Effects of Manual Therapy in Strenght, Pain and Functional Capacity for Sport Related Groin Pain

Study Overview
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Brief Summary
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Athletic osteitis pubis is a pathologic entity that can cause functional impairment. Scientific evidence have noticed that athletes experiment pain and a decrease on strength. Moreover, this symptomathology can affect daily life and functionality. There is no scientific evidence about the influence of manual therapy (MT) as a single treatment to improve this condition. The investigators decided to conduct a randomized controlled trial to compare the effects of a MT technique with placebo technique.

Official Title
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Effects on Pain, Strength and Functional Capacity of High Force Distraction of the Hip in Athletes With Osteitis Pubis.

Conditions
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Osteitis Pubis, Athletic Pubalgia

Intervention / Treatment
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* Other: High force lateral distraction
* Other: Placebo distraction group


Participation Criteria
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Eligibility Criteria
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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
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Minimum Age: 18 Years
Maximum Age: 40 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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: High force lateral distraction group<br>High force lateral distraction of the hip in maximun adjusted position. | Other: High force lateral distraction<br>* High force lateral distraction on the affected hip.<br>|
| Sham Comparator: Placebo distraction group<br>Placebo lateral distraction of the affected hip in maximun adjusted position. | Other: Placebo distraction group<br>* Placebo lateral distraction on the affected hip.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Strength | Strength evaluate for internal and external hip rotators with a conical pulley. | Baseline | 
| Strength | Strength evaluate for internal and external hip rotators with a conical pulley. | Through study completion, an average of two weeks | 
| Strength | Strength evaluate for internal and external hip rotators with a conical pulley. | 3 months follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain in sports activities | Appearance time of pain during activities | Baseline | 
| Pain in sports activities | Appearance time of pain during activities | Through study completion, an average of two weeks | 
| Pain in sports activities | Appearance time of pain during activities | 3 months follow-up | 
| Pain intensity during/after pain provocation tests: Single adductor, squeeze and bilateral adductor tests | Appearance of pain during or after the execution of Single adductor, squeeze and bilateral adductor tests. If pain appears it will be reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | Baseline | 
| Pain intensity after pain provocation tests: Single adductor, squeeze and bilateral adductor tests | Appearance of pain during or after the execution of Single adductor, squeeze and bilateral adductor tests. If pain appears it will be reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | Through study completion, an average of two weeks | 
| Pain intensity after pain provocation tests: Single adductor, squeeze and bilateral adductor tests | Appearance of pain during or after the execution of Single adductor, squeeze and bilateral adductor tests. If pain appears it will be reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse. | 3 months follow-up | 
| Functional capacity | Evaluated with a patient reported outcome questionnaire called Copenhagen Hip and Groin Outcome score (HAGOS) which assesses pain, symptoms, physical function in daily living, physical function in sport and recreation, participation in physical activities and hip and groin -related quality of life. For each item answer range from never to always. | Baseline | 
| Functional capacity | Evaluated with a patient reported outcome questionnaire called Copenhagen Hip and Groin Outcome score (HAGOS) which assesses pain, symptoms, physical function in daily living, physical function in sport and recreation, participation in physical activities and hip and groin -related quality of life. For each item answer range from never to always. | Through study completion, an average of two weeks | 
| Functional capacity | Evaluated with a patient reported outcome questionnaire called Copenhagen Hip and Groin Outcome score (HAGOS) which assesses pain, symptoms, physical function in daily living, physical function in sport and recreation, participation in physical activities and hip and groin -related quality of life. For each item answer range from never to always. | 3 months follow-up |