title: Efficacy of live feedback to improve objectively monitored compliance to prescribed, home-based, exercise therapy-dosage in 15 to 19 year old adolescents with patellofemoral pain- a study protocol of a randomized controlled superiority trial (The XRCISE-AS-INSTRUcted-1 trial).
abstract: Patellofemoral pain is one of the most frequent knee conditions among adolescents with a prevalence of 7 %. Evidence-based treatment consists of patient education combined with hip and quadriceps strengthening. Recent evidence suggests that a large proportion of adolescents does not follow their exercise prescription, performing too few repetitions or too fast below the prescribed time under tension. Live feedback, such as a metronome or exercise games, has previously shown promising results in improving the quality of exercises. The aim of this study is to investigate if live feedback from a sensor (BandCizer™) and an iPad will improve the ability of adolescents with PFP to perform exercises as prescribed.
  
  
  
  This study is a randomized, controlled, participant-blinded, superiority trial with a 2-group parallel design. Forty 15 to 19 year old adolescents with patellofemoral pain will be randomized to receive either live visual and auditory feedback on time under tension or no feedback on time under tension during a 6-week intervention period. Adolescents will be instructed to perform three elastic band exercises. Feedback will be provided by BandCizer™ and an iPad. The adolescents perform the exercises twice a week unsupervised and once a week during a supervised group training session. The primary outcome will be the mean deviation of the prescribed time under tension per repetition in seconds during the course of the intervention.
  
  
  
  Low compliance is a major problem among adolescents with patellofemoral pain. Providing the adolescents with real time feedback on time under tension from a sensor and an iPad could potentially help the adolescents perform the exercises as prescribed. This may increase the total exercise dosage they receive during treatment which may help improve patient outcomes.
  
  
  
  Registered at ClinicalTrials.gov (identifier: NCT02674841 ) on February 4(th) 2016.
authors.affiliation: Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7D, 9220, Aalborg East, Denmark. hriel14@student.aau.dk.|Research Unit for General Practice in Aalborg and Department of Clinical Medicine, Aalborg University, Fyrkildevej 7, 9220, Aalborg East, Denmark. hriel14@student.aau.dk.
authors.forename: Henrik
authors.initials: H
authors.lastname: Riel
authors.affiliation: School of Health and Rehabilitation Sciences: Physiotherapy: Sports Injury Rehabilitation and Prevention for Health, The University of Queensland, St. Lucia, QLD, 4072, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Matthews
authors.affiliation: School of Health and Rehabilitation Sciences: Physiotherapy: Sports Injury Rehabilitation and Prevention for Health, The University of Queensland, St. Lucia, QLD, 4072, Australia.
authors.forename: Bill
authors.initials: B
authors.lastname: Vicenzino
authors.affiliation: Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical Therapy, Department of Orthopedic Surgery, Clinical Research Centre, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bandholm
authors.affiliation: Sports Orthopedic Research Center - Copenhagen (SORC-C). Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Thorborg
authors.affiliation: Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7D, 9220, Aalborg East, Denmark.|Research Unit for General Practice in Aalborg and Department of Clinical Medicine, Aalborg University, Fyrkildevej 7, 9220, Aalborg East, Denmark.|Department of occupational therapy and physiotherapy, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark.
authors.forename: Michael Skovdal
authors.initials: MS
authors.lastname: Rathleff
mesh_terms: D000293:Adolescent; D034201:Computers, Handheld; D005081:Exercise Therapy; D056228:Feedback, Sensory; D006801:Humans; D046788:Patellofemoral Pain Syndrome / Q000628:therapy*; D012107:Research Design; D055815:Young Adult
keywords: Adolescents; Compliance; Exercise; Feedback; Patellofemoral pain; Time under tension