Femoroacetabular Impingement
Conditions
Brief summary
1. Purpose: 1) compare three conservative treatment approaches for subjects with femoroacetabular impingement syndrome (FAI), and 2) analyze functional outcome comparatively across groups. 2. Interventions will be provided based on randomized assignment. Group 1 will receive treatment based on identified impairments and treated twice weekly to address said impairments with hip manual therapy and exercise, as well as a prescriptive exercise for strengthening and mobility of the hip. Group 2 will receive only the prescriptive exercise program. Group 3 will be a control group (supervised neglect) 3. Primary outcomes data analysis will involve a mixed design (repeated measures) ANOVA for assessment of the primary outcome measure of the HAGOS. Secondary analyses will include chi square analyses (PASS, surgery at 6 months, adverse events), ANCOVA (PPMs, and expectations measures), or other appropriate comparative measures. None of the proposed treatment is considered outside of 'standard of practice'.
Interventions
OTHERExercise
Prescriptive exercise program of self-mobilization and/or strengthening program to address impairments of the subject.
OTHERManual therapy
Hip joint and spine manual therapy techniques applied toward the impairments of the subject.
OTHEREducation and advice
All three groups will receive standardized education on the current state of FAI interventions (with both conservative and surgical care).
OTHERSupervised neglect
Monitoring of group without formal intervention.
Sponsors
Duke University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Individuals age 18 to 60 years, * diagnosed with FAI by an orthopedic surgeon and exhibiting * hip/groin symptoms for at least 3 months (symptomatic); and * signs, symptoms and imaging findings conducive to FAI will be recruited from a surgical practice of an orthopedic surgeon in Durham, North Carolina.
Exclusion criteria
* subjects that have radiographic evidence of hip osteoarthritis that is more than mild in severity defined as Tonnis \>grade 1 or Kellgren-Lawrence \>2; * have other concurrent injury/conditions that will affect their ability to participate in the rehabilitation program and/or assessment procedures; * exhibit hip dysplasia (center edge angle \<20 degrees on AP radiograph * are unable to attend a study physiotherapist or participate in the rehabilitation program if randomized to the PT group; * are unable to understand English.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Did subject elect to undergo surgery? | up to 6 months after intervention | Determination of whether the subject had surgery for femoroacetabular impingement or not |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Patient Acceptable Symptom State (PASS) | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | subject acceptance of what their current symptom state is |
| Change in numeric pain rating scale | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | — |
| Change in Hip and Groin Outcome Score | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | — |
| Change in Single leg stance (SLS) | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | measure of single leg balance and stability |
| Change in Stanford Expectations of Treatment Scale (SETS) | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | subject expectation of treatment |
| Change in Single Leg Anteroposterior Hop | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | Measure of single leg balance, strength, power and coordination |
| Change in Standing Hip Internal Rotation Range-of-Motion | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | Measure of single leg weight-bearing range of motion |
| Change in Complications/Adverse Events of assigned treatment | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | — |
| Change in Lower Quarter Y Balance Test (YBT-LQ) | initial visit, 4 to 6 weeks after initial visit, and 6 months after initial visit | measure of single leg balance, strength and coordination |
Outcome results
None listed