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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.
Background:
Patellofemoral pain (PFP) is a chronic knee pain disorder that has high recurrence rates after treatment. While longer pain duration (>4 months) is one of the primary mediators for poor PFP prognosis, there are no clinical studies testing patients' response to early physiotherapy. This study aims to determine the effectiveness of an early physiotherapy programme compared with a delayed-delivery programme for people with PFP at short-term, medium-term and long-term follow-up.
Methods:
Young adults (18-35 years old) with PFP will be recruited in Brazil, the USA and Belgium. 152 eligible participants will be assessed at baseline and allocated to early (treatment initiated between 4 and 12 weeks after pain onset) or delayed (treatment initiated after ≥6 months after pain onset) intervention groups. The programme (education plus exercise therapy) will be similar for both groups and consists of a 12-week online programme with individual supervised and unsupervised sessions performed three times a week. Primary (self-reported pain, function, recovery and treatment response) and secondary (psychosocial features) outcomes will be reassessed immediately and at 3, 6 and 12 months after treatment completion. Regression models with generalised estimating equations or χ² tests will determine group*time interactions (intention-to-treat analyses).
Impact:
The timing of physiotherapy may have a significant effect on patient outcomes with PFP. This study can provide relevant clinical messages about early management of PFP.
