Does treatment by a specialist physiotherapist change pain and function in young adults with symptoms from femoroacetabular impingement? A pilot project for a randomised controlled trial.
OBJECTIVE
Femoroacetabular impingement (FAI) is recognised as a source of hip pain but the effect of conservative treatment remains untested. This pilot study aimed to inform and evaluate the methods required to conduct a substantive trial comparing the effect of treatment by a physiotherapist versus routine care on the symptoms of FAI.


METHODS
A parallel group, pilot randomised controlled trial (RCT).


METHODS
A single NHS acute hospital trust, Devon, England.


METHODS
30 adults with symptomatic FAI were recruited. 23 (77%) completed the study.


METHODS
Intervention was 3 months of treatment by a specialist physiotherapist. The control group received routine care.


RESULTS
Change in pain and function was measured using a Visual Analogue Scale, Non Arthritic Hip Score (NAHS), Lower Extremity Functional Score (LEFS) and Hip Outcome Score.


RESULTS
Participants in the intervention arm undertook a personalised exercise programme to improve pelvic and femoral control plus advice on posture, activity pacing and pain relief. The mean change in NAHS for the intervention group was 12.7 (95% CI 4.7 to 20.7) and 1.8 (95% CI -5.3 to 9.0) in the control group; Median change in LEFS was 11.5 (95% CI 5.0 to 26.0) versus -1.0 (95% CI -7.0 to 4.0). This improvement in LEFS was beyond minimal clinically important difference in the intervention group. Pain scores improved marginally in both groups.


CONCLUSIONS
Methodological strengths and weaknesses were successfully identified for a substantive study. Further research is needed to evaluate the relative influence of structural and neuromuscular features on symptoms of FAI and the role of conservative treatment.
Royal Devon & Exeter NHS Foundation Trust (RDEFT), Barrack Road, Exeter EX2 5DW, Devon, United Kingdom; Princess Elizabeth Orthopaedic Centre, Barrack Road, Exeter EX2 5DW, Devon, United Kingdom. Electronic address: Alisonsmeatham@nhs.net.
Alison
A
Smeatham
Royal Devon & Exeter NHS Foundation Trust (RDEFT), Barrack Road, Exeter EX2 5DW, Devon, United Kingdom; University of Exeter Medical School, St. Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom.
Roy
R
Powell
Royal Devon & Exeter NHS Foundation Trust (RDEFT), Barrack Road, Exeter EX2 5DW, Devon, United Kingdom.
Sarah
S
Moore
Royal Devon & Exeter NHS Foundation Trust (RDEFT), Barrack Road, Exeter EX2 5DW, Devon, United Kingdom; University of Exeter Medical School, St. Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom.
Rohan
R
Chauhan
Princess Elizabeth Orthopaedic Centre, Barrack Road, Exeter EX2 5DW, Devon, United Kingdom.
Matthew
M
Wilson
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D004739:England; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D057925:Femoracetabular Impingement / Q000523:psychology / Q000534:rehabilitation*; D005269:Femur / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology / Q000534:rehabilitation*; D010388:Pelvis / Q000503:physiopathology; D059825:Physical Therapists / Q000592:standards*; D010865:Pilot Projects; D011187:Posture / Q000502:physiology; D012107:Research Design; D055815:Young Adult
Femoroacetabular impingement (FAI); Function; Pain; Physiotherapy; RCT