Effect of an online education and exercise program for people with knee cap pain.

INTERVENTION: Participants in the Web‐based education and exercise group will receive access to a website (www.mykneecap.trekeducation.org) for 6 weeks. The website is designed to educate participants with knee pain on how to self‐manage their knee pain based on the current evidence, along with a self‐directed exercise‐therapy program. This website consists of a public access area which includes three main sections: (1) Understanding patellofemoral pain; (2) Treatment options and (3) Exercise program. In all sections, the content will be provided using a mix of resources, such as animated videos, infographics and small paragraphs of text. ‐ The “Understanding patellofemoral painâ€? section provides information covering a variety of subjects including diagnosis, prognosis, incidence and prevalence, crepitus, kinesiophobia, self‐management of exercise load and self‐management of pain. ‐ The “Treatment optionsâ€? section includes treatment options that can be beneficial (taping/bracing, foot orthosis and exercises) and information about common treatments with inconsistent evidence (knee surgery, ultrasound, platelet‐rich‐plasma, dry needling and others). ‐ The “Exercise programâ€? section is focused in 4 types of exercise (bridges, planks, squats and hip abduction), based primarily on a previously published exercise‐therapy trial (Barton et al. doi:10.1016/j.ptsp.2019.04.010). The participants will have access to videos designed to help them performing the exercises proposed in the “exercise programâ€? section. Options about how to progress the exercises will be also provided. Participants will be instructed to perform the exercise program which consists of four exercises (one exercise of each type ‐ bridges, planks, squats and hip abduction), 3 times a week, for 6 week CONDITION: Musculoskeletal ‐ Other muscular and skeletal disorders Patellofemoral pain; ; Patellofemoral pain PRIMARY OUTCOME: Global rating of change (GROC) assessed with a 6‐point likert scale (‘completely recovered’, ‘marked improvement’, ‘moderate improvement’, ‘same’, ‘moderate worsening’, and ‘marked worsening’).[Baseline, 6 weeks after baseline assessment (primary timepoint), 12 weeks baseline assessment.] Worst Knee pain in the last week assessed with a 100mm Visual Analogue Scale (VAS)[Baseline, 6 weeks after baseline assessment (primary timepoint), 12 weeks baseline assessment.] SECONDARY OUTCOME: Adherence of the treatment using a participant diary[6 weeks after baseline assessment, 12 weeks after baseline assessment.] Kinesiophobia assessed with the Tampa Scale for Kinesiophobia (TSK)[Baseline, 6 weeks after baseline assessment, 12 weeks baseline assessment.] Knee related quality of life assessed with the Quality of Life subscale of the KOOS (KOOS‐QoL)[Baseline, 6 weeks after baseline assessment, 12 weeks baseline assessment.] Patient's knowledge about knee pain assessed with the Pain CAT knowledge questionnaire.[Baseline, 6 weeks after baseline assessment, 12 weeks after baseline assessment.] Self‐reported knee related function assessed with the Anterior Knee Pain Scale (AKPS)[Baseline, 6 weeks after baseline assessment, 12 weeks baseline assessment.] INCLUSION CRITERIA: Participants will be considered eligible if they present with anterior or retropatellar pain: (i) corresponding to at least 30 on a 100 visual analogue scale (VAS) in the previous week; (ii) for at least 3 months; (iii) during at least two or more of the following activities: prolonged sitting, squatting, kneeling, running, ascending and descending stairs, jumping and landing; (iv) if they who could read/understand English; and (v) if they have access to computer/internet.