Schulthess Clinic and Laboratory of Exercise and Health, Swiss Federal Institute of Technology, Zurich, Switzerland.
Schulthess Clinic, Zurich, Switzerland.
Arthritis Care Res (Hoboken). 2019 Aug;71(8):1074-1083. doi: 10.1002/acr.23728. Epub 2019 Jul 9.
To investigate the responsiveness to exercise therapy of patients with femoroacetabular impingement syndrome (FAIS), and to investigate differences in hip function, strength, and morphology between responders versus nonresponders.
Patients with FAIS underwent 12 weeks of semi-standardized and progressive exercise therapy. A good therapy outcome (responders) versus a poor therapy outcome (nonresponders) was determined at week 18 with the Global Treatment Outcome questionnaire for hip pain. Hip function was evaluated using the Hip Outcome Score (HOS) activities of daily living (ADL) and Sport at baseline, and at weeks 6, 12, and 18. Hip muscle strength and dynamic pelvic control were evaluated using dynamometry and video analysis, respectively, at baseline, week 12, and week 18. Hip morphology was evaluated with imaging at baseline.
Thirty-one patients (mean age 24 years) were included. Sixteen patients (52%) were responsive and 15 patients (48%) were not responsive to exercise therapy. Only responders improved HOS ADL and HOS Sport by 10 points (95% confidence interval [95% CI] 7, 14; P < 0.001) and by 20 points (95% CI 15, 25; P < 0.001), respectively, and hip abductor strength by 0.27 Nm/kg (95% CI 0.18, 0.36; P < 0.001). The prevalence of patients showing good dynamic pelvic control only increased in responders (44%; P = 0.029). The prevalence of severe cam morphology was higher in nonresponders than in responders (40% versus 6%; P = 0.037).
Half of patients with FAIS benefit from exercise therapy in the short term. Responsiveness to hip abductor strength and dynamic pelvic control improvements is associated with a good therapy outcome, whereas the presence of severe cam morphology is associated with a poor therapy outcome.
探讨髋关节撞击综合征（FAIS）患者对运动疗法的反应，并研究反应者与无反应者之间髋关节功能、力量和形态的差异。
FAIS 患者接受 12 周半标准化和渐进性运动治疗。18 周时使用髋关节疼痛全球治疗结果问卷（Global Treatment Outcome questionnaire for hip pain）确定治疗结果良好（反应者）和治疗结果不佳（无反应者）。在基线时、6 周、12 周和 18 周时使用髋关节结局评分（Hip Outcome Score，HOS）日常生活活动（ADL）和运动部分评估髋关节功能。在基线时、12 周和 18 周时使用测力法和视频分析分别评估髋关节肌肉力量和动态骨盆控制。在基线时进行髋关节形态学评估。
共纳入 31 例患者（平均年龄 24 岁）。16 例（52%）患者对运动疗法有反应，15 例（48%）患者无反应。仅反应者的 HOS ADL 和 HOS 运动分别改善 10 分（95%置信区间 [95%CI] 7，14；P < 0.001）和 20 分（95%CI 15，25；P < 0.001），髋关节外展肌力量改善 0.27 Nm/kg（95%CI 0.18，0.36；P < 0.001）。只有反应者的动态骨盆控制良好的患者比例增加（44%；P = 0.029）。无反应者中严重凸轮形态的患病率高于反应者（40%与 6%；P = 0.037）。
髋关节撞击综合征患者中，有一半患者在短期内从运动疗法中受益。对髋关节外展肌力量和动态骨盆控制改善的反应与治疗结果良好相关，而严重凸轮形态的存在与治疗结果不佳相关。
