Virtual Physical Therapy for Running Injuries

Overseen By Jamie Bolliong

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Florida

Disqualifiers: Pregnancy, Neurologic disease, Acute injury, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 7

Duration: 4 weeks

85 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate the effectiveness of virtual physical therapy (VPT) for runners recovering from injuries. It compares standard home exercise routines with a program that includes these exercises plus four virtual physical therapy sessions. The goal is to determine if adding virtual physical therapy aids in pain relief and movement during recovery. This trial may suit those who regularly run at least 12 miles a week and have chronic running-related injuries, such as knee pain or tendon issues. As an unphased trial, it offers runners a unique opportunity to explore innovative recovery methods that could enhance their rehabilitation process.

Do I need to stop my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that virtual physical therapy is safe for running injury rehabilitation?

Research shows that virtual physical therapy (VPT) is generally safe for treating muscle and bone issues. Studies have found that people using VPT often experience better health improvements. When a physical therapist guides virtual care, patients are likely to achieve better results.

No major reports of serious side effects from VPT exist. Both patients and therapists have observed long-term benefits from online physical therapy. Therefore, VPT is considered safe and well-tolerated for most people, including those with running injuries. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Virtual Physical Therapy (VPT) for running injuries because it offers a fresh approach by using digital platforms to deliver therapy. Unlike traditional paper-based exercise programs, VPT allows for real-time feedback and personalized adjustments, which can enhance adherence and outcomes for patients. This tech-driven method not only makes therapy more accessible but also leverages data to tailor exercises to individual needs, potentially speeding up recovery times and improving overall effectiveness.

What evidence suggests that virtual physical therapy is effective for running injuries?

Research has shown that virtual physical therapy (VPT), one of the treatment options in this trial, is as effective as traditional in-person therapy for many muscle and bone issues. Studies have found that VPT can enhance movement, such as lifting an arm or performing overhead activities, and reduce pain during daily tasks. One report found that virtual health tools, when guided by a physical therapist, can lead to real improvements in managing pain and enhancing physical function. These findings suggest that VPT could be a promising method for treating running injuries, aiding recovery by improving movement and reducing discomfort. Participants in this trial will receive either VPT or a paper-based standard care exercise program. ^{4 6 7 8 9}

Who Is on the Research Team?

Sharareh Sharififar, PhD, PT

Principal Investigator

University of Florida

Are You a Good Fit for This Trial?

This trial is for runners aged 18-65 with a BMI <=35, who run at least 12 miles weekly and have chronic lower body injuries from running. They shouldn't have had lower limb surgery or major bone injury in the past year. Excluded are pregnant women, those under legal supervision, unwilling to pause in-person therapy post-enrollment, with uncontrolled diabetes, end-stage diseases, high BMI (>35), neurologic/degenerative conditions or acute injuries.

Inclusion Criteria

I have not had surgery on my legs.

I have long-term pain in my lower body from running, like knee or back pain.

I haven't had a major bone injury in my leg in the last year.

Exclusion Criteria

Current acute running related or sport related injury (e.g., ankle sprain, hip labral tear, ACL strain during an event or run)

I have conditions like uncontrolled diabetes or smoke, which may affect bone healing.

Mental disablement (Down's syndrome or dementia)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a combined treatment of home exercise with an individually provided four-session virtual physical therapy support program intervention

4 weeks

4 visits (virtual)

Follow-up

Participants are monitored for changes in pain and physical function movements, including squat and hopping quality

6 months

3 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• VPT

Trial Overview The study tests if adding four sessions of virtual physical therapy (VPT) support to standard home exercises improves pain and physical function in injured runners. Participants will perform controlled movements like squats and hops to measure the effectiveness of VPT combined with their regular rehabilitation routine.

How Is the Trial Designed?

Group I: VPT Experimental Treatment 1 Intervention

Group II: paper-based standard care exercise program Active Control 1 Intervention

Who Is Running the Clinical Trial?

University of Florida

Lead Sponsor

Trials

1,428

Recruited

987,000+

Published Research Related to This Trial

Telerehabilitation, particularly virtual physical therapy (PT), has shown to improve patient function and satisfaction, indicating its effectiveness as a healthcare delivery method.

The article emphasizes that ongoing research and technological advancements will enhance virtual PT, suggesting a promising future for its application across various treatment areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Physical Therapy and Telerehabilitation. Havran, MA., Bidelspach, DE.[2021]

A pilot study involving 15 orthopedic trauma patients showed that a Virtual Reality physical therapy (VR-PT) program was well-received, with an average enjoyment rating of 7.5 out of 10, indicating high patient engagement.

Patients expressed a strong interest in participating in further trials of VR-PT, suggesting that this innovative approach could improve access to physical therapy for those unable to attend traditional in-office sessions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality-based physical therapy for patients with lower extremity injuries: feasibility and acceptability. Reilly, CA., Greeley, AB., Jevsevar, DS., et al.[2022]

Telehealth sessions that include physical therapists have been successfully used for various health services, such as physical examinations and shared appointments for diabetes management.

These sessions also support obesity and weight management classes, indicating that telehealth can effectively facilitate important health interventions remotely.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Physical Therapist's Role in Clinical Video Telehealth. Gitlin-Nitti, YJ., Shah, CD., Kharlamb, V.[2023]

Telecommunication technology offers significant potential to improve access to medical services for patients in underserved areas, particularly in cardiopulmonary physical therapy, where its use is currently limited.

