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 study will compare standard of care of home exercise for running rehabilitation to the combined treatment of home exercise with an individually provided four-session virtual physical therapy support program intervention on pain and physical function movements (controlled dual and single leg squat and lateral hopping in individuals post running injury. These collective findings will help provide new evidence of the responses to an individually provided virtual PT interventions among runners.

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.

Is virtual physical therapy safe for humans?

Research shows that virtual physical therapy is generally safe and provides high-quality care, with both patients and providers satisfied. It is considered as effective as traditional in-person therapy for various musculoskeletal issues, and it has been successfully used for postoperative rehabilitation. ^{1 2 3 4 5}

How does virtual physical therapy for running injuries differ from other treatments?

Virtual physical therapy for running injuries is unique because it allows patients to receive treatment remotely, overcoming barriers to access that prevent many from attending in-person sessions. This approach uses technology like videoconferencing and virtual reality to deliver effective therapy, making it more convenient and accessible compared to traditional in-office physical therapy. ^{4 6 7 8 9}

What data supports the effectiveness of the treatment 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 generally satisfied with the care they receive remotely. ^{2 7 9 10 11}

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

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]

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]

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 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]

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 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]

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]

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]

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]

Citations

1. England pubmed.ncbi.nlm.nih.gov

A preliminary analysis of physical therapist agreement regarding the perceived impairments in cases of runners with knee pain. [2022]

2. England pubmed.ncbi.nlm.nih.gov

A scoping review of the feasibility, acceptability, and effects of physiotherapy delivered remotely. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Virtual reality-based physical therapy for patients with lower extremity injuries: feasibility and acceptability. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

A Physical Therapist's Role in Clinical Video Telehealth. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

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

7. United States pubmed.ncbi.nlm.nih.gov

Mobilization and calibration of the HTC VIVE for virtual reality physical therapy. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Use of real-time videoconferencing to deliver physical therapy services: A scoping review of published and emerging evidence. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Videoconferencing psychotherapy for veterans with PTSD: Results from a randomized controlled non-inferiority trial. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Virtual Physical Therapy and Telerehabilitation. [2021]

11. United States 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. [2020]