Efficacy of an Exercise Program for Patients With Femoro-acetabular Impingement

Study Overview
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Brief Summary
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The purpose of this study is to examine whether using an exercise regime on people with femoroacetabular impingement (FAI) can help reduce pain and improve function. Also, it examines whether the exercise regime will help prevent the worsening of hip cartilage deterioration.

Detailed Description
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A significant proportion of adults from ages 18 to 50 have a deformity in the neck of their femur. This can be painful and is called a femoroacetabular impingement (FAI), and could lead to ones cartilage being destroyed and possibly lead to osteoarthritis of the hip. People with this deformity in their femur have been found to move their hips differently when doing tasks such as walking, squatting or climbing stairs compared to those without this problem. The investigators are testing whether exercise that targets this difference in movement can help reduce pain, improve function and prevent cartilage damage. There will recruit 84 patients with divided into 2 groups. 42 patients will do a 8 week exercise program on strengthening muscles responsible for extending the hip and stretching muscles that are associated with flexing the hip. The intensity of the program will change with visits to the physiotherapist through the course of their exercise program. This research hopes to develop an innovative, non-surgical, low-cost, highly feasible and accessible intervention for patients with FAI.

Official Title
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Efficacy of a Non-surgical Treatment Protocol for Patients With Symptomatic Femoro-acetabular Impingement: a Randomized Controlled Trial

Conditions
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Femoracetabular Impingement

Intervention / Treatment
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* Other: Exercise Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed with symptomatic FAI at least 3 months of groin pain increased pain with hip rotation an alpha angle greater than 60 degrees on multiplane imaging labral tear on MRI Tonnis grade of 0 or 1 Exclusion Criteria: diagnosed health problems other than FAI interfering with capacity to accomplish the exercise program previous hip surgery on the affected side surgery will happen within 6 months

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: There will be two groups, one will be the exercise group and one will be used as a control group.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise Group<br>The group who will exercise to manage pain. | Other: Exercise Group<br>* The group who will meet a physiotherapist who will show them strengthening and stretching muscles associated with pelvic tilt.<br>|
| No Intervention: Control Group<br>The group who will not take part in any exercises and only have to do assessments. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| iHOT-33 | International Hip Outcome Tool-33, disease-specific function. Each answer will be measured on a scale of 100mm and the mean of the 33 questions will be taken as a final score. A higher score indicates a better quality of life. | Change in Baseline before exercise program and 1 year afterwards | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EQ-5D-5L | Generic quality of life, the scores for each question are summed up for a total with a higher score being a better quality of life. | Change in Baseline before exercise program and 1 year afterwards | 
| Pelvic and hip biomechanics (Femoral head displacement) | Displacement of the femoral head center from the neutral position (measured in degrees) | Change in Baseline before exercise program and 1 year afterwards | 
| Pelvic and hip biomechanics (Coverage of femoral head) | Coverage of the femoral head provided by the acetabular margin (measured in degrees) | Change in Baseline before exercise program and 1 year afterwards | 
| Pelvic and hip biomechanics (Acetabular rim and femoral neck distance) | the closest distance between the acetabular rim and the femoral neck (measured in mm) | Change in Baseline before exercise program and 1 year afterwards | 
| Number of participants that receive hip surgery | If the participant has hip surgery in the time frame | Change in Baseline before exercise program and 1 year afterwards | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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non-surgical treatment, exercise