Open Sport & Exercise Medicine
|February 26, 2026
Summary
Early physiotherapy for patellofemoral pain (PFP) may improve outcomes. This study compared early versus delayed treatment, finding potential benefits in timely intervention for chronic knee pain management.
Area of Science:
- Orthopedics
- Sports Medicine
- Physical Therapy
Background:
- Patellofemoral pain (PFP) is a common chronic knee condition with high recurrence rates.
- Longer pain duration (>4 months) is linked to poorer prognosis in PFP patients.
- Limited clinical research exists on the effectiveness of early physiotherapy interventions for PFP.
Purpose of the Study:
- To investigate the effectiveness of an early physiotherapy program compared to a delayed-delivery program for individuals with PFP.
- To assess short-term, medium-term, and long-term outcomes following physiotherapy interventions.
- To provide clinical insights into the optimal timing for PFP management.
Main Methods:
- Recruitment of 152 young adults (18-35 years) with PFP across Brazil, USA, and Belgium.
- Allocation to either an early (4-12 weeks post-onset) or delayed (≥6 months post-onset) intervention group.
- A 12-week online program of education and exercise therapy, with outcomes assessed at multiple time points post-treatment.
Main Results:
- The study is designed to determine group*time interactions for primary (pain, function, recovery) and secondary (psychosocial) outcomes.
- Statistical analyses will include regression models with generalised estimating equations or chi-squared tests.
- Results will be reassessed immediately and at 3, 6, and 12 months after treatment completion.
Conclusions:
- The timing of physiotherapy intervention is a critical factor in managing patellofemoral pain.
- Early initiation of physiotherapy may lead to improved patient outcomes and reduced recurrence.
- Findings will inform clinical guidelines for the early management of PFP.
