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- Title
Physiotherapist-led treatment for Femoroacetabular Impingement Syndrome (The PhysioFIRST study): A participant and assessor-blinded randomised controlled trial.
- Authors
Kemp, Joanne; Smith, Anne; Scholes, Mark; Johnston, Richard; Coburn, Sally; Jones, Denise; Girdwood, Michael; Schache, Anthony; Mentiplay, Benjamin; King, Matthew; de Oliveira Silva, Danilo; Crossley, Kay
- Abstract
Introduction: There have been no full-scale randomised controlled trials (RCTs) comparing physiotherapist-led interventions for FAI syndrome.1 Objectives: Evaluate the effect of physiotherapist-led targeted-strengthening (STRENGTH) compared to physiotherapist-led standardised-stretching (STRETCH) on hip-related quality of life (QOL) and perceived improvement at six months in people with femoroacetabular impingement (FAI) syndrome. Study design: Double-blind, parallel, superiority RCT(2). Methods: Participants aged 18-50 years, pain ≥3/10 for ≥6 weeks, cam morphology (alpha angle ≥60°), positive flexion-- adduction--internal rotation test were included. People were excluded for physiotherapy treatment or hip joint injection in the past three months, previous or planned hip, back lower limb surgery, radiographic hip osteoarthritis. Both groups received 6-months of one-on-one treatment with a physiotherapist. STRENGTH undertook a supervised, targeted, individualised exercise therapy and education programme. STRETCH undertook a supervised standardised stretching and education program. Primary outcomes were change in hip-related QOL (International Hip Outcome Tool-33 (iHOT-33, 0-100 points)); and patient-perceived global improvement (7-point Likert scale) at six months. Secondary outcomes were hip muscle strength, functional task performance, and kinesiophobia. Statistical analyses compared betweengroup differences by intention-to-treat. Results: We recruited 154 participants (STRENGTH n=79 (53% women, 35(9) years); STRETCH n=75 (45% women, 36(9) years)). There was no difference between groups for change in hip-related QOL (mean difference (95% confidence interval) 1.6 (-4.9 to 8.1) p=0.63) or patient-perceived global improvement (0.3 (-0.1 to 0.7) p=0.11) at six-months. Both groups improved in iHOT-33 over six-months of 21.9 points. STRENGTH had greater improvements in hip abduction (21.6(7.6 to 35.5) Newtons; p=0.002) and adduction (16.9(3.9 to 29.9) Newtons; p=0.011) strength than STRETCH. Conclusions: We found no difference between a targeted, individualised strengthening program and a standardised stretching program on hip-related QOL or perceived improvement at six-months in people with FAI syndrome. Both groups showed improvements much larger than the minimal clinically important change in hip-related QOL at six- months.
- Subjects
NORWAY; PHYSICAL therapy; STRETCH (Physiology); STATISTICAL sampling; FEMORACETABULAR impingement; TREATMENT effectiveness; CONFERENCES &; conventions; RANDOMIZED controlled trials; QUALITY of life
- Publication
International Journal of Sports Physical Therapy, 2024, Vol 19, Issue 6, p775
- ISSN
2159-2896
- Publication type
Article