NCT05799235

Brief Summary

Anterior cruciate ligament (ACL) injuries are common in adolescents and its prevalence has increased over the years, especially with more adolescents engaging in physical activities and competitive sports. Standard of care for these injuries would be an ACL reconstruction (ACLR) to allow return to function and sports and reduce the risk of post-traumatic arthritis and recurrent knee injuries. Rehabilitation post-ACLR is crucial to optimise surgical outcomes and prevent re-rupture of ACL. However, good compliance to rehabilitation is often a challenge for patients and healthcare providers. Telerehabilitation for this group of patients may help to augment rehabilitation by improving patient compliance and overcome barriers to behavioural change often observed in traditional in-person physiotherapy. It can also allow remote monitoring and provide feedback to patients during exercises. In addition, it is a useful tool during pandemic when in-person visits are not possible. Currently, very few studies have evaluated the use of telerehabilitation with remote monitoring for ACLR, especially in adolescents. The use of home-based telerehabilitation post ACLR may be key to improving patient motivation and exercise compliance in adolescents. For this pilot study, the intervention group will undergo the TAR program in addition to standard care, which involves self-administered exercises in initial 12 weeks post ACLR using a mobile application. The mobile application will detect key landmarks on the body for human pose estimation. Participants will be able to perform their exercises with real-time feedback given, allowing for proper execution of the exercises. Exercise adherence, range of motion and pain scores will be tracked via the application and therapists are able to monitor via the online dashboard. The control group will undergo standard in-person physiotherapy. Primary aim of this study is to examine exercise adherence in TAR program versus standard care post ACLR in adolescents. Secondary aims of this study are to examine the effects of TAR program on knee strength, range, function, quality of life, treatment satisfaction, self-determination and number of face-to-face rehabilitation sessions required after ACLR.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Feb 2023

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 10, 2023

Completed
5 days until next milestone

Study Start

First participant enrolled

February 15, 2023

Completed
2 months until next milestone

First Posted

Study publicly available on registry

April 5, 2023

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 31, 2024

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2025

Completed
Last Updated

April 5, 2023

Status Verified

March 1, 2023

Enrollment Period

1.7 years

First QC Date

February 10, 2023

Last Update Submit

March 22, 2023

Conditions

Keywords

TelerehabilitationAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionMobile applicationAdolescent

Outcome Measures

Primary Outcomes (1)

  • Exercise adherence

    This will be measured via the Exercise Adherence Rating Scale (via the 6 item questions on assessing adherence to prescribed home exercises) over 12 weeks post-operatively, via changes in scores over the time points. The scores will range from 0-24, with higher scores indicating higher adherence.

    Post-operatively: Week 3, Week 6, Week 9, Week 12

Secondary Outcomes (11)

  • Pain intensity

    Pre-operatively (≤one month prior to operation), Post-operatively: Week 3, Week 6, Week 9, Week 12

  • Range of motion

    Pre-operatively (≤one month prior to operation), Post-operatively: Week 3, Week 6, Week 9, Week 12

  • Quadriceps and hamstring strength

    Pre-operatively (≤one month prior to operation), Post-operatively: Week 6, Week 12

  • One leg sit to stand

    Pre-operatively (≤one month prior to operation), Post-operatively: Week 6, Week 12

  • Self-reported function

    Pre-operatively (≤one month prior to operation), Post-operatively: Week 6, Week 12

  • +6 more secondary outcomes

Study Arms (2)

Telerehabilitation TAR program using a mobile application (intervention group)

EXPERIMENTAL

Participants in the intervention group will undergo the telerehabilitation TAR program and install and utilise the application on their mobile device, and self-administer the home exercises as prescribed by their physiotherapists. The mobile application uses novel deep learning algorithm on a mobile platform to detect key landmarks on the body for human pose estimation. Participants will be able to perform their rehabilitation exercise with real-time feedback allowing for proper execution of the exercises. The participants will be instructed on the installation and use of the mobile application and will be expected to perform the prescribed exercises independently (using the application) as instructed by their Physiotherapists. This application will be used for the initial 12 weeks of post-op rehabilitation.

Device: Telerehabilitation TAR program using a mobile application

Standard rehabilitation (control group)

ACTIVE COMPARATOR

Participants in the control group will attend standard in person rehabilitation sessions at the outpatient clinic. Participants will be prescribed a home exercise program as per standard care.

Other: Standard rehabilitation sessions

Interventions

Participants in this study arm will use a mobile application which allows participants to perform their home exercises with real-time feedback given, allowing for proper execution of exercises, on top of standard care.

Telerehabilitation TAR program using a mobile application (intervention group)

Participants in this control group will attend standard in person rehabilitation sessions with home exercise program given as per standard care.

Standard rehabilitation (control group)

Eligibility Criteria

Age12 Years - 20 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Participants age 12 to 20 years old
  • Participants undergoing ACLR surgery
  • Participants willing to be included in either the intervention group (utilizing the mobile application) or control group

You may not qualify if:

  • Participants with complications after ACLR surgery
  • Participants with significant neurological or other lower limb impairments or conditions affecting mobility and function
  • Participants with previous ACL surgeries of the same affected lower limb
  • Participants with previous surgeries or trauma to the unaffected lower limb

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

KK Women's and Children's Hospital

Singapore, Singapore

RECRUITING

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Knee InjuriesLeg InjuriesWounds and Injuries

Study Officials

  • Siao Hui Toh, PhD

    KK Women's and Children's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

February 10, 2023

First Posted

April 5, 2023

Study Start

February 15, 2023

Primary Completion

October 31, 2024

Study Completion

April 30, 2025

Last Updated

April 5, 2023

Record last verified: 2023-03

Data Sharing

IPD Sharing
Will not share

Locations