Movement Pattern Training in People With Intra-articular, Prearthritic Hip Disorders
Condition: Chronic Hip Joint Pain; Prearthritic Hip Disease
MeSH terms: Arthralgia
Study type: Interventional

Summary: 
      Intra-articular, prearthritic hip disorders (PAHD) result in substantial dysfunction in young
      adults and are proposed precursors to hip osteoarthritis (OA). Effective treatment of PAHD is
      needed to improve function in the young adult and prevent or delay the onset of hip OA,
      however evidence related to treatment of PAHD is limited. This research will provide the
      foundation for a future clinical trial to assess the efficacy of movement pattern training,
      an innovative rehabilitation approach for the treatment of PAHD.
    

Detailed description: 
      Significance: Intra-articular, prearthritic hip disorders (PAHD) result in substantial
      dysfunction in young adults and are proposed precursors to hip osteoarthritis. The number of
      surgical procedures to treat PAHD has grown exponentially in the past decade, despite the
      lack of high level evidence to guide treatment decisions. The potential exists for surgery to
      become standard treatment before rigorous investigation of treatment options has been
      completed. This trend may be partially due to a lack of evidence related to rehabilitation.
      Although some authors believe rehabilitation can improve function in people with PAHD, others
      state that rehabilitation is contra-indicated and recommend surgery as the best option. There
      are no published clinical trials to support or refute either opinion, therefore little is
      known about the comparative effectiveness of rehabilitation.

      Innovation: The investigators' long term goal is to develop effective treatment strategies
      for people with PAHD that will improve function and prevent or delay the onset of OA.
      Movement pattern training is an innovative rehabilitation approach designed to reduce
      stresses on the hip joint by optimizing the biomechanics of functional tasks through
      task-specific instruction. Preliminary work suggests that abnormal movement patterns may be
      associated with PAHD and that movement pattern training may be an effective treatment
      approach, however comparison to standard rehabilitation has not been completed.

      Purpose: This study was designed to assess the feasibility of conducting a multicenter
      randomized clinical trial (RCT) to determine the efficacy of movement pattern training
      compared to standard rehabilitation for people with PAHD. Participants enrolled at Washington
      University and University of Pittsburgh will be randomized into one of two treatment groups,
      movement pattern training or standard rehabilitation. In addition to assessing feasibility of
      the trial, preliminary estimates of effect sizes for treatment outcomes will be obtain in
      preparation for the future definitive trial. Post-treatment improvements in patient-reported
      function as measured by the Hip disability and Osteoarthritis Outcome Score and hip adduction
      motion during functional tasks, a proposed mechanistic factor associated with PAHD will be
      assessed. Upon completion of this study, the investigators will be positioned to implement a
      multicenter RCT to definitively assess the efficacy of movement pattern training.

      Impact: Ultimately, if movement pattern training is determined to be effective, it will
      provide a relatively inexpensive alternative to surgical intervention. Further, the
      theoretical concepts of movement pattern training could be used to possibly serve a role in
      injury prevention, as well as optimize post-surgical outcomes in those who do require
      surgery.
    

Intervention name(s): Rehabilitation
Intervention type(s): Other
Intervention description(s): Comparison of two rehabilitation approaches
Other intervention name(s): Physical Therapy; Therapeutic exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: femoroacetabular impingement; labral tear; rehabilitation