Coxa Saltans External, External Snapping Hip
Conditions
Keywords
External snapping hip, Progressive resistance training, Coxa saltans external, Exercise
Brief summary
External snapping hip is characterised by an audible and painful snap during hip movement among physical active people around 15-40 years old. Progressive resistance training has been suggested as a new potential treatment path in treating patients with external snapping hip. The investigators conducted a feasibility study and found that patients reported less pain and improved their physical function, quality of life and muscle strength after 12 weeks of progressive resistance training. The overall aim of the project is to compare hip pain in patients with external snapping hip treated with progressive resistance training to a wait-and-see approach, in a randomised controlled trial. This study has the potential to establish a new and specific treatment option for patients with external snapping hip, to be used nationally and internationally.
Detailed description
This trial is an international multicentre randomised controlled trial, following the CONSORT guidelines. The intervention is a 12-week progressive resistance training programme, and the trial is designed with three follow-up time points. After the baseline test, the patients will be randomised in a 1:1 ratio to either the intervention or the control group using the Research Electronic Data Capture (REDCap) source hosted at Aarhus University. For both groups, the first test will be the baseline test, conducted before the randomisation. The second test will be conducted 6 weeks after randomisation, the third test will be conducted 12 weeks after randomisation and the fourth and last test will be conducted 24 weeks after randomisation. The primary outcome will be the change from baseline to the third follow-up, and the trial will be powered based on this period. The lasting effect of the intervention will be evaluated from baseline to the fourth follow-up test for the intervention group.
Interventions
OTHERProgressive resistance training
The progressive resistance program consist of a five-minute aerobic warm-up on either an ergometer bike, treadmill or rowing machine followed by six resistance training exercises: landmine twist, walking lunges, leg press, hip abduction, hip adduction and hip flexion. All training sessions (three per week) will be supervised for the first two weeks. After that, there will be one weekly supervised training session and two self-directed sessions. The subjects will be scheduled for 36 training sessions over 12 weeks, of which 16 will be supervised. Each training session is designed based on the findings from the feasibility study and is expected to last approximately one hour. If a subject cannot perform all scheduled sessions in a week, additional sessions will be planned for the following week to obtain the 16 supervised sessions.
BEHAVIORALWaiting time
12 weeks of waiting time
BEHAVIORALSelf guided exercise
12 weeks of self guided exercise
Sponsors
Aarhus University Hospital
University of Aarhus
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-40 years (10) * Experienced lateral hip joint "snapping" with pain discomfort within the last 14 days * Able to demonstrate the audible and/or visible lateral "snapping" during lateral hip joint movementor popping sound when the hip joint moves * Capable of commuting to the training facility * Proficient in reading and understanding Danish or English
Exclusion criteria
* Previous surgery on the affected hip * Planned surgery on lower extremities within the trial period * Anterior or medial hip discomfort that substantially exceeds the lateral hip discomfort * Any contraindication to exercise * Neurological, rheumatoid, or mental conditions affecting the hip function * Ongoing active cancer treatment * Planned vacation for more than 14 days within the intervention period * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HAGOS Pain | Baseline, week 6, week 12 and week 24 | The HAGOS is a patient-reported questionnaire consisting of six different subscales. The pain subscale consists of 10 questions, which are all answered using standardised answer options following a 0-4-point Likert Scale. The scores are transformed into a subscale score ranging from 0 (worst) to 100 (best). A minimal clinically relevant difference of the HAGOS pain subscale has been reported to be 9.7 points among a group of patients undergoing hip arthroscopy for femoroacetabular impingement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HAGOS | Baseline, week 6, week 12 and week 24 | The remaining five subscales of HAGOS: symptoms, function in daily living (ADL), function in sport and recreation (Sports/Rec), participation in physical activities (PA) and hip and/or groin-related quality of life (QOL). The scores are transformed into a subscale score ranging from 0 (worst) to 100 (best). |
| UCLA-AS | Baseline, week 12 and week 24 | The patient-reported questionnaire: the University of California Los Angeles Activity Scale. There is only one question with 10 answers, ranging from 1 (worst) to 10 (best). |
| GPE | Baseline, week 12 and week 24 | The patient-reported questionnaire: the Global Perceived Effect, where the participant answers four questions about the effect of the treatment received. Each question has 7 possible answers, ranging from 1 (best) to 7 (worst). |
| Single leg hop test | Baseline, week 12 and week 24 | The objective measures include the single-leg hop for a distance test to test hip function. The hop distance is measured in cm. |
| 30 second unilateral sit-to-stand test | Baseline, week 12 and week 24 | The unilateral 30 second Sit to Stand test (unilateral 30STS) is a clinical test of lower extremity function. The unilateral 30STS tests how many correct repetitions of a sit to stand from a chair, a participant can complete in 30 seconds. |
| Number of training sessions the participant participated in | Throughout the study, summed in week 24 | Adherence to the exercise protocol will be evaluated based on information from the physiotherapists and a self-reported training diary. Good adherence will be defined as participation in more than ≥70% of all training sessions (both supervised and self-training). |
| Adverse events | Throughout the study, summed in week 24 | The physiotherapist will record any adverse events occurring during the study period. |
Countries
Denmark
Contacts
CONTACTLisa U Tønning, MHSc
CONTACTInger Mechlenburg, DMSc
STUDY_DIRECTORStig S Jakobsen, PhD
Department of Orthopedic Surgery, Aarhus University Hospital, DK
PRINCIPAL_INVESTIGATORLisa U Tønning, MHSc
Department of Orthopedic Surgery, Aarhus University Hospital, DK
STUDY_DIRECTORInger Mechlenburg, DMSc
Department of Clinical Medicine, Aarhus University, DK
STUDY_DIRECTORUlrik Dalgas, PhD
Department of Public Health, Sports, Aarhus University, DK
STUDY_DIRECTORTroels Kjeldsen, PhD
Department of Orthopedic Surgery, Aarhus University Hospital, DK
STUDY_DIRECTORCara Lewis, PhD
Department of Physical Therapy, Boston University, Boston, US
STUDY_DIRECTORMartin Lamm, MSc
Department of Orthopedic Surgery, Aarhus University Hospital, DK
STUDY_DIRECTORJoanne L Kemp, PhD
La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
Outcome results
None listed