Diagnosis and management of femoroacetabular impingement syndrome (FAIS): a survey of contemporary physiotherapy practice.

Abstract

Background: Femoroacetabular impingement syndrome (FAIS) is a motion-related hip disorder characterised by altered hip-joint morphology and symptoms. Recent consensus statements have provided guidance on the diagnosis and management of FAIS but given the knowledge gaps in translating research into practice, it is unclear at what level this is being utilised by primary contact physiotherapists. This study undertook a cross-sectional multi-centre international survey to describe contemporary physiotherapy practice for the diagnosis and management of femoroacetabular impingement syndrome (FAIS).

Methods: An online survey comprising 32 questions based around current consensus recommendations for the diagnosis and management of FAIS, was developed. The survey was distributed to six English-speaking countries (Australia, Canada, Ireland, New Zealand, South Africa and the United Kingdom) where physiotherapists work as primary contact practitioners. Questions were answered with a 5-point Likert scale. To describe the 'most commonly' utilised tools for diagnosis and management, the two highest ranked responses ('always' and 'often') were combined for analysis and presented as a percentage of total respondents.

Results: Four hundred and twenty-nine (72%) of eligible respondents were included. Respondents varied across the six countries, 58% were female, and most worked in private practice (70%). When diagnosing FAIS, patient-reported signs/symptoms (90%), functional tests (88%), special tests (87%), and strength assessments (70%) were 'most commonly' used, while imaging (60%) and balance assessment (33%) were less frequently implemented. Most respondents employed strengthening exercises (97%) and education (96%) in their management of FAIS, and some utilised range of motion/stretching (62%), and manual therapy (62%). Half of the respondents (52%) use patient-reported outcome measures to assess treatment effectiveness.

Conclusions: Our findings of physiotherapy diagnosis and management of FAIS from six countries broadly aligns with contemporary expert recommendations. Physiotherapy diagnosis of FAIS in practice is guided by patient-reported symptoms, and functional and special tests. Central to physiotherapy management is exercise and advice/education. Other modalities are less frequently utilised.

Clinical trial number: Not applicable.