Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Australia.
J Sci Med Sport. 2018 Feb;21(2):111-116. doi: 10.1016/j.jsams.2017.09.185. Epub 2017 Oct 3.
This study evaluates whether hip bracing in patients with femoroacetabular impingement (FAI) (a) immediately reduces range of hip internal rotation, flexion, adduction, and pain during functional tasks; and (b) improves patient-reported outcomes when worn daily over 4 weeks.
Within-participant design followed by a case series.
Twenty-five adults with symptomatic FAI underwent 3D kinematic assessment with and without a hip brace during single-leg squat, double-leg squat, stair ascent, and stair descent. A subset of this population (n=17) continued to wear the brace daily for 4-weeks. A linear mixed statistical model was used to assess pain and kinematic differences between the braced and unbraced conditions at baseline testing. Patient-reported outcomes (NRS pain, iHot-33 and HAGOS questionnaires) at 4-weeks were compared to baseline using paired t-tests.
Bracing resulted in significant but small reductions in peak hip flexion ranging between 5.3° (95% CI 0.8°-9.7°) and 5.6° (95% CI 1.1°-10.0°), internal rotation ranging between 2.5° (95% CI 0.6°-4.4°) and 6.4° (95% CI 4.5°-8.2°), and adduction ranging between 2.2° (95% CI 0.5°-3.8°) and 3.3° (95% CI 1.6°-5.0°) during all tasks, except flexion during single-leg squat, compared with the unbraced condition; pain was not significantly improved with the brace. Bracing over four weeks did not significantly change patient-reported outcomes.
Bracing subtly limited impinging hip movements during functional tasks, but did not immediately reduce pain or improve patient-reported clinical outcomes after 4 weeks in a young adult cohort with long-standing FAI.
本研究评估髋关节支具在股骨髋臼撞击症（FAI）患者中：（a）是否能立即减少功能任务中髋关节内旋、屈曲、内收和疼痛的活动范围；以及（b）在佩戴 4 周后是否能改善患者报告的结果。
参与者内设计，随后是病例系列研究。
25 名有症状的 FAI 成年人在单腿深蹲、双腿深蹲、上楼梯和下楼梯时进行了 3D 运动学评估，同时佩戴和不佩戴髋关节支具。该人群的一部分（n=17）继续每天佩戴支具 4 周。使用线性混合统计模型来评估基线测试时支具和不支具条件下疼痛和运动学的差异。使用配对 t 检验比较 4 周时的患者报告结果（NRS 疼痛、iHot-33 和 HAGOS 问卷）与基线时的结果。
支具导致髋关节屈曲的峰值显著减小，范围在 5.3°（95%CI 0.8°-9.7°）和 5.6°（95%CI 1.1°-10.0°）之间，内旋范围在 2.5°（95%CI 0.6°-4.4°）和 6.4°（95%CI 4.5°-8.2°）之间，内收范围在 2.2°（95%CI 0.5°-3.8°）和 3.3°（95%CI 1.6°-5.0°）之间，除单腿深蹲时的屈曲外，与不支具条件相比；但佩戴支具并没有显著改善疼痛。佩戴支具 4 周并没有显著改变患者报告的结果。
支具在功能任务中轻微限制了撞击髋关节的运动，但在长期患有 FAI 的年轻成年人队列中，佩戴 4 周后并没有立即减轻疼痛或改善患者报告的临床结果。
