Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR)
ObjectivesAlthough several rehabilitation programmes following hip arthroscopy for femoracetabular impingement (FAI) syndrome have been described, there are no clinical trials evaluating whether formal physiotherapy-prescribed rehabilitation improves recovery compared with self-directed rehabilitati...
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description | ObjectivesAlthough several rehabilitation programmes following hip arthroscopy for femoracetabular impingement (FAI) syndrome have been described, there are no clinical trials evaluating whether formal physiotherapy-prescribed rehabilitation improves recovery compared with self-directed rehabilitation. The objective of this study was to evaluate the efficacy of adding a physiotherapist-prescribed rehabilitation programme to arthroscopic surgery for FAI syndrome.DesignRandomised controlled trial.MethodsPeople aged ≥16 years with FAI syndrome scheduled for hip arthroscopy were recruited and randomly allocated to physiotherapy (PT) or control. The PT group received seven PT sessions (one preoperative and six postoperative) incorporating education, manual therapy and a progressive rehabilitation programme of home, aquatic and gym exercises while the control group did not undertake PT rehabilitation. Measurements were taken at baseline (2 weeks presurgery) and 14 and 24 weeks postsurgery. The primary outcomes were the International Hip Outcome Tool (iHOT-33) and the sport subscale of the Hip Outcome Score (HOS) at week 14.ResultsDue to slower than expected recruitment and funding constraints, recruitment was ceased after 23 months. Thirty participants (14 PT and 16 control) were randomised and 28 (14 PT and 14 control; 93%) and 22 (11 PT and 11 control; 73%) completed week 14 and 24 measurements, respectively. For the 14-week primary outcomes, the PT group showed significantly greater improvements on the iHOT-33 (mean difference 14.2 units; 95% CI 1.2 to 27.2) and sport subscale of the HOS (13.8 units; 95% CI 0.3 to 27.3). There were no significant between-group differences at week 24.ConclusionsAn individual PT treatment and rehabilitation programme may augment improvements in patient-reported outcomes following arthroscopy for FAI syndrome. However, given the small sample size, larger trials are needed to validate the findings.Trial registration numberTrial registered with the Australian New Zealand Clinical Trials Registry :ACTRN12613000282785, Results. |
doi_str_mv | 10.1136/bmjopen-2016-014658 |
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The objective of this study was to evaluate the efficacy of adding a physiotherapist-prescribed rehabilitation programme to arthroscopic surgery for FAI syndrome.DesignRandomised controlled trial.MethodsPeople aged ≥16 years with FAI syndrome scheduled for hip arthroscopy were recruited and randomly allocated to physiotherapy (PT) or control. The PT group received seven PT sessions (one preoperative and six postoperative) incorporating education, manual therapy and a progressive rehabilitation programme of home, aquatic and gym exercises while the control group did not undertake PT rehabilitation. Measurements were taken at baseline (2 weeks presurgery) and 14 and 24 weeks postsurgery. The primary outcomes were the International Hip Outcome Tool (iHOT-33) and the sport subscale of the Hip Outcome Score (HOS) at week 14.ResultsDue to slower than expected recruitment and funding constraints, recruitment was ceased after 23 months. Thirty participants (14 PT and 16 control) were randomised and 28 (14 PT and 14 control; 93%) and 22 (11 PT and 11 control; 73%) completed week 14 and 24 measurements, respectively. For the 14-week primary outcomes, the PT group showed significantly greater improvements on the iHOT-33 (mean difference 14.2 units; 95% CI 1.2 to 27.2) and sport subscale of the HOS (13.8 units; 95% CI 0.3 to 27.3). There were no significant between-group differences at week 24.ConclusionsAn individual PT treatment and rehabilitation programme may augment improvements in patient-reported outcomes following arthroscopy for FAI syndrome. However, given the small sample size, larger trials are needed to validate the findings.Trial registration numberTrial registered with the Australian New Zealand Clinical Trials Registry :ACTRN12613000282785, Results.