TY - JOUR
T1 - Movement pattern training compared with standard strengthening and flexibility among patients with hip-related groin pain
T2 - Results of a pilot multicentre randomised clinical trial
AU - Harris-Hayes, Marcie
AU - Steger-May, Karen
AU - Bove, Allyn M.
AU - Foster, Stefanie N.
AU - Mueller, Michael J.
AU - Clohisy, John C.
AU - Fitzgerald, G. Kelley
N1 - Funding Information:
Funding This work was supported by the following grants: R21HD086644 and NIH T32HD007434 from the National Center for Medical Rehabilitation Research, National Institute of Child Health and Human Development; the Orthopaedic Research Grant from the Foundation for Physical Therapy Research; Washington University Institute of Clinical and Translational Sciences grant UL1TR002345 from the National Center for Advancing Translational Sciences of the National Institutes of Health. Additional support was provided by Program in Physical Therapy at Washington University School of Medicine, Clinical and Translational Science Award.
Publisher Copyright:
© Author(s) (or their employer(s)) 2020.
PY - 2020/3/23
Y1 - 2020/3/23
N2 - Study design: Pilot, multicentre randomised clinical trial (RCT). Objectives: Assess viability of performing a definitive RCT and compare preliminary effects of movement pattern training (MoveTrain) and strengthening/flexibility (Standard) to improve function in people with chronic hip-related groin pain (HRGP). Background: To determine the best physical therapist-led intervention for patients with HRGP, we must understand treatment effects of different treatment modes. Methods: Forty-six patients (17M:29F; 29±5.3 years; body mass index 25.6±6.3 kg/m 2) with HRGP were randomised. MoveTrain included task-specific training to optimise biomechanics during daily tasks. Standard included strengthening/flexibility. Treatment included 10 visits/12 weeks and home exercise programme (HEP). Primary outcomes for feasibility were recruitment, retention, treatment adherence and treatment fidelity. Secondary outcomes were patient-reported function (Hip disability and Osteoarthritis Outcome Score (HOOS)), lower extremity kinematics and hip muscle strength. Results: We achieved target recruitment, and retention was excellent (91%). Patient session attendance was high (93%); however, reported HEP adherence (62%) was lower than expected. Physical therapists' adherence to treatment protocols was high (90%). Patients demonstrated high treatment receipt; 91% of exercises performed were rated independent. Both groups demonstrated clinically important improvements in function (HOOS) and muscle strength; however, there were no between-group differences (HOOS subscales, p≥0.13, strength, p≥0.34). Compared with Standard, MoveTrain demonstrated greater reductions in hip adduction (p=0.016) and pelvic drop (p=0.026) during a single leg squat. No adverse events were noted. Conclusion: Our experience in completing this RCT confirmed that a larger, multicentre RCT is feasible and highlighted modifications we will implement to optimise the future RCT.
AB - Study design: Pilot, multicentre randomised clinical trial (RCT). Objectives: Assess viability of performing a definitive RCT and compare preliminary effects of movement pattern training (MoveTrain) and strengthening/flexibility (Standard) to improve function in people with chronic hip-related groin pain (HRGP). Background: To determine the best physical therapist-led intervention for patients with HRGP, we must understand treatment effects of different treatment modes. Methods: Forty-six patients (17M:29F; 29±5.3 years; body mass index 25.6±6.3 kg/m 2) with HRGP were randomised. MoveTrain included task-specific training to optimise biomechanics during daily tasks. Standard included strengthening/flexibility. Treatment included 10 visits/12 weeks and home exercise programme (HEP). Primary outcomes for feasibility were recruitment, retention, treatment adherence and treatment fidelity. Secondary outcomes were patient-reported function (Hip disability and Osteoarthritis Outcome Score (HOOS)), lower extremity kinematics and hip muscle strength. Results: We achieved target recruitment, and retention was excellent (91%). Patient session attendance was high (93%); however, reported HEP adherence (62%) was lower than expected. Physical therapists' adherence to treatment protocols was high (90%). Patients demonstrated high treatment receipt; 91% of exercises performed were rated independent. Both groups demonstrated clinically important improvements in function (HOOS) and muscle strength; however, there were no between-group differences (HOOS subscales, p≥0.13, strength, p≥0.34). Compared with Standard, MoveTrain demonstrated greater reductions in hip adduction (p=0.016) and pelvic drop (p=0.026) during a single leg squat. No adverse events were noted. Conclusion: Our experience in completing this RCT confirmed that a larger, multicentre RCT is feasible and highlighted modifications we will implement to optimise the future RCT.
KW - biomechanics
KW - hip
KW - rehabilitation
KW - strength isometric isokinetic
UR - http://www.scopus.com/inward/record.url?scp=85082548871&partnerID=8YFLogxK
U2 - 10.1136/bmjsem-2019-000707
DO - 10.1136/bmjsem-2019-000707
M3 - Article
C2 - 32518674
AN - SCOPUS:85082548871
SN - 2055-7647
VL - 6
JO - BMJ Open Sport and Exercise Medicine
JF - BMJ Open Sport and Exercise Medicine
IS - 1
M1 - e000707
ER -