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Trial registered on ANZCTR
Registration number
ACTRN12621001525875
Ethics application status
Approved
Date submitted
14/09/2021
Date registered
9/11/2021
Date last updated
10/05/2023
Date data sharing statement initially provided
9/11/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
A feasibility trial of flat, flexible school shoes for management of adolescent patellofemoral pain
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Scientific title
A feasibility trial of flat, flexible school shoes for management of adolescent patellofemoral pain
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Secondary ID [1]
305304
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Patellofemoral pain
323621
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Condition category
Condition code
Musculoskeletal
321155
321155
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0
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Other muscular and skeletal disorders
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Physical Medicine / Rehabilitation
321158
321158
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Flat, flexible shoes:
Participants will receive a commercially available flat flexible shoe that conforms to school uniform guidelines (e.g. Vivobarefoot Primus Lite or RA II). The shoe will be lightweight, have minimal stability features, a low stack height and no heel-toe offset. Participants will attend a 30 minute baseline session with research staff to have the shoes individually fitted. Participants will wear this shoe as per school requirements throughout the 12-week intervention period. A graduated exposure to the shoe based on days per week will be used. Participants will be instructed to wear the shoes for 2 school days in the first week, 3 school days in weeks 2-3, and every day that school shoes are worn in weeks 4-12 (except for sports uniform day). Written instructions for this exposure and adaption, specific to this study, will be provided. Participants will be asked to record their daily hours of wear in a weekly logbook.
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Intervention code [1]
321715
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Treatment: Devices
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Comparator / control treatment
Regular school shoe:
Participants will be provided with a new pair of standard school shoes (e.g. Clarks Daytona) and instructed to wear them at all times they would usually wear their school shoe. Participants will be asked to record their daily hours of wear in a weekly logbook.
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Control group
Active
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Outcomes
Primary outcome [1]
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Feasibility is a composite outcome, and will be assessed by evaluating:
(i) willingness of participants to enrol (from recruitment database);
(ii) number of eligible participants (from recruitment database);
(iii) recruitment rate (from recruitment database);
(iv) adherence with allocated intervention and log book completion (from participant logbooks);
(v) adverse effects (from participant logbooks); and
(vi) drop-out rate (from trial database).
Participants will be asked to complete their log-books (electronic or paper), assisted by their parent/guardian as required and checked for completion. Participants will record their footwear worn and any adverse effects. Possible adverse events include blisters, calf or Achilles tendon pain, or heel or arch pain.
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Assessment method [1]
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Timepoint [1]
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Assessed at completion of data collection
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Secondary outcome [1]
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Worst pain severity will be measured using a 100mm visual analogue scales (where 0mm = no pain and 100mm = worst pain imaginable). Participants will be asked to rate their worst pain in the preceding week.
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Assessment method [1]
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Timepoint [1]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [2]
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Global rating of change (GROC) will be measured on an 7-point Likert scale (‘completely recovered’, ‘strongly recovered’, ‘slightly recovered’, ‘same’, ‘slightly worse’, ‘much worse’ and ‘worse than ever’).
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Assessment method [2]
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Timepoint [2]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [3]
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Participants will complete the Knee Injury and Osteoarthritis Outcome Score (KOOS) patellofemoral subscale (KOOS-PF).
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Assessment method [3]
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Timepoint [3]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [4]
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Participants will complete the Child Version of the Knee injury and Osteoarthritis Outcome Score (KOOS-Child).
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Assessment method [4]
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Timepoint [4]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [5]
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The Anterior Knee Pain Scale will be used to measure symptoms and function.
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Assessment method [5]
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Timepoint [5]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [6]
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Participants will complete the Youth quality of life- short form (YQOL-SF) as a measure of their quality of life
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Assessment method [6]
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Timepoint [6]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [7]
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Use of co-interventions: Participants will be asked to keep a daily record of any other interventions utilised throughout the study (outside of their allocated intervention) (e.g. pain medication, physiotherapy).
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Assessment method [7]
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Timepoint [7]
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Baseline and 6 and 12 weeks post-intervention commencement.
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Secondary outcome [8]
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Lower limb kinematics and kinetics: Participant's lower limb kinematics and kinetics will be assessed during walking and running using an 8 camera motion analysis and instrumented treadmill.
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Assessment method [8]
400924
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Timepoint [8]
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Baseline and 12 weeks post intervention commencement.
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Secondary outcome [9]
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Pain severity will be measured using a 100mm visual analogue scales (where 0mm = no pain and 100mm = worst pain imaginable). Participants will be asked to rate their average pain in the preceding week.
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Assessment method [9]
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Timepoint [9]
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Baseline and 6 and 12 weeks post intervention commencement.
