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Feedback leads to better exercise quality in adolescents with patellofemoral pain
Riel H, Matthews M, Vicenzino B, Bandholm T, Thorborg K, Rathleff MS
Medicine and Science in Sports and Exercise 2018 Jan;50(1):28-35
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: Adolescents with patellofemoral pain (PFP) do not comply with their exercise prescription, performing too few and too fast repetitions, compromising recovery. We investigated if real-time feedback on contraction time would improve the ability of adolescents with PFP to perform exercises as prescribed. METHODS: A randomised, controlled, participant-blinded, superiority trial with a 6-week intervention of three weekly sessions of three elastic band exercises was undertaken. Forty 15 to 19-year-old adolescents with PFP were randomised to real-time BandCizer-iPad feedback on contraction time or not by a physiotherapist. The primary outcome was the mean deviation from the prescribed contraction time of 8 seconds per repetition. Secondary outcomes included isometric hip and knee strength, Kujala Patellofemoral Scale and Global Rating of Change. RESULTS: The mean deviation from prescribed 8 seconds per repetition contraction time was 1.5s (+/- 0.5) for the feedback group, compared to 4.3s (+/- 1.0) for the control group (mean difference: 2.7s (95% CI 2.2 to 3.2, p < 0.001). Based on total contraction time during the intervention, the feedback group received 35.4% of the prescribed exercise dose whilst the control group received 20.3%. Isometric hip and knee strength increased significantly more in the feedback group compared to controls (mean difference 1.35 N/kg (95%CI 0.02 to 2.68, p = 0.047)). There were no significant differences in Kujala Patellofemoral Scale and Global Rating of Change between groups, but the study was not powered for this. CONCLUSION: Real-time feedback on contraction time resulted in the ability to perform exercises closer to the prescribed dose, and also induced larger strength gains.

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