Comparison of Movement Pattern Training and Manual Therapy for Prearthritic Hip Disorders
Condition: Hip-related Groin Pain; Femoroacetabular Impingement; Dysplasia Mild; Prearthritic Hip Disorder
MeSH terms: Femoracetabular Impingement
Study type: Interventional

Summary: 
      Significance: Intra-articular, prearthritic hip disorders (PAHD) result in substantial
      dysfunction in young adults and are proposed precursors to hip osteoarthritis (OA). Our long
      term goal is to develop effective treatment strategies for people with PAHD that will improve
      function, decrease pain and prevent or delay the onset of OA. The purpose of this study is to
      compare movement pattern training (MoveTrain) and manual therapy (ManTher) in their effect on
      post-treatment, patient-reported outcomes and targeted impairments thought to contribute to
      PAHD.

      This pilot study will collect sufficient data to power a future study that will determine the
      efficacy of MoveTrain compared to ManTher for people with PAHD. Participants with PAHD will
      be randomized into one of two treatment groups, MoveTrain or ManTher. The Hip disability and
      Osteoarthritis Outcome Score (HOOS) will be the primary outcome measure. A measure of hip
      adduction motion during functional tasks and quantitative sensory assessment (pain pressure
      threshold and temporal summation) will be the secondary measures used to assess the effect of
      respective treatment on the impairments thought to contribute to PAHD, thus addressing the
      mechanisms of pain. Upon completion of this study, we will be positioned to implement a large
      RCT (randomized clinical trial) to definitively assess the efficacy of MoveTrain and ManTher
      to improve PAHD.

      Specific Aims: To obtain preliminary estimates of effect sizes for planning the future
      definitive randomized clinical trial,

      Aim 1 (Function): we will compare post-treatment improvements in hip-specific,
      patient-reported outcomes among the two treatment groups. After treatment completion:

      Aim 2 (Mechanism): we will compare pre- and post-treatment measures in lower extremity
      movement patterns during functional tasks (MoveTrain) and quantitative sensory testing
      (ManTher). After treatment completion:

      Aim 3 (Prognosis): we will determine the association among personal factors at baseline
      (demographic and psychosocial) and treatment prognosis (improvement in HOOS).

      Impact: Our line of research will improve our understanding of each proposed treatment and
      its effect on patient function and each treatment's targeted impairment. This improved
      understanding will lead to the development of treatment strategies that will ultimately
      result in comparative effectiveness studies of surgical and non-surgical treatment.
    


Intervention name(s): Movement Pattern Training; Manual Therapy
Intervention type(s): Other; Other
Intervention description(s): Treatment will include 10 supervised sessions over 12 weeks and instruction in a home exercise program After randomization, participants will be scheduled with a physical therapist trained in standard procedures. Treatment will include assessment of patient goals, patient education and instruction in a home program. Patient education will focus on patient-specific tasks, identified by the participant to be symptom-producing.; Treatment will include 10 supervised sessions over 12 weeks and instruction in a home exercise program After randomization, participants will be scheduled with a physical therapist trained in standard procedures. Treatment will include assessment of patient goals, patient education and instruction in a home program. Patient education will focus on patient-specific tasks, identified by the participant to be symptom-producing.
Other intervention name(s): Joint Mobilization
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will complete self-report questionnaires and participate in a clinical examination that will include movement pattern, range of motion and quantitative sensory assessment. Participants will be randomized into one of two treatment groups, movement pattern training (MoveTrain) or manual therapy (ManTher). Both groups will participate in 10 supervised sessions within a 12 week time frame. MoveTrain will include task-specific training to optimize biomechanics during daily tasks and patient-specific tasks including work and fitness. ManTher will include select manual techniques including joint and soft tissue mobilization. Both groups will receive a home exercise program. At 13 weeks after enrollment, participants will return for testing to assess post-treatment improvements in primary and secondary outcomes. We also obtain 6 and 12 month questionnaires to assess patient outcomes.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: clinical trial; rehabilitation; joint mobilization; movement training