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Eligibility
Key inclusion criteria
(i) Aged 12-18 years; (ii) anterior knee pain of non-traumatic origin for at least 6 weeks duration; (iii) pain that is rated at least 3 on an 11-point numerical rating scale (0=no pain, 10=maximal pain); and (iv) knee pain aggravated by activities that load the patellofemoral joint (e.g. squatting, stair climbing)
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Minimum age
12
Years
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Maximum age
18
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(i) Concomitant pain at sites other than the anterior knee; (ii) history of knee, hip or spine surgery, or other suspected knee joint pathology (e.g. Osgood Schlatter’s Disease); (iii) planned lower limb surgery (e.g. arthroscopy); (iv) neurological condition or systemic arthritis; (v) currently wearing a flat,flexible shoe for school; and (vi) any foot condition precluding the use of flat, flexible shoes.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation will be concealed. The assessor who determines eligibility will be unaware of which group the participant will be allocated to, and will remain blinded to group allocation throughout the study period. Allocation will be determined by an independent investigator, who will hold the allocation sequence and communicate each participant's group allocation to an unblinded assessor.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
This study will use simple randomisation, with the sequence generated by computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
A formal sample size calculation is not appropriate for feasibility trials. A sample of 24 participants will enable us to observe feasibility outcomes. Descriptive statistics will be used for the primary outcomes of feasibility. Estimates of i) group means and standard deviation of the secondary clinical outcomes, and ii) between-group differences in secondary clinical outcomes, with accompanying 95% confidence intervals, will be calculated.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/03/2022
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Actual
6/05/2022
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Date of last participant enrolment
Anticipated
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Actual
3/02/2023
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Date of last data collection
Anticipated
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Actual
25/04/2023
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Sample size
Target
24
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Accrual to date
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Final
24
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
35292
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3216 - Waurn Ponds
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Funding & Sponsors
Funding source category [1]
309674
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University
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Name [1]
309674
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Deakin Univeristy
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Address [1]
309674
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75 Pigdons Road
Waurn Ponds
Victoria 3216 Australia
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Country [1]
309674
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Australia
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Primary sponsor type
University
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Name
Deakin University
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Address
75 Pigdons Road
Waurn Ponds
Victoria 3216 Australia
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Country
Australia
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Secondary sponsor category [1]
310693
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Individual
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Name [1]
310693
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Dr Jason Bonacci
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Address [1]
310693
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Centre for Sports Research
Deakin University
75 Pigdons Road
Waurn Ponds
Victoria 3216 Australia
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Country [1]
310693
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Australia
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Secondary sponsor category [2]
310695
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Individual
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Name [2]
310695
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Dr Aaron Fox
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Address [2]
310695
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Centre for Sports Research
Deakin University
75 Pigdons Road
Waurn Ponds
Victoria 3216 Australia
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Country [2]
310695
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Australia
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Secondary sponsor category [3]
310696
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Individual
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Name [3]
310696
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Dr Natalie Saunders
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Address [3]
310696
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Centre for Sports Research
Deakin University
75 Pigdons Road
Waurn Ponds
Victoria 3216 Australia
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Country [3]
310696
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Australia
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Secondary sponsor category [4]
310697
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Individual
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Name [4]
310697
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Professor Bill Vicenzino
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Address [4]
310697
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School of Health and Rehabilitation Sciences
The University of Queensland
St Lucia QLD 4072
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Country [4]
310697
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
309442
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Deakin University Human Research Ethics Committee
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Ethics committee address [1]
309442
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Deakin University Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC 3125
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Ethics committee country [1]
309442
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Australia
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Date submitted for ethics approval [1]
309442
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Approval date [1]
309442
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16/07/2021
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Ethics approval number [1]
309442
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2021-135
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Summary
Brief summary
Patellofemoral pain is experienced by one in four adolescents. This pain is debilitating, leads to reduced quality of life and decreased participation in physical activity. Adolescent patellofemoral pain persists into adulthood, with up to 78% continuing to experience pain up to 20 years later. A longer duration of patellofemoral pain is the most consistent predictor of poor prognosis, highlighting the need to intervene early. We know very little about how to effectively manage patellofemoral pain in adolescents. Evidence-based treatments that are effective in adults, such as exercise therapy, are not as effective in adolescent populations. Adolescents spend up to nine hours per weekday in stiff, raised heel school shoes whilst performing a significant amount of their daily physical activity. Stiff, raised heel shoes are known to elevate patellofemoral joint loads. Flat, flexible footwear have been shown to reduce patellofemoral joint loads. This is a simple, low-cost treatment option that directly targets repetitive patellofemoral joint loading known to contribute to pain in adolescents. This trial will determine the feasibility of conducting a full-scale randomised clinical trial investigating flat, flexible school shoes for adolescents with patellofemoral pain. Findings will inform future large-scale clinical trials and guide clinical practice guidelines for management of adolescent patellofemoral pain.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Jason Bonacci
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Address
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Centre for Sports Research
School of Exercise and Nutrition Sciences
Deakin University
75 Pigdons Road
Waurn Ponds
Victoria 3216
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Country
114174
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Australia
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Phone
114174
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+61 3 5227 2634
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Fax
114174
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Email
114174
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[email protected]
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Contact person for public queries
Name
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Jason Bonacci
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Address
114175
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Centre for Sports Research
School of Exercise and Nutrition Sciences
Deakin University
75 Pigdons Road
Waurn Ponds
Victoria 3216
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Country
114175
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Australia
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Phone
114175
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+61 3 5227 2634
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Fax
114175
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Email
114175
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[email protected]
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Contact person for scientific queries
Name
114176
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Jason Bonacci
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Address
114176
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Centre for Sports Research
School of Exercise and Nutrition Sciences
Deakin University
75 Pigdons Road
Waurn Ponds
Victoria 3216
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Country
114176
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Australia
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Phone
114176
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+61 3 5227 2634
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Fax
114176
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Email
114176
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified individual participant data collected during the trial
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When will data be available (start and end dates)?
After publication, no end date determined
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Available to whom?
Access to this data will be determined on a case-by-case basis at the discretion of Primary Investigator
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Access to the data will be subject to approval by Principal Investigator (email:
[email protected]
), with a requirement to sign a data access agreement.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Flat flexible school shoes for adolescents with patellofemoral pain: a randomised, assessor-blinded, parallel-group feasibility trial.
2023
https://dx.doi.org/10.1136/bmjsem-2023-001717
N.B. These documents automatically identified may not have been verified by the study sponsor.
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