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2016-014658</identifier><identifier>PMID: 28645960</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Arthritis ; Arthroscopy ; Australia ; Clinical trials ; Evidence-based medicine ; Exercise ; Exercise Therapy ; Female ; Femoracetabular Impingement - rehabilitation ; Femoracetabular Impingement - surgery ; Hip Joint - surgery ; Humans ; Linear Models ; Male ; Patients ; Physical therapy ; Rehabilitation ; Rehabilitation Medicine ; Researchers ; Severity of Illness Index ; Surgeons ; Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>BMJ open, 2017-06, Vol.7 (6), p.e014658-e014658</ispartof><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-58ffbb792901994f39f69b165142c83a0273772bb1f1028fff710d40991539363</citedby><cites>FETCH-LOGICAL-b472t-58ffbb792901994f39f69b165142c83a0273772bb1f1028fff710d40991539363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/7/6/e014658.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/7/6/e014658.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27526,27527,27901,27902,53766,53768,77570,77601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28645960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bennell, Kim L</creatorcontrib><creatorcontrib>Spiers, Libby</creatorcontrib><creatorcontrib>Takla, Amir</creatorcontrib><creatorcontrib>O’Donnell, John</creatorcontrib><creatorcontrib>Kasza, Jessica</creatorcontrib><creatorcontrib>Hunter, David J</creatorcontrib><creatorcontrib>Hinman, Rana S</creatorcontrib><title>Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR)</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesAlthough several rehabilitation programmes following hip arthroscopy for femoracetabular impingement (FAI) syndrome have been described, there are no clinical trials evaluating whether formal physiotherapy-prescribed rehabilitation improves recovery compared with self-directed rehabilitation. The objective of this study was to evaluate the efficacy of adding a physiotherapist-prescribed rehabilitation programme to arthroscopic surgery for FAI syndrome.DesignRandomised controlled trial.MethodsPeople aged ≥16 years with FAI syndrome scheduled for hip arthroscopy were recruited and randomly allocated to physiotherapy (PT) or control. The PT group received seven PT sessions (one preoperative and six postoperative) incorporating education, manual therapy and a progressive rehabilitation programme of home, aquatic and gym exercises while the control group did not undertake PT rehabilitation. Measurements were taken at baseline (2 weeks presurgery) and 14 and 24 weeks postsurgery. The primary outcomes were the International Hip Outcome Tool (iHOT-33) and the sport subscale of the Hip Outcome Score (HOS) at week 14.ResultsDue to slower than expected recruitment and funding constraints, recruitment was ceased after 23 months. Thirty participants (14 PT and 16 control) were randomised and 28 (14 PT and 14 control; 93%) and 22 (11 PT and 11 control; 73%) completed week 14 and 24 measurements, respectively. For the 14-week primary outcomes, the PT group showed significantly greater improvements on the iHOT-33 (mean difference 14.2 units; 95% CI 1.2 to 27.2) and sport subscale of the HOS (13.8 units; 95% CI 0.3 to 27.3). There were no significant between-group differences at week 24.ConclusionsAn individual PT treatment and rehabilitation programme may augment improvements in patient-reported outcomes following arthroscopy for FAI syndrome. However, given the small sample size, larger trials are needed to validate the findings.Trial registration numberTrial registered with the Australian New Zealand Clinical Trials Registry :ACTRN12613000282785, Results.</description><subject>Adult</subject><subject>Arthritis</subject><subject>Arthroscopy</subject><subject>Australia</subject><subject>Clinical trials</subject><subject>Evidence-based medicine</subject><subject>Exercise</subject><subject>Exercise Therapy</subject><subject>Female</subject><subject>Femoracetabular Impingement - rehabilitation</subject><subject>Femoracetabular Impingement - surgery</subject><subject>Hip Joint - surgery</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Male</subject><subject>Patients</subject><subject>Physical therapy</subject><subject>Rehabilitation</subject><subject>Rehabilitation Medicine</subject><subject>Researchers</subject><subject>Severity of Illness Index</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkl2L1TAQhoso7rLuLxAk4M160TUfTdt4ISzLfsGCIHodpmlyTg5NUtNU6A_yf5rS47J6ZW4yMM-8M5O8RfGW4EtCWP2xc4cwal9STOoSk6rm7YvilOKqKmvM-ctn8UlxPk0HnE_FBef0dXFC2zrHNT4tft0YYxWoBQWDoO-t3yFA436ZbEh7HWFcUNR76OxgEyQbPBpj2EVwTqMUEMS0j2FSYbQKOfCw0077tKoZ7UIMoHSCbh4gIuvGLL_lp8X3MTj9KXeL4Pvg7KR7pIJPMQxDDlO0MKCL26uHrx_eFK8MDJM-P95nxffbm2_X9-Xjl7uH66vHsqsamkreGtN1jaACEyEqw4SpRUdqTiqqWgaYNqxpaNcRQzDNsGkI7issBOFMsJqdFZ833XHunO5VnjTCIMdoHcRFBrDy74y3e7kLPyWvKatIkwUujgIx_Jj1lGTeS-lhAK_DPEkiCGOiZS3N6Pt_0EOYo8_rrRRtBaXNSrGNUvmVp6jN0zAEy9UJ8ugEuTpBbk7IVe-e7_FU8-ffM3C5Abn6vxR_A0Tcws8</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Bennell, Kim