Efficacy of a home-based hip exercise programme for patients with symptomatic cam femoroacetabular impingement: a randomized controlled trial.

Abstract

Aims: We aimed to determine if a home-based hip exercise programme, designed to use strength and flexibility exercises to modify pelvic positioning, is superior to usual care in reducing pain and improving function and quality of life in patients with symptomatic femoroacetabular impingement (FAI).

Methods: This was a single-blind parallel-group randomized controlled trial. Eligible participants were aged ≥ 16 years and diagnosed with symptomatic cam FAI. A sample size of 94 was needed to detect a clinically important difference. Participants were randomly allocated to: 1) an eight-week home-based exercise programme focused on posterior pelvic tilt supervised by a physiotherapist every two weeks in addition to usual care; and 2) usual care. The primary outcome measure was function (patient-reported 33-Item International Hip Outcome Tool (iHOT-33)) and secondary outcome measures were quality of life (EuroQol five-dimension five-level questionnaire (EQ-5D-5L)), and pain (visual analogue scale (VAS)) at baseline, nine weeks, and six months. The Mann-Whitney U test was used to test between-group differences in scores using a two-tailed level of significance of p < 0.05.

Results: A total of 95 participants were recruited (48 intervention, 47 control), 55 were males (57.9%), the mean age was 32 years (SD 8.5), and both groups were similar at baseline. There were no statistically significant differences in the primary outcome measure between groups at nine weeks and six months for function (nine weeks: p = 0.394, 95% CI -15.5 to 6.5; six months: p = 0.526, 95% CI -8.8 to 13.7). There were no statistically significant differences in the secondary outcome measures between groups: pain (nine weeks: p = 0.153, 95% CI -0.4 to 2.4; six months: p = 0.743, 95% CI -1.1 to 1.7), and quality of life (quality of life VAS nine weeks: p = 0.877, 95% CI -10.0 to 6.0; six months: p = 0.269, 95% CI -15.0 to 5.0; index value nine weeks: p = 0.815, 95% CI -0.067 to 0.052; six months: p = 0.217, 95% CI -0.099 to 0.020).

Conclusion: Our results demonstrated no statistical differences in pain, function, and quality of life for participants following an eight-week home-based exercised programme supervised by a physiotherapist compared to usual care.