Feedback Leads to Better Exercise Quality in Adolescents with Patellofemoral Pain
Riel, H.; Matthews, M.; Vicenzino, B.; Bandholm, T.; Thorborg, K.; Rathleff, M.Skovdal.
Medicine and Science in Sports and Exercise 50(1): 28-35
ISSN/ISBN: 0195-9131 PMID: 28846562 DOI: 10.1249/mss.0000000000001412
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. A randomized, controlled, participant-blinded, superiority trial with a 6-wk intervention of three weekly sessions of three elastic band exercises was undertaken. Forty 15- to 19-yr-old adolescents with PFP were randomized 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 s per repetition. Secondary outcomes included isometric hip and knee strength, Kujala Patellofemoral Scale, and Global Rating of Change. The mean deviation from prescribed 8 s per repetition contraction time was 1.5 ± 0.5 s for the feedback group, compared with 4.3 ± 1.0 s for the control group (mean difference: 2.7 s (95% confidence interval = 2.2-3.2, P < 0.001). On the basis of total contraction time during the intervention, the feedback group received 35.4% of the prescribed exercise dose whereas the control group received 20.3%. Isometric hip and knee strength increased significantly more in the feedback group compared with controls (mean difference = 1.35 N·kg, 95% confidence interval = 0.02-2.68, 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. Real-time feedback on contraction time resulted in the ability to perform exercises closer to the prescribed dose and also induced larger strength gains.