L</creator><creator>Spiers, Libby</creator><creator>Takla, Amir</creator><creator>O’Donnell, John</creator><creator>Kasza, Jessica</creator><creator>Hunter, David J</creator><creator>Hinman, Rana S</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170601</creationdate><title>Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR)</title><author>Bennell, Kim L ; Spiers, Libby ; Takla, Amir ; O’Donnell, John ; Kasza, Jessica ; Hunter, David J ; Hinman, Rana S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-58ffbb792901994f39f69b165142c83a0273772bb1f1028fff710d40991539363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Arthritis</topic><topic>Arthroscopy</topic><topic>Australia</topic><topic>Clinical trials</topic><topic>Evidence-based medicine</topic><topic>Exercise</topic><topic>Exercise Therapy</topic><topic>Female</topic><topic>Femoracetabular Impingement - rehabilitation</topic><topic>Femoracetabular Impingement - surgery</topic><topic>Hip Joint - surgery</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Male</topic><topic>Patients</topic><topic>Physical therapy</topic><topic>Rehabilitation</topic><topic>Rehabilitation Medicine</topic><topic>Researchers</topic><topic>Severity of Illness Index</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bennell, Kim L</creatorcontrib><creatorcontrib>Spiers, Libby</creatorcontrib><creatorcontrib>Takla, Amir</creatorcontrib><creatorcontrib>O’Donnell, John</creatorcontrib><creatorcontrib>Kasza, Jessica</creatorcontrib><creatorcontrib>Hunter, David J</creatorcontrib><creatorcontrib>Hinman, Rana S</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bennell, Kim L</au><au>Spiers, Libby</au><au>Takla, Amir</au><au>O’Donnell, John</au><au>Kasza, Jessica</au><au>Hunter, David J</au><au>Hinman, Rana S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR)</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>7</volume><issue>6</issue><spage>e014658</spage><epage>e014658</epage><pages>e014658-e014658</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesAlthough several rehabilitation programmes following hip arthroscopy for femoracetabular impingement (FAI) syndrome have been described, there are no clinical trials evaluating whether formal physiotherapy-prescribed rehabilitation improves recovery compared with self-directed rehabilitation. The objective of this study was to evaluate the efficacy of adding a physiotherapist-prescribed rehabilitation programme to arthroscopic surgery for FAI syndrome.DesignRandomised controlled trial.MethodsPeople aged ≥16 years with FAI syndrome scheduled for hip arthroscopy were recruited and randomly allocated to physiotherapy (PT) or control. The PT group received seven PT sessions (one preoperative and six postoperative) incorporating education, manual therapy and a progressive rehabilitation programme of home, aquatic and gym exercises while the control group did not undertake PT rehabilitation. Measurements were taken at baseline (2 weeks presurgery) and 14 and 24 weeks postsurgery. The primary outcomes were the International Hip Outcome Tool (iHOT-33) and the sport subscale of the Hip Outcome Score (HOS) at week 14.ResultsDue to slower than expected recruitment and funding constraints, recruitment was ceased after 23 months. Thirty participants (14 PT and 16 control) were randomised and 28 (14 PT and 14 control; 93%) and 22 (11 PT and 11 control; 73%) completed week 14 and 24 measurements, respectively. For the 14-week primary outcomes, the PT group showed significantly greater improvements on the iHOT-33 (mean difference 14.2 units; 95% CI 1.2 to 27.2) and sport subscale of the HOS (13.8 units; 95% CI 0.3 to 27.3). There were no significant between-group differences at week 24.ConclusionsAn individual PT treatment and rehabilitation programme may augment improvements in patient-reported outcomes following arthroscopy for FAI syndrome. However, given the small sample size, larger trials are needed to validate the findings.Trial registration numberTrial registered with the Australian New Zealand Clinical Trials Registry :ACTRN12613000282785, Results.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>28645960</pmid><doi>10.1136/bmjopen-2016-014658</doi><oa>free_for_read</oa></addata></record> |
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subjects | Adult Arthritis Arthroscopy Australia Clinical trials Evidence-based medicine Exercise Exercise Therapy Female Femoracetabular Impingement - rehabilitation Femoracetabular Impingement - surgery Hip Joint - surgery Humans Linear Models Male Patients Physical therapy Rehabilitation Rehabilitation Medicine Researchers Severity of Illness Index Surgeons Surgery Treatment Outcome Young Adult |
title | Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR) |
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