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股骨髋臼撞击症的非手术治疗:一项前瞻性随机对照临床试验的初步研究。

Non-operative management of femoroacetabular impingement: A prospective, randomized controlled clinical trial pilot study.

作者信息

Wright Alexis A, Hegedus Eric J, Taylor Jeffrey B, Dischiavi Steven L, Stubbs Allston J

机构信息

Department of Physical Therapy, High Point University, High Point, NC 27268, USA.

Department of Physical Therapy, High Point University, High Point, NC 27268, USA.

出版信息

J Sci Med Sport. 2016 Sep;19(9):716-21. doi: 10.1016/j.jsams.2015.11.008. Epub 2016 Jan 6.

Abstract

OBJECTIVES

To determine the efficacy of physical therapy on pain and physical function in patients with femoroacetabular impingement.

DESIGN

Randomized, participant- and assessor blinded controlled trial pilot study.

METHODS

This trial was registered at ClinicalTrials.gov (NCT01814124) and reported according to Consolidated Standards of Reporting Trials (CONSORT) requirements. Patients were randomly assigned to receive either a combination of manual therapy and supervised exercise (MTEX), plus advice and home exercise or advice and home exercise alone (Ad+HEP) over six weeks. Primary outcomes were average pain (Visual Analog Scale) and physical function (Hip Outcome Score) at week seven.

RESULTS

Fifteen patients, mean age 33.7 (SD 9.5, 73% female) satisfied the eligibility criteria and completed week seven measurements. The between group differences for changes in pain or physical function were not significant. Both groups showed statistically significant improvements in pain: the MTEX group improved a mean of 17.6mm and the Ad+HEP group, 18.0mm.

CONCLUSIONS

The results of this pilot study provide preliminary evidence that symptomatic femoroacetabular impingement may be amenable to conservative treatment strategies however further full-scale randomized controlled trials are required to demonstrate this. In this small pilot study, supervised manual therapy and exercise did not result in greater improvement in pain or function compared to advice and home exercise in patients with symptomatic femoroacetabular impingement.

摘要

目的

确定物理治疗对股骨髋臼撞击症患者疼痛和身体功能的疗效。

设计

随机、参与者和评估者双盲对照试验试点研究。

方法

该试验在ClinicalTrials.gov(NCT01814124)注册,并按照报告试验的统一标准(CONSORT)要求进行报告。患者被随机分配接受手法治疗和监督下锻炼(MTEX)的组合,加上建议和家庭锻炼,或仅接受建议和家庭锻炼(Ad+HEP),为期六周。主要结局指标是第7周时的平均疼痛(视觉模拟量表)和身体功能(髋关节结局评分)。

结果

15名患者,平均年龄33.7岁(标准差9.5,73%为女性)符合纳入标准并完成了第7周的测量。两组之间疼痛或身体功能变化的差异不显著。两组在疼痛方面均显示出统计学上的显著改善:MTEX组平均改善17.6mm,Ad+HEP组改善18.0mm。

结论

这项试点研究的结果提供了初步证据,表明有症状的股骨髋臼撞击症可能适合保守治疗策略,然而需要进一步的大规模随机对照试验来证实这一点。在这项小型试点研究中,对于有症状的股骨髋臼撞击症患者,与建议和家庭锻炼相比,监督下的手法治疗和锻炼在疼痛或功能改善方面并没有带来更大的效果。

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