Manual Therapy for the Treatment of Athletic Pubalgia

Study Overview
=================
Brief Summary
-----------------
Athletic osteitis pubis is a high prevalent pathology among athletes, especially in those who make quick change of direction of the movement, like runners or footballers. Despite the fact that there is evidence about conservative treatments, there is a lack of evidence about manual therapy (MT) techniques applied in isolation and its consequences in pain and range of movement. The investigators decided to conduct a randomized controlled trial to compare the effects of a MT technique with placebo technique.

Official Title
-----------------
Effects on Pain Anda Range of Motion of High Force Lateral Distraction Mobilization of the Hip in Athletes With Hip-related Groin Pain. A Randomized Controlled Trial.

Conditions
-----------------
Osteitis Pubis

Intervention / Treatment
-----------------
* Other: High force hip Lateral distraction
* Other: Placebo force hip lateral distraction


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Athletes diagnosed with osteitis pubis stage 1 with at least 3 months of evolution. Internal rotation ROM limited. Positive provocation pain tests. Exclusion Criteria: Pain due to intraarticular hip pathology. Hip pain due to inflamatory diseases. Previous surgical interventions in hip, pelvis or lumbar spine. MRI results or provocation pain tests inconcluyent.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Lateral distraction group<br>High force lateral distraction of affected hip. | Other: High force hip Lateral distraction<br>* Hip lateral distraction in adjusted position of maximun flexion and internal rotation, with neutral position of abduction/adduction applying high force of distraction.<br>|
| Sham Comparator: Placebo distraction group<br>Placebo lateral traction of affected hip. | Other: Placebo force hip lateral distraction<br>* Hip lateral distraction in adjusted position of maximun flexion and internal rotation, with neutral position of abduction/adduction applying placebo force of distraction.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Actual PAIN | actual pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | Baseline | 
| Actual PAIN | actual pain reported by the patient using visual analog scale (VAS)from 0 to 10, in which higher scores are worse. | after to two weeks of treatment | 
| Actual PAIN | actual pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | 3 months follow-up | 
| Last week PAIN | past week pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | Baseline | 
| Last week PAIN | past week pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | after to two weeks of treatment | 
| Last week PAIN | past week pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | 3 months follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Range of Movement (ROM) | Hip ROM as described by Pua et al. (2008) | Baseline | 
| Range of Movement (ROM) | Hip ROM as described by Pua et al. (2008) | after to two weeks of treatment | 
| Range of Movement (ROM) | Hip ROM as described by Pua et al. (2008) | 3 months follow-up | 
| Global Rating of Change | Subjective impression as described in GROC scale by Jaeschke, Singer & Guyat (1989) | after to two weeks of treatment | 
| Global Rating of Change | Subjective impression as described in GROC scale by Jaeschke, Singer & Guyat (1989) | 3 months follow-up | 
| Group of treatment assignment | Question about which group of treatment was the patient assigned in. | after to two weeks of treatment | 
| Group of treatment assignment | Question about which group of treatment was the patient assigned in. | 3 months follow-up |