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物理治疗师主导的慢性髋关节相关腹股沟疼痛干预治疗一年后的结果:一项试点多中心随机临床试验的辅助分析。

One-year outcomes following physical therapist-led intervention for chronic hip-related groin pain: Ancillary analysis of a pilot multicenter randomized clinical trial.

机构信息

Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA.

出版信息

J Orthop Res. 2021 Nov;39(11):2409-2418. doi: 10.1002/jor.24985. Epub 2021 Mar 2.

Abstract

Evidence related to physical therapist-led intervention for patients with chronic hip-related groin pain (HRGP) is limited. The purpose was to assess sustainability of treatment effects for people with HRGP undergoing two physical therapist-led interventions. We completed an ancillary analysis of a pilot multicenter, randomized clinical trial. Forty-six patients with chronic HRGP, 15-40 years, were enrolled. Patients were randomized to participate in 10 sessions over 12 weeks of either movement pattern training (MoveTrain) or traditional strength/flexibility (Standard). Participants completed self-report questionnaires before treatment and 6 and 12 months after treatment completion. Outcome measures included Hip disability and Osteoarthritis and Outcome Score (HOOS), Patient Specific Functional Scale and Numeric Pain Rating Scale for average and worst pain. Continuous data were analyzed with mixed model repeated measures analysis of variance (RM-ANOVA) within each group. Numeric pain rating scale (NPRS) was analyzed using multinomial generalized estimating equations (GEE) with a cumulative logit. Reported p values are from statistical contrasts within the RM-ANOVAs and GEEs testing a priori hypotheses regarding change from pretest to month 6, and pretest to month 12. A total of 43/46 (93.5%) participants completed treatment, 40 (87.0%) completed 6 and 38 (82.6%) completed 12 month questionnaires. At 6 and 12 months, both groups demonstrated clinically significant improvements, compared to pretest, in all subscales of HOOS (p < 0.01), Patient Specific Functional Scale (p < 0.001), and NPRS (p < 0.0001). Among patients with chronic HRGP, both MoveTrain and Standard resulted in improved outcomes that were sustained 12 months after treatment. Further investigation in a larger sample is needed to confirm our findings.

摘要

针对慢性髋关节相关腹股沟疼痛(HRGP)患者的物理治疗师主导干预的证据有限。本研究旨在评估接受两种物理治疗师主导的干预措施的 HRGP 患者治疗效果的可持续性。我们对一项试点多中心随机临床试验进行了辅助分析。纳入了 46 名患有慢性 HRGP 的 15-40 岁患者。患者随机分为 10 次 12 周的运动模式训练(MoveTrain)或传统力量/柔韧性(Standard)。参与者在治疗前和治疗完成后 6 个月和 12 个月完成自我报告问卷。结果测量包括髋关节残疾和骨关节炎结局评分(HOOS)、患者特定功能量表和平均及最差疼痛的数字疼痛评分量表(NPRS)。使用混合模型重复测量方差分析(RM-ANOVA)对每个组的连续数据进行分析。使用累积对数比的多项广义估计方程(GEE)分析数字疼痛评分量表(NPRS)。报告的 p 值来自 RM-ANOVA 和 GEE 中的统计对比,用于测试从预测试到第 6 个月以及从预测试到第 12 个月的变化的先验假设。共有 43/46(93.5%)名参与者完成了治疗,40 名(87.0%)完成了 6 个月的问卷,38 名(82.6%)完成了 12 个月的问卷。与预测试相比,两组在 HOOS 的所有子量表(p<0.01)、患者特定功能量表(p<0.001)和 NPRS(p<0.0001)中,在第 6 个月和第 12 个月均表现出临床显著改善。在慢性 HRGP 患者中,MoveTrain 和 Standard 均能改善治疗后 12 个月的结果。需要在更大的样本中进一步研究以确认我们的发现。

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本文引用的文献

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