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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Veröffentlicht in:BMJ open 2017-06, Vol.7 (6), p.e014658-e014658
Hauptverfasser: Bennell, Kim L, Spiers, Libby, Takla, Amir, O’Donnell, John, Kasza, Jessica, Hunter, David J, Hinman, Rana S
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container_end_page e014658
container_issue 6
container_start_page e014658
container_title BMJ open
container_volume 7
creator Bennell, Kim L
Spiers, Libby
Takla, Amir
O’Donnell, John
Kasza, Jessica
Hunter, David J
Hinman, Rana S
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. 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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 &amp; 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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.</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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