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Exercise therapy for the management of femoroacetabular impingement syndrome: preliminary results of clinical responsiveness


Casartelli, Nicola C; Bizzini, Mario; Maffiuletti, Nicola A; Sutter, Reto; Pfirrmann, Christian W; Leunig, Michael; Naal, Florian D (2018). Exercise therapy for the management of femoroacetabular impingement syndrome: preliminary results of clinical responsiveness. Arthritis Care & Research:Epub ahead of print.

Abstract

OBJECTIVE To investigate the responsiveness to exercise therapy of patients with femoroacetabular impingement syndrome (FAIS), and differences in hip function, strength and morphology between responders vs. non-responders. METHODS Patients with FAIS underwent 12 weeks of semi-standardized and progressive exercise therapy. Good therapy outcome (responders) vs. poor therapy outcome (non-responders) was determined at week 18 with the Global Treatment Outcome for hip pain. Hip function was evaluated using the Hip Outcome Score (HOS) activities of daily living (ADL) and Sport at baseline, week 6, 12 and 18. Hip muscle strength and dynamic pelvic control were evaluated using dynamometry and video analysis, respectively, at baseline, week 12 and 18. Hip morphology was evaluated with imaging at baseline. RESULTS Thirty-one patients (mean age: 24 years) were included. Sixteen (52%) patients were responsive and 15 (48%) were not responsive to exercise therapy. Only responders improved HOS ADL and HOS Sport by 10 (95% CI: 7 to 14, P<0.001) and 20 points (95%CI: 15 to 25, P<0.001), respectively, and hip abductor strength by 0.27 Nm/kg (95%CI: 0.18 to 0.36, P<0.001). The prevalence of patients showing good dynamic pelvic control only increased in responders (44%, P=0.029). The prevalence of severe cam morphology was higher in non-responders than responders (40% vs. 6%, P=0.037). CONCLUSION Half of patients with FAIS benefits from exercise therapy at short term. Responsiveness to hip abductor strength and dynamic pelvic control improvements is associated with good therapy outcome, whereas presence of severe cam morphology is associated with poor therapy outcome. This article is protected by copyright. All rights reserved.

Abstract

OBJECTIVE To investigate the responsiveness to exercise therapy of patients with femoroacetabular impingement syndrome (FAIS), and differences in hip function, strength and morphology between responders vs. non-responders. METHODS Patients with FAIS underwent 12 weeks of semi-standardized and progressive exercise therapy. Good therapy outcome (responders) vs. poor therapy outcome (non-responders) was determined at week 18 with the Global Treatment Outcome for hip pain. Hip function was evaluated using the Hip Outcome Score (HOS) activities of daily living (ADL) and Sport at baseline, week 6, 12 and 18. Hip muscle strength and dynamic pelvic control were evaluated using dynamometry and video analysis, respectively, at baseline, week 12 and 18. Hip morphology was evaluated with imaging at baseline. RESULTS Thirty-one patients (mean age: 24 years) were included. Sixteen (52%) patients were responsive and 15 (48%) were not responsive to exercise therapy. Only responders improved HOS ADL and HOS Sport by 10 (95% CI: 7 to 14, P<0.001) and 20 points (95%CI: 15 to 25, P<0.001), respectively, and hip abductor strength by 0.27 Nm/kg (95%CI: 0.18 to 0.36, P<0.001). The prevalence of patients showing good dynamic pelvic control only increased in responders (44%, P=0.029). The prevalence of severe cam morphology was higher in non-responders than responders (40% vs. 6%, P=0.037). CONCLUSION Half of patients with FAIS benefits from exercise therapy at short term. Responsiveness to hip abductor strength and dynamic pelvic control improvements is associated with good therapy outcome, whereas presence of severe cam morphology is associated with poor therapy outcome. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:21 August 2018
Deposited On:19 Sep 2018 13:21
Last Modified:19 Sep 2018 13:22
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:2151-464X
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1002/acr.23728
PubMed ID:30133164

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