RecruitingACTRN12617001350314

A double-blind randomised controlled trial comparing two physiotherapy interventions to treat hip impingement.

The physiotherapy for Femoroacetabular Impingement Rehabilitation STudy (PhysioFIRST): A participant and assessor blinded randomised controlled trial of physiotherapy to reduce pain and improve function for hip impingement.

Sponsor

La Trobe Sports and Exercise Medicine Research Centre

Enrollment

164 participants

Start Date

Mar 1, 2018

Study Type

Interventional

Conditions

Physiotherapy

Summary

Femoroacetabular (hip) impingement (FAI) is a painful condition that commonly affects healthy active younger adults. It can limit their ability to continue playing sport and perform normal daily activities. It can be related to extra bone formation at the hip joint known as a cam deformity. Physiotherapy is one treatment people may use to reduce their symptoms and improve their function. This double-blind, randomised controlled trial (RCT) aims to compare the effects of two different physiotherapy treatment interventions to reduce pain and improve function in people with FAI.

Eligibility

Sex: Both males and femalesMin Age: 18 YearssMax Age: 50 Yearss

Plain Language Summary

Simplified for easier understanding

This study compares two different physiotherapy programs to treat femoroacetabular impingement (FAI) — also known as hip impingement. FAI is a condition where extra bone on the hip joint (often called a "cam" deformity) causes the hip to pinch during movement, causing pain, especially with activities like squatting or sitting. It most commonly affects active younger adults. This double-blind study compares two different physiotherapy approaches over 24 weeks to see which one better reduces pain and improves hip function. You may be eligible if: - You are between 18 and 50 years old - You have hip or groin pain greater than 3/10 on a pain scale during hip impingement testing - Your hip pain has been present for more than 6 weeks - Your hip X-ray shows an alpha angle above 60 degrees (confirming FAI anatomy) You may NOT be eligible if: - You have had physiotherapy for your hip in the last 3 months - You have had previous hip or back surgery - You have another joint condition such as rheumatoid arthritis - You are planning lower limb surgery in the next 24 weeks - You are pregnant or have a contraindication to X-ray or MRI Talk to your doctor about whether this trial might be right for you.

This is a simplified summary. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

The physiotherapy intervention will be delivered to participants in two consecutive 12 week phases. Phase I physiotherapy treatment (week 0-12), will consist of 6x 30 minute face to face physiotherapy sessions delivered fortnightly. Participants will also attend one 45 minute supervised gym session per week. Gym sessions will be semi-standardised and reflect the same program tailored to suit the individual within the face to face physiotherapy session and will be supervised by physiotherapists. Physiotherapy face to face treatment and gym sessions will consists of: i) manual hip mobilisation and stretching based on the persons clinical presentation addressing any assessed range of movement deficits in hip, knee and spinal joints; ii) hip muscle retraining tailored according to any assessed strength deficits with progression based on achievement of repetition and resistance goals in a semi-standardised strength program iii) trunk muscle retraining in same semi-standardised program iv) functional, proprioceptive and sports- or activity-specific retraining tailored to assessed sport or occupational loads within same semi-standardised program v) enhancing physical activity via a semi-standardised, 12 phase cardiovascular fitness program with progression based on achievement of training goal within set parameters for perceived effort and pain vi) education will be individualised and could include topics including exercise, weight loss if appropriate and appropriate stretching. The physiotherapist will supervise exercises during each face to face session for 15 minutes. The same exercise program will be performed independently at home two times per week for 30 minutes per session. An information and exercise manual will be provided to each participant as well as access to a mobile phone app which contains the home exercise program. Participants will be asked to record both the number of exercises completed and any associated symptoms for each exercise. They may record this in the app or in a paper, self-report diary if they prefer. Compliance with the home program will be reviewed at each visit, as well as use of medications and additional activity undertaken. Phase II physiotherapy treatment (week 13-24) consists of three 30min face to face treatment sessions (monthly) and continuation of the exercise program by attendance at a community gym three times per week., Face to face physiotherapy sessions will address any participant concerns regarding symptoms or their program and advise strength, functional and cardiovascular exercise progressions for the unsupervised gym sessions.