Bennell Kim L, Spiers Libby, Takla Amir, O'Donnell John, Kasza Jessica, Hunter David J, Hinman Rana S
Department of Physiotherapy, The University of Melbourne, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, Melbourne, Victoria, Australia.
Ivanhoe Sports and Physiotherapy Clinic, Melbourne, Victoria, Australia.
BMJ Open. 2017 Jun 23;7(6):e014658. doi: 10.1136/bmjopen-2016-014658.
Although several rehabilitation programmes following hip arthroscopy for femoracetabular impingement (FAI) syndrome have been described, there are no clinical trials evaluating whether formal physiotherapy-prescribed rehabilitation improves recovery compared with self-directed rehabilitation. The objective of this study was to evaluate the efficacy of adding a physiotherapist-prescribed rehabilitation programme to arthroscopic surgery for FAI syndrome.
Randomised controlled trial.
People aged ≥16 years with FAI syndrome scheduled for hip arthroscopy were recruited and randomly allocated to physiotherapy (PT) or control. The PT group received seven PT sessions (one preoperative and six postoperative) incorporating education, manual therapy and a progressive rehabilitation programme of home, aquatic and gym exercises while the control group did not undertake PT rehabilitation. Measurements were taken at baseline (2 weeks presurgery) and 14 and 24 weeks postsurgery. The primary outcomes were the International Hip Outcome Tool (iHOT-33) and the sport subscale of the Hip Outcome Score (HOS) at week 14.
Due to slower than expected recruitment and funding constraints, recruitment was ceased after 23 months. Thirty participants (14 PT and 16 control) were randomised and 28 (14 PT and 14 control; 93%) and 22 (11 PT and 11 control; 73%) completed week 14 and 24 measurements, respectively. For the 14-week primary outcomes, the PT group showed significantly greater improvements on the iHOT-33 (mean difference 14.2 units; 95% CI 1.2 to 27.2) and sport subscale of the HOS (13.8 units; 95% CI 0.3 to 27.3). There were no significant between-group differences at week 24.
An individual PT treatment and rehabilitation programme may augment improvements in patient-reported outcomes following arthroscopy for FAI syndrome. However, given the small sample size, larger trials are needed to validate the findings.
Trial registered with the Australian New Zealand Clinical Trials Registry :ACTRN12613000282785, Results.
尽管已有多项关于髋关节镜治疗股骨髋臼撞击症（FAI）综合征后的康复方案被描述，但尚无临床试验评估与自主康复相比，由物理治疗师制定的正规康复方案是否能改善恢复情况。本研究的目的是评估在FAI综合征的关节镜手术基础上增加物理治疗师制定的康复方案的疗效。
随机对照试验。
招募年龄≥16岁、计划接受髋关节镜治疗FAI综合征的患者，并随机分配至物理治疗（PT）组或对照组。PT组接受7次PT治疗（术前1次，术后6次），包括教育、手法治疗以及家庭、水上和健身房锻炼的渐进性康复方案，而对照组不进行PT康复。在基线（术前2周）、术后14周和24周进行测量。主要结局指标是术后14周时的国际髋关节结局工具（iHOT-33）和髋关节结局评分（HOS）的运动子量表。
由于招募速度慢于预期且资金受限，23个月后停止招募。30名参与者（14名PT组和16名对照组）被随机分组，分别有28名（14名PT组和14名对照组；93%）和22名（11名PT组和11名对照组；73%）完成了14周和24周的测量。对于14周的主要结局指标，PT组在iHOT-33（平均差异14.2分；95%CI 1.2至27.2）和HOS运动子量表（13.8分；95%CI 0.3至27.3）上的改善明显更大。在24周时，组间差异无统计学意义。
个体化的PT治疗和康复方案可能会增强FAI综合征关节镜手术后患者报告结局的改善。然而，鉴于样本量小，需要更大规模的试验来验证这些发现。
在澳大利亚新西兰临床试验注册中心注册的试验：ACTRN12613000282785，结果。
