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Personalised hip therapy : development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial
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Wall, Peter D. H., Dickenson, Edward J., Robinson, David, Hughes, Ivor, Realpe, Alba, Hobson, Rachel, Griffin, Damian R. and Foster, Nadine E. (2016) Personalised hip therapy : development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial. British Journal of Sports Medicine, 50 (19). pp. 1217-1223. doi:10.1136/bjsports-2016-096368
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Official URL: http://dx.doi.org/10.1136/bjsports-2016-096368
Abstract
Introduction
Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility.
Methods
In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events.
Results
The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12–26 weeks in 6–10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events.
Conclusion
PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839).
| Item Type: | Journal Article | |||||||||
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| Subjects: | Q Science > QM Human anatomy R Medicine > RD Surgery |
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| Divisions: | Faculty of Medicine > Warwick Medical School | |||||||||
| Library of Congress Subject Headings (LCSH): | Hip joint -- Diseases -- Treatment -- Great Britain, Femur -- Abnormalities, Acetabulum (Anatomy) -- Abnormalities, Pelvic bones, Arthroscopy, Joints -- Examination, Physical therapy, Clinical trials | |||||||||
| Journal or Publication Title: | British Journal of Sports Medicine | |||||||||
| Publisher: | B M J Group | |||||||||
| ISSN: | 0306-3674 | |||||||||
| Official Date: | October 2016 | |||||||||
| Dates: |
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| Volume: | 50 | |||||||||
| Number: | 19 | |||||||||
| Page Range: | pp. 1217-1223 | |||||||||
| DOI: | 10.1136/bjsports-2016-096368 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access | |||||||||
| RIOXX Funder/Project Grant: |
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