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ORIGINAL RESEARCH article

Front. Digit. Health

Sec. Connected Health

Volume 7 - 2025 | doi: 10.3389/fdgth.2025.1678382

Hybrid Telerehabilitation Approach for Patellofemoral Pain Management in South African Runners: A Feasibility Case Series

Provisionally accepted
Eugene  NizeyimanaEugene Nizeyimana*Onele  MalungaOnele MalungaDawn  ErnstzenDawn ErnstzenQuinette  LouwQuinette Louw
  • Stellenbosch University, Stellenbosch, South Africa

The final, formatted version of the article will be published soon.

Background: Patellofemoral pain (PFP) is a prevalent condition in sports medicine, with rising incidence as sports competitions become increasingly popular. South Africa's healthcare system faces substantial challenges in delivering rehabilitation services due to geographical constraints, limited resources including professional shortages, and inadequate access to specialised musculoskeletal care. This study evaluated the feasibility of implementing a hybrid telerehabilitation program combining face-to-face sessions with WhatsApp video consultations for managing PFP in South African runners. Methods: A feasibility case series was conducted with five runners aged 25-39 years with PFP duration ≥6 weeks, recruited from Johannesburg. The 6-week intervention comprised an initial in-person assessment, weekly WhatsApp video consultations, and bi-weekly face-to-face sessions. Primary feasibility outcomes included recruitment success, session adherence, and acceptability measured using the Telehealth Usability Questionnaire (TUQ). Secondary clinical outcomes assessed pain intensity (Numerical Pain Rating Scale) and functional status (Anterior Knee Pain Scale). Results: Recruitment targets were fully achieved with 100% adherence to all scheduled sessions. Participants demonstrated high exercise compliance and good acceptability scores (mean TUQ 5.9/7), though participants expressed a preference for in-person consultations. Significant clinical improvements were observed, with pain scores decreasing from 3.8 to 0.6 and functional scores improving from 79.6 to 94.0 over six weeks. Conclusion: Hybrid telerehabilitation demonstrated feasibility and preliminary effectiveness for PFP management in South African runners, achieving excellent adherence rates and clinically meaningful improvements in pain and function. This approach shows promise for addressing healthcare delivery challenges in resource-constrained settings.

Keywords: feasibility, hybrid rehabilitation, In-person rehabilitation, Patellofemoral pain, Runners, South Africa, telerehabilitation, WhatsApp video consultations

Received: 02 Aug 2025; Accepted: 15 Sep 2025.

Copyright: © 2025 Nizeyimana, Malunga, Ernstzen and Louw. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Eugene Nizeyimana, nizeyimana@sun.ac.za

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.