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针对股骨髋臼撞击症行髋关节镜检查术后自我管理的物理治疗与常规护理物理治疗的对比:一项随机对照试验的研究方案

Physical therapy aimed at self-management versus usual care physical therapy after hip arthroscopy for femoroacetabular impingement: study protocol for a randomized controlled trial.

作者信息

Tijssen M, van Cingel R E H, Staal J B, Teerenstra S, de Visser E, Nijhuis-van der Sanden M W G

机构信息

Sports Medical Center Papendal, Scientific Institute for Health Sciences, IQ Healthcare, Papendallaan 7, 6816 VD, Arnhem, The Netherlands.

Radboud University Medical Center, Scientific Institute for Health Sciences, IQ Healthcare, PO Box 9101, 114 IQ, 6500 HB, Nijmegen, The Netherlands.

出版信息

Trials. 2016 Feb 17;17:91. doi: 10.1186/s13063-016-1222-7.


DOI:10.1186/s13063-016-1222-7
PMID:26883504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4756499/
Abstract

BACKGROUND: Femoroacetabular impingement has been recognized as a common cause of hip pain and dysfunction, especially in athletes. Femoroacetabular impingement can now be better treated by hip arthroscopy but it is unclear what postoperative rehabilitation of hip arthroscopy should look like. Several rehabilitation protocols have been described, but none presented clinical outcome data. These protocols also differ in frequency, duration and level of supervision. We developed a rehabilitation protocol with supervised physical therapy which showed good clinical results and is considered usual care in our treatment center. However, it is unknown whether, due to the relatively young age and low complication rate of hip arthroscopy patients, rehabilitation based on self-management might lead to similar results. The aims of this pilot study are (1) to determine feasibility and acceptability of the self-management intervention, (2) to obtain a preliminary estimate of the difference in effect between physical therapy aimed at self-management versus usual care physical therapy in patients who undergo hip arthroscopy for femoroacetabular impingement. METHODS/DESIGN: Thirty participants (aged 18-50 years) scheduled for hip arthroscopy will be included and randomized (after surgery) to either self-management or usual care physical therapy in this assessor-blinded randomized controlled trial. After surgery, the self-management group will perform a home-based exercise program three times a week and will receive physical therapy treatment once every 2 weeks for 14 weeks. The usual care group will receive physical therapy treatment twice a week for 14 weeks and will perform an additional home-based exercise program once a week. Assessment will occur preoperatively and at 6, 14, 26 and 52 weeks after surgery. Primary outcomes are feasibility, acceptability and preliminary effectiveness. Feasibility and acceptability will be determined by the willingness to enroll, recruitment rate, adherence to treatment, patient satisfaction, drop-out rate and adverse events. Preliminary effectiveness will be determined using the following outcomes: the International Hip Outcome Tool 33 and hip functional performance as measured with the Single Leg Squat Test 14 weeks after surgery. DISCUSSION: The results of this study will be used to help decide on the need, feasibility and acceptability of a large-scale randomized controlled trial. TRIAL REGISTRATION: This protocol was registered with the Dutch Trial Registry (NTR5168) on 8 May 2015.

摘要

背景:股骨髋臼撞击症已被公认为是髋关节疼痛和功能障碍的常见原因,尤其是在运动员中。现在,髋关节镜检查可以更好地治疗股骨髋臼撞击症,但髋关节镜检查术后的康复方案尚不清楚。已有几种康复方案被描述,但均未提供临床结果数据。这些方案在频率、持续时间和监督水平上也存在差异。我们制定了一种有监督的物理治疗康复方案,该方案显示出良好的临床效果,并且在我们的治疗中心被视为常规治疗。然而,由于髋关节镜检查患者相对年轻且并发症发生率较低,基于自我管理的康复是否能产生类似的结果尚不清楚。这项初步研究的目的是:(1)确定自我管理干预措施的可行性和可接受性;(2)初步评估针对自我管理的物理治疗与接受髋关节镜检查治疗股骨髋臼撞击症患者的常规护理物理治疗之间的效果差异。 方法/设计:在这项评估者盲法随机对照试验中,30名计划接受髋关节镜检查的参与者(年龄在18 - 50岁之间)将被纳入并(在手术后)随机分为自我管理组或常规护理物理治疗组。手术后,自我管理组将每周进行三次家庭锻炼计划,并每2周接受一次物理治疗,持续14周。常规护理组将每周接受两次物理治疗,持续14周,并每周额外进行一次家庭锻炼计划。评估将在术前以及术后6周、14周、26周和52周进行。主要结果是可行性、可接受性和初步有效性。可行性和可接受性将通过参与意愿、招募率、治疗依从性、患者满意度、退出率和不良事件来确定。初步有效性将使用以下结果来确定:国际髋关节结果工具33以及术后14周通过单腿深蹲测试测量的髋关节功能表现。 讨论:本研究的结果将用于帮助决定大规模随机对照试验的必要性、可行性和可接受性。 试验注册:本方案于2015年5月8日在荷兰试验注册中心(NTR5168)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c3b/4756499/21cacd8332d6/13063_2016_1222_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c3b/4756499/21cacd8332d6/13063_2016_1222_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c3b/4756499/21cacd8332d6/13063_2016_1222_Fig1_HTML.jpg

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Int J Sports Phys Ther. 2023-2-1

[3]
Prehabilitation and Rehabilitation Program for Patients Undergoing Arthroscopic Acetabular Labral Repair: A Comprehensive 5-Phase Patient-Guided Program.

Orthop J Sports Med. 2022-2-8

[4]
EVIDENCE-BASED PROCEDURES FOR PERFORMING THE SINGLE LEG SQUAT AND STEP-DOWN TESTS IN EVALUATION OF NON-ARTHRITIC HIP PAIN: A LITERATURE REVIEW.

Int J Sports Phys Ther. 2018-6

[5]
Similar views on rehabilitation following hip arthroscopy among physiotherapists and surgeons in Scandinavia: a specialized care survey.

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[6]
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本文引用的文献

[1]
A clinical observational study on patient-reported outcomes, hip functional performance and return to sports activities in hip arthroscopy patients.

Phys Ther Sport. 2016-7

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J Orthop Sports Phys Ther. 2014-6

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Efficacy of a physiotherapy rehabilitation program for individuals undergoing arthroscopic management of femoroacetabular impingement - the FAIR trial: a randomised controlled trial protocol.

BMC Musculoskelet Disord. 2014-2-26

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Restricted hip mobility: clinical suggestions for self-mobilization and muscle re-education.

Int J Sports Phys Ther. 2013-10

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