Barriers to the adoption of telehealth in physical therapy include unfamiliarity with technology and misconceptions about costs, highlighting the need for better education and clarity in terminology related to telehealth practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Overview of telehealth and its application to cardiopulmonary physical therapy. Shaw, DK.[2021]

Telephysiotherapy (TPT) significantly reduced pain in patients with various musculoskeletal issues, as shown by a study involving 15 participants in rural Nepal, with notable improvements measured through the Numeric Pain Rating Scale (NPRS).

The study suggests that TPT is a feasible and effective treatment option for rural patients, but further large-scale trials are needed to confirm its effectiveness and integrate it into standard clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Effectiveness of Telephone-Based Telephysiotherapy for Treatment of Pain in Low-Resource Setting: A Retrospective Pre-Post Design. Adhikari, SP., Shrestha, P., Dev, R.[2020]

A systematic review of 100 studies on telehealth in physical therapy revealed that most research focuses on musculoskeletal conditions, with Australia, Canada, and the US leading in published evidence.

Despite the growth in telehealth research, only 14% of studies utilized secure videoconferencing platforms, highlighting a gap in safety measures for delivering physical therapy services remotely.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of real-time videoconferencing to deliver physical therapy services: A scoping review of published and emerging evidence. Horsley, S., Schock, G., Grona, SL., et al.[2021]

Telehealth visits provide high-quality care with strong patient and provider satisfaction, showing that virtual physical therapy is just as effective as traditional in-person therapy for musculoskeletal disorders.

Postoperative telerehabilitation significantly improves clinical outcomes and offers increased intensity in rehabilitation programs, making it a promising option for patient recovery, especially following the COVID-19 pandemic which has enhanced telehealth reimbursement and implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation. Phuphanich, ME., Sinha, KR., Truong, M., et al.[2021]

A study involving 207 veterans with PTSD found that cognitive processing therapy (CPT) delivered via videoconference (VC) was as effective as in-person (IP) therapy in reducing PTSD symptoms at a six-month follow-up, indicating that VC can be a viable treatment option.

While VC showed non-inferiority to IP for long-term symptom improvement, it was less effective immediately after treatment, suggesting that in-person therapy may provide quicker benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Videoconferencing psychotherapy for veterans with PTSD: Results from a randomized controlled non-inferiority trial. Liu, L., Thorp, SR., Moreno, L., et al.[2021]

Remote physiotherapy is safe, feasible, and acceptable to patients, showing comparable effectiveness to in-person physiotherapy while being more cost-effective, based on a review of 41 studies covering various health conditions.

Patients reported high satisfaction with remote physiotherapy due to its accessibility and convenience, although adherence to exercise varied, suggesting that a combination of remote and in-person sessions may be the most effective approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A scoping review of the feasibility, acceptability, and effects of physiotherapy delivered remotely. Hawley-Hague, H., Lasrado, R., Martinez, E., et al.[2023]

The HTC VIVE virtual reality system, when configured for portability, showed a mean translational error of below 4.9 cm during motion tracking, which is higher than research-grade systems but still valid for tracking aggregate movement in physical therapy.

The advantages of using the portable VIVE system, such as increased accessibility for patients in various therapy settings, may outweigh its limitations in precision, making it a useful tool for both inpatient and outpatient physical therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobilization and calibration of the HTC VIVE for virtual reality physical therapy. Hemphill, S., Nguyen, A., Rodriguez, ST., et al.[2022]

A study involving 12 physical therapists assessing runners with knee pain showed a wide range of agreement (8%-100%) on selecting individual perceived impairments, indicating variability in clinical judgment.

However, when therapists attempted to agree on combinations of three impairments, their agreement was worse than chance, suggesting a lack of consensus on treatment priorities for knee pain in runners.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A preliminary analysis of physical therapist agreement regarding the perceived impairments in cases of runners with knee pain. Losciale, J., Wayman, K., Mansfield, CJ., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7928601/

Effectiveness of Telerehabilitation in Physical Therapy The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy.

2. sciencedirect.com sciencedirect.com/science/article/pii/S2666639125001798

Digital and virtual reality–based rehabilitation versus ... It has been directly associated with improved functional outcomes such as lifting the arm, performing overhead activities, and reducing pain during daily tasks.

3. withpower.com withpower.com/trial/phase-musculoskeletal-complications-7-2023-ef6d8

Virtual Physical Therapy for Running Injuries Research shows that virtual physical therapy is just as effective as traditional in-person therapy for various muscle and bone conditions, and patients are ...

4. apta.org apta.org/news/2024/06/05/phti-report-on-virtual-care

New Report Confirms Health Outcomes Are Improved ... A report released today revealed that virtual health technologies, when guided by a physical therapist, deliver clinically meaningful improvements in pain and ...

5. frontiersin.org frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2022.915332/pdf

Physical Therapist Impressions of Telehealth and Virtual ... These studies show the results for online physical therapy have been effective with long term benefits to both the patient and the therapist ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05994833

Virtual Physical Therapy Support for Runners No history of major bony injury to the lower limb such as traumatic fracture, within the past 12 months; Presence of chronic lower body running related injuries ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12234422/

The Role of Virtual Physical Therapy in the Management ... This article seeks to explore the role of virtual physical therapy (VPT) in managing patients with musculoskeletal (MSK) conditions and its impact on ...

8. thenonclinicalpt.com thenonclinicalpt.com/telehealth-physical-therapy/

Telehealth Physical Therapy (PT) - Your Guide Telehealth physical therapy is on the rise. Learn about telehealth PT jobs, how to start your own practice, and get started!

9. frontiersin.org frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2022.915332/full

Physical Therapist Impressions of Telehealth and Virtual ... These studies show the results for online physical therapy have been effective with long term benefits to both the patient and the therapist.