Patients' real-world engagement with movement pattern modifications for nonarthritic hip-related pain.

Abstract

Background: Nonarthritic hip-related pain can cause chronic pain and disability. Movement pattern training is an effective nonoperative treatment when delivered via formal physical therapy, but some patients have limited access to physical therapy. Discussion of movement pattern training during a patient's initial visit to a medical provider could be a valuable addition to first-line management of hip pain. However, the general acceptability of movement pattern related activity modification is not yet known.

Objective: To understand the real-world willingness of patients with nonarthritic hip-related pain to implement movement pattern modifications. A secondary goal was to explore adherence to movement pattern related activity modification after a single instructional session.

Design: Prospective cohort study.

Setting: Outpatient clinics of two U.S. tertiary care academic medical centers.

Participants: Eighty-eight 15-40-year-old patients who were diagnosed by a musculoskeletal clinician with nonarthritic hip-related pain and advised to pursue nonoperative management.

Interventions: Participants received a single instructional session of movement pattern training principles, in addition to usual nonoperative care.

Main outcome measures: The primary outcome was the proportion of participants who reported implementing one or more movement pattern related activity modifications during the 12-week follow-up period. The secondary outcome was participants' self-reported proportion of time that movement pattern related activity modifications were implemented.

Results: Eighty-eight participants enrolled (mean 27 [SD 8] years old, 81% (n = 71) female). By 12-week follow-up, 100% of the 80 retained participants implemented one or more movement pattern related activity modifications. Participants incorporated movement pattern modifications a median of 73% (interquartile range 50%-85%) of the time.

Conclusions: Participants with nonarthritic hip-related pain demonstrated high willingness to engage in movement pattern related activity modification, even after a single instructional session. Instruction in movement pattern training principles during an initial medical visit for nonarthritic hip-related pain may be a valuable, well-received addition to traditional first-line management.