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NCT Number: NCT07705945

Using Telehealth to Improve Musculoskeletal Care Through Expanded Physical Therapy Access

The purpose of this study is to explore and compare the effectiveness of in-person versus remote physical therapy (PT) for the treatment of musculoskeletal (MSK) pain within the Military Health System (MHS).

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Key information

Conditions

Musculoskeletal Pain Muscular Diseases Musculoskeletal Diseases Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tripler Army Medical Center, Tripler AMC, Hawaii, United States

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About this study

This study will explore the effect of remote two-way video conference telehealth physical therapy sessions compared to standard of care in-person physical therapy. Eligible participants will be randomized into one of the 2 treatment arms. Specific aims will compare the effectiveness of physical therapy delivery strategies on the primary outcome of Pain, Enjoyment, and General Activity (PEG-3) Scale, which measures pain interference, and secondary outcomes of PROMIS short forms (mood, physical function, fatigue, sleep disturbance, and prescription medication misuse), patient global impression of change, and pain self-efficacy.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Ages 18-64
  • TRICARE Beneficiary (active duty, retiree, dependent)
  • Health care visit for their MSK condition in the past 6 weeks
  • Diagnosed with an MSK condition that has persisted for at least 2 weeks
  • Has a computer (either smartphone, tablet or laptop), with video and audio capabilities for telehealth, including access to internet
  • Able to speak and read English well enough to provide informed consent, follow study instructions and independently answer the questionnaires
  • Available to attend treatment sessions over the next 2 months

Exclusion criteria

  • Surgery for any MSK condition in the past 6 months
  • Currently known to be pregnant
  • Medical contraindication to exercise
  • Currently receiving or scheduled to receive invasive or other nonpharmacologic interventions for any MSK condition (e.g., chiropractic, injections, etc.) with the exception of a physical therapy referral, an issued profile or duty restriction, or other related patient education
  • Anyone separating from the military within 9 months (other than normal military retirement), pending a medical or physical evaluation board, discharge from the military for medical reasons, or pending or undergoing any litigation for an injury
  • Signs of serious or systemic pathology that could be responsible for the musculoskeletal pain (i.e. ankylosing spondylitis, rheumatoid arthritis, gout, lupus, vertebral osteomyelitis, or psoriatic arthritis), currently receiving treatment for cancer other than skin cancer or acute fracture (in the last 3 months) of the musculoskeletal region.

Treatment and study plan

In-person physical therapy (PT)

Other

Participants assigned to in-person PT will receive individual treatment sessions provided by a licensed, on-site PT. Participants will receive 1-on-1 sessions based on the preference and clinical expertise of the clinician. Participants assigned to in-person physical therapy will receive individual treatment sessions provided by a licensed, on-site physical therapist at the participating military treatment facility. Physical therapists delivering in-person physical therapy will have the option to provide participants a digital home exercise program, however this will not be required. If you choose to download and use either app, you will have to accept the app's terms of service.

Telehealth physical therapy (TH-PT)

Other

Participants assigned to telehealth physical therapy will use two-way video conferencing with a licensed physical therapist via a secure platform approved for patient care. Video conferencing will be accessible via a mobile app or web browser on your home computer. Participants assigned to telehealth physical therapy will be provided a digital home exercise program. The home exercise program is accessible via a mobile app or web browser on your home computer. This is an app that some military clinics already use as standard of care for providing home exercise programs to their patients, so there is a chance you would be receiving your exercises by this method even if you didn't participate in this study.

Primary outcomes

  1. Pain, Enjoyment, and General Activity Scale (PEG-3)

    Time frame: 12 Weeks

    The PEG-3 measure includes 3 items evaluating 1) pain severity; and interference of pain with 2) enjoyment and 3) general activity. Item response options range from 0-10. The PEG-3 score is expressed as the mean of all item scores ranging from 0-10.

Secondary outcomes

  1. PROMIS-29

    Time frame: 12 Weeks

    The PROMIS-29 assesses additional domains relevant to patients with MSK pain including physical function, fatigue, depression, anxiety, pain intensity, ability to participate in social roles, and sleep disturbance. The PROMIS-29 can also be used to calculate a physical and mental health summary score and can be used in cost-effectiveness analyses.

  2. Pain Self-Efficacy Questionnaire (PSEQ)

    Time frame: 12 Weeks

    Because of its role in patients' capacity of selfmanagement, we will use the 10 item Pain Self-Efficacy Questionnaire (PSEQ) to quantify an individual's confidence in performing activities despite pain.

  3. Patient Global Assessment of Change (PGIC)

    Time frame: 12 Weeks

    Participants' satisfaction with their intervention will be based on the single-item Patient Global Assessment of Change (PGIC).

  4. PROMIS Short Form Prescription Pain Medication Misuse

    Time frame: 26 Weeks

    The PROMIS short form 7a assesses the abuse of prescription pain medication. The short form uses fixed items from the PROMIS item bank to provide a T-score with population mean = 50 (sd=10).

  5. EuroQoL (EQ-5D)

    Time frame: 12 Weeks

    The EQ-5D is a generic quality of life questionnaire that will assess quality of life on a scale that can be referenced to other disease conditions. The EQ-5D covers 5 domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each domain has 3 response categories: level 1, "no problems"; level 2, "some problems"; and level 3, "inability or extreme problems." Responses are combined to give a 5-digit descriptive health state classification (e.g., 11222). The EQ-5D yields a total of 243 possible health states. Valuations for each health state are available. The EQ-5D is commonly used in economic evaluation of interventions and cost-effectiveness analysis.

Study contacts

Contact information is provided by the study sponsor or research team.

Cedar Sexton

CONTACT

[email protected]

210-916-8634

Tina Greenlee, PhD

CONTACT

[email protected]

210-539-9638

Sponsors and collaborators

Lead sponsor

Brooke Army Medical Center

Fed

Collaborators

  • C.R.Darnall Army Medical Center
  • Madigan Army Medical Center
  • Tripler Army Medical Center
  • University of Utah

Registry information

Official study title

Using Telehealth to Improve Musculoskeletal Care Through Expanded Physical Therapy Access: The TELE-MC Trial

Acronym: TELE-MC

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Jul 15, 2026
Registry last updated
Jul 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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