Optimizing Clinical Outcomes for Patients with Patellofemoral Pain Using Strength Training Rehabilitation Incorporating Power Exercises (STRIPE)
Abstract
This study will compare the effects of standard of care (SOC) intervention to a SOC that includes power-based exercises (Strength Training Rehabilitation Incorporating Power Exercises STRIPE) intervention in patients with patellofemoral pain (PFP). This proposed research study will address the focus area of Retention Strategies with the Return to Duty as the rehabilitation strategy to be used in the study. This study will evaluate rehabilitation strategies for PFP, with the focus on enabling return to duty within one year of injury. Patellofemoral pain (PFP) is a common knee injury that accounts for 9.7-571.4 cases per 1000 person- years in the military. PFP presents as chronic knee pain during walking, running, jumping, squatting, and stair ambulation, placing a significant impact on activities of daily living and occupational military requirements. Overuse musculoskeletal conditions like PFP account, for 70% of limited duty days in the United States Army and are one of the most frequent causes of discharges in military recruits. Current treatment programs target hip and thigh muscle weakness; however, programs do not target muscle power, which is the ability to generate force as quickly as possible. Recently evidence has emerged that hip muscle power has a greater difference between those with and without PFP than more standard strength measurements, suggesting power should be targeted with rehabilitation programs. Targeting power might improve rehabilitation outcomes in those with PFP. Long-term outcomes are suboptimal following current PFP treatment interventions, with over 90% of patients experiencing pain and dysfunction 5-18 years after diagnosis. Currently, no rehabilitation programs that target hip muscle power have evaluated long-term outcomes in a PFP population. Long-term success is essential as patients with PFP have decreased health-related quality of life and more mental health disorders, which increases medical costs and recurrence rates that negatively impact military readiness. Successful accomplishment of the study aims will address the research agenda of treatment strategies utilized along the continuum of care and enable return to duty within one year of injury. The STRIPE intervention will seek to improve pain, subjective function, recurrence rates, and hip neuromuscular function in patients with PFP. We expect the additive effect of STRIPE with SOC will reduce pain (Aim 1), improve self-reported function (Aim 2), decrease PFP recurrence rates (Aim 3), and improve hip power and biomechanical function of the hip muscles (Aim 4). This study will be conducted over a 4- year period through collaboration between the University of Connecticut, University of Central Florida, and University of Toledo. This study will establish the STRIPE protocol as a more effective strategy for improving self-reported function, decreased pain, decreased recurrence rates, improvements in the hip muscle’s ability to rapidly produce force, and improve biomechanical function in individuals with PFP than a SOC intervention. This study will provide the first evidence of comparison between SOC and SOC supplemented with STRIPE in those with PFP. The outcomes of this study will provide military and civilian clinicians with recommendations to treat PFP and enhance long-term outcomes in various patient populations experiencing PFP. This study supports the vision of the FY21 PRORP to improve Retention Strategies with a focus on return to duty following musculoskeletal injuries. The military has a high rate of PFP recurrence rates, which increases financial costs and increases medical visits. This study will determine if the addition of STRIPE to SOC reduces PFP recurrence rates and improves military readiness.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210532
Entities
People
- Neal Glaviano
Organizations
- United States Army
- University of Connecticut