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Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation

BACKGROUND: Patellar dislocations mainly affect adolescents and young adults. After this injury, patients are usually referred to physiotherapy for exercise-based rehabilitation. Currently, limited high-quality evidence exists to guide rehabilitation practice and treatment outcomes vary. A full-scal...

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Autores principales: Forde, Colin, Costa, Matthew L., Cook, Jonathan A., Tutton, Elizabeth, Appelbe, Duncan, Franssen, Marloes, Barker, Rupert, Keene, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332065/
https://www.ncbi.nlm.nih.gov/pubmed/37430340
http://dx.doi.org/10.1186/s40814-023-01349-4
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author Forde, Colin
Costa, Matthew L.
Cook, Jonathan A.
Tutton, Elizabeth
Appelbe, Duncan
Franssen, Marloes
Barker, Rupert
Keene, David J.
author_facet Forde, Colin
Costa, Matthew L.
Cook, Jonathan A.
Tutton, Elizabeth
Appelbe, Duncan
Franssen, Marloes
Barker, Rupert
Keene, David J.
author_sort Forde, Colin
collection PubMed
description BACKGROUND: Patellar dislocations mainly affect adolescents and young adults. After this injury, patients are usually referred to physiotherapy for exercise-based rehabilitation. Currently, limited high-quality evidence exists to guide rehabilitation practice and treatment outcomes vary. A full-scale trial comparing different rehabilitation approaches would provide high-quality evidence to inform rehabilitation practice. Whether this full-scale trial is feasible is uncertain: the only previous trial that compared exercise-based programmes in this patient population had high loss to follow-up. This study aims to assess the feasibility of conducting a future full-scale trial comparing the clinical and cost-effectiveness of two different rehabilitation approaches for people with an acute patellar dislocation. METHODS: Two-arm parallel external pilot randomised controlled trial and qualitative study. We aim to recruit at least 50 participants aged ≥ 14 years with an acute first-time or recurrent patellar dislocation from at least three English National Health Service hospitals. Participants will be randomised 1:1 to supervised rehabilitation (four to six, one-to-one, physiotherapy sessions of advice and prescription of tailored progressive home exercise over a maximum of 6 months) or self-managed rehabilitation (one physiotherapy session of self-management advice, exercise, and provision of self-management materials). Pilot objectives are (1) willingness to be randomised, (2) recruitment rate, (3) retention, (4) intervention adherence, and (5) intervention and follow-up method acceptability to participants assessed through one-to-one semi-structured interviews (maximum 20 participants). Follow-up data will be collected 3, 6, and 9 months after randomisation. Quantitative pilot and clinical outcomes will be numerically summarised, with 95% confidence intervals generated for the pilot outcomes using Wilson’s and exact Poisson methods as appropriate. DISCUSSION: This study will assess the feasibility of conducting a full-scale trial comparing supervised versus self-managed rehabilitation for people after acute first-time or recurrent patellar dislocation. This full-scale trial’s results would provide high-quality evidence to guide rehabilitation provision for patients with this injury. TRIAL REGISTRATION: ISRCTN registry ISRCTN14235231. Registered on 09 August 2022. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40814-023-01349-4.
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spelling pubmed-103320652023-07-11 Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation Forde, Colin Costa, Matthew L. Cook, Jonathan A. Tutton, Elizabeth Appelbe, Duncan Franssen, Marloes Barker, Rupert Keene, David J. Pilot Feasibility Stud Study Protocol BACKGROUND: Patellar dislocations mainly affect adolescents and young adults. After this injury, patients are usually referred to physiotherapy for exercise-based rehabilitation. Currently, limited high-quality evidence exists to guide rehabilitation practice and treatment outcomes vary. A full-scale trial comparing different rehabilitation approaches would provide high-quality evidence to inform rehabilitation practice. Whether this full-scale trial is feasible is uncertain: the only previous trial that compared exercise-based programmes in this patient population had high loss to follow-up. This study aims to assess the feasibility of conducting a future full-scale trial comparing the clinical and cost-effectiveness of two different rehabilitation approaches for people with an acute patellar dislocation. METHODS: Two-arm parallel external pilot randomised controlled trial and qualitative study. We aim to recruit at least 50 participants aged ≥ 14 years with an acute first-time or recurrent patellar dislocation from at least three English National Health Service hospitals. Participants will be randomised 1:1 to supervised rehabilitation (four to six, one-to-one, physiotherapy sessions of advice and prescription of tailored progressive home exercise over a maximum of 6 months) or self-managed rehabilitation (one physiotherapy session of self-management advice, exercise, and provision of self-management materials). Pilot objectives are (1) willingness to be randomised, (2) recruitment rate, (3) retention, (4) intervention adherence, and (5) intervention and follow-up method acceptability to participants assessed through one-to-one semi-structured interviews (maximum 20 participants). Follow-up data will be collected 3, 6, and 9 months after randomisation. Quantitative pilot and clinical outcomes will be numerically summarised, with 95% confidence intervals generated for the pilot outcomes using Wilson’s and exact Poisson methods as appropriate. DISCUSSION: This study will assess the feasibility of conducting a full-scale trial comparing supervised versus self-managed rehabilitation for people after acute first-time or recurrent patellar dislocation. This full-scale trial’s results would provide high-quality evidence to guide rehabilitation provision for patients with this injury. TRIAL REGISTRATION: ISRCTN registry ISRCTN14235231. Registered on 09 August 2022. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40814-023-01349-4. BioMed Central 2023-07-10 /pmc/articles/PMC10332065/ /pubmed/37430340 http://dx.doi.org/10.1186/s40814-023-01349-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Study Protocol
Forde, Colin
Costa, Matthew L.
Cook, Jonathan A.
Tutton, Elizabeth
Appelbe, Duncan
Franssen, Marloes
Barker, Rupert
Keene, David J.
Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
title Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
title_full Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
title_fullStr Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
title_full_unstemmed Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
title_short Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
title_sort physiotherapy rehabilitation post patellar dislocation (prepped)—protocol for an external pilot randomised controlled trial and qualitative study comparing supervised versus self-managed rehabilitation for people after acute patellar dislocation
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332065/
https://www.ncbi.nlm.nih.gov/pubmed/37430340
http://dx.doi.org/10.1186/s40814-023-01349-4
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