The effectiveness of telehealth gait retraining in addition to standard physical therapy treatment for overuse knee injuries in soldiers: a protocol for a randomized clinical trial

• Published in: Current controlled trials in cardiovascular medicine Vol. 24; no. 1; p. 672
• Main Authors: Crowell, Michael S, Brindle, Richard A, Miller, Erin M, Reilly, Nicholas, Ford, Kevin R, Goss, Donald L
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 16.10.2023; BioMed Central; BMC
• Subjects: Analysis; Biomechanics; Care and treatment; Clinical trials; Gait; Health aspects; Injuries; Intervention; Knee; Methods; Military health care; Military personnel; Military readiness; Military training; Pain; Patient outcomes; Physical therapy; Physiological aspects; Psychological aspects; Rehabilitation; Running; Running biomechanics; Running injury; Self report; Soldiers; Study Protocol; Telemedicine; Therapeutics, Physiological; United Kingdom; United States > US
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/s13063-023-07502-x

Abstract Introduction Running is the most common cardiovascular exercise in the military. However, there is a high incidence of running-related overuse injuries that reduces military readiness. Gait retraining is a common intervention to treat running-related injuries, but the high cost of equipment and lack of clinician expertise and availability reduces utilization. Gait retraining intervention in a telehealth format might improve feasibility. The purpose of this randomized clinical trial is to determine the effectiveness of a telehealth gait retraining intervention on pain, self-reported function, and biomechanical risk factors for injury in service members who present to a Military Health System physical therapy clinic with an overuse knee injury. Methods This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels: telehealth gait retraining intervention with standard of care or only standard of care) and time (3 levels: baseline, 10 weeks or post-intervention, 14 weeks). Participants between the ages of 18 to 60 years will be included if they report knee pain during and/or after running to be anywhere from a 3 to a 7 on the numerical pain rating scale and demonstrate a rearfoot strike pattern. The primary dependent variables are as follows: (1) pain (worst pain during and/or after running) and (2) foot strike pattern (conversion rate from rearfoot to non-rearfoot foot strike pattern during running). Secondary outcomes include patient self-reported function and running biomechanics. Discussion The effectiveness of a telehealth gait retraining intervention to reduce pain and modify foot strike pattern is not known. The results of this study may help determine the effectiveness and feasibility of a telehealth gait retraining intervention to reduce pain, change foot strike, improve function, and improve running gait biomechanics. Trial registration ClinicalTrials.gov, NCT04269473 . Registered 05 February 2020.