Movement Pattern Training in People With Intra-articular, Prearthritic Hip Disorders

NCT02913222 | Completed Results

• 2 other identifiers: R21HD086644-01A1-201609106R21HD086644-01A1
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 2

Brief Summary

Intra-articular, prearthritic hip disorders (PAHD) result in substantial dysfunction in young adults and are proposed precursors to hip osteoarthritis (OA). Effective treatment of PAHD is needed to improve function in the young adult and prevent or delay the onset of hip OA, however evidence related to treatment of PAHD is limited. This research will provide the foundation for a future clinical trial to assess the efficacy of movement pattern training, an innovative rehabilitation approach for the treatment of PAHD.

Conditions

Chronic Hip Joint Pain; Prearthritic Hip Disease

Keywords

femoroacetabular impingement; labral tear; rehabilitation

Outcome Measures

Primary Outcomes (1)

• Percentage of Participants Who Are Adherent to Treatment Attendance

  Percentage of study participants who attend 90% (9/10) of the supervised treatment sessions.

  Immediately after treatment (13 weeks after baseline)

Secondary Outcomes (2)

• Change in Function Using the Hip Disability and Osteoarthritis Outcome Score (HOOS) Activities in Daily Living Subscale From Baseline to Post-treatment (13 Weeks)

  Immediately after treatment (13 weeks after baseline)

• Change in Hip Disability and Osteoarthritis Outcome Score (HOOS) Symptoms Subscale From Baseline to Post-treatment (13 Weeks)

  Immediately after treatment (13 weeks after baseline)

Other Outcomes (28)

• Change in Function Using the Hip Disability and Osteoarthritis Outcome Score (HOOS) Pain Subscale From Baseline to Post-treatment (13 Weeks)

  Between Baseline and Immediately after treatment (13 weeks after baseline)

• Change in Function Using the Hip Disability and Osteoarthritis Outcome Score (HOOS) Sport Subscale From Baseline to Post-treatment (13 Weeks)

  Between Baseline and Immediately after treatment (13 weeks after baseline)

• Change in Function Using the Hip Disability and Osteoarthritis Outcome Score (HOOS) Quality of Life (QOL) Subscale From Baseline to Post-treatment (13 Weeks)

  Between Baseline and Immediately after treatment (13 weeks after baseline)

Study Arms (2)

Movement Pattern Training (MPT)

EXPERIMENTAL

Treatment: 10 sessions over 12 weeks and a home program provided by a physical therapist. Treatment includes assessment of patient goals and patient education. Movement Pattern Training (MPT) will focus on task-specific training to improve lower extremity movement patterns during basic tasks, such as sit to stand and stairs, and reported patient-specific tasks. Patient education will include instruction in abnormal movement patterns and methods to optimize movement patterns during each task. Exercises will include repeated practice of tasks using optimized movement patterns. Verbal cues and visual aids will be used to assist the participant. Difficulty of the task-specific activities will be progressed by varying repetitions performed, increasing load or changing the support surface.

Other: Rehabilitation

Standard Rehabilitation

ACTIVE COMPARATOR

Treatment: 10 sessions over 12 weeks and a home program provided by a physical therapist. Treatment includes assessment of patient goals and patient education. For the Standard Rehabilitation, focus will be on progressive lower extremity and trunk strengthening and lower extremity flexibility. Patient education will include instruction to modify intensity, frequency or duration of patient-specific tasks. Using current clinical practice guidelines and previous reports, strengthening and flexibility exercises will be prescribed and progressed by varying the repetitions performed or increasing the load.

Other: Rehabilitation

Interventions

Rehabilitation OTHER

Comparison of two rehabilitation approaches

Also known as: Physical Therapy, Therapeutic exercise

Movement Pattern Training (MPT); Standard Rehabilitation

Eligibility Criteria

• Age: 15 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• be 15-40 years old
• report deep hip joint or anterior groin pain, confirmed upon physical exam
• report pain \> 3/10 and present \> 3 months
• demonstrate functional limitation with modified Harris Hip Score \<90.

You may not qualify if:

• previous hip surgery, fracture, pelvic/hip infection
• pain due to high impact trauma
• inflammatory disease, e.g. rheumatoid arthritis, gout
• neurological involvement affecting balance
• age \<15 or \>40
• Slipped Capital Femoral Epiphysis (SCFE) or Legg-Calve-Perthes Disease (LCP)
• pain, numbness or tingling that radiates into the thigh
• known pregnancy

Sponsors & Collaborators

• Washington University School of Medicine: lead
• University of Pittsburgh: collaborator
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): collaborator

Study Sites (2)

Program in Physical Therapy, Washington University

St Louis, Missouri, 63108, United States

Location

University of Pittsburgh

Pittsburgh, Pennsylvania, 15219, United States

Location

Related Publications (5)

• Harris-Hayes M, Steger-May K, Bove A, Foster S, Mueller MJ, Clohisy JC, Fitzgerald GK. Sustained Outcomes Following Movement Pattern Training or Strengthening/Flexibility Among Patients with Prearthritic Hip Disorders: Results of a Pilot Multicenter Randomized Clinical Trial. Accepted for OARSI World Congress on Osteoarthritis, April 2020.

  BACKGROUND

• Foster SN, Harris MD, Hastings MK, Mueller MJ, Salsich GB, Harris-Hayes M. Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain. J Sport Rehabil. 2020 Dec 8;30(4):638-645. doi: 10.1123/jsr.2020-0140.

  PMID: 33291065 BACKGROUND

• Koch K, Semciw AI, Commean PK, Hillen TJ, Fitzgerald GK, Clohisy JC, Harris-Hayes M. Comparison between movement pattern training and strengthening on muscle volume, muscle fat, and strength in patients with hip-related groin pain: An exploratory analysis. J Orthop Res. 2022 Jun;40(6):1375-1386. doi: 10.1002/jor.25158. Epub 2021 Aug 18.

  PMID: 34370330 RESULT

• Harris-Hayes M, Steger-May K, M Bove A, Mueller MJ, Clohisy JC, Fitzgerald GK. One-year outcomes following physical therapist-led intervention for chronic hip-related groin pain: Ancillary analysis of a pilot multicenter randomized clinical trial. J Orthop Res. 2021 Nov;39(11):2409-2418. doi: 10.1002/jor.24985. Epub 2021 Mar 2.

  PMID: 33458839 RESULT

• Harris-Hayes M, Steger-May K, Bove AM, Foster SN, Mueller MJ, Clohisy JC, Fitzgerald GK. Movement pattern training compared with standard strengthening and flexibility among patients with hip-related groin pain: results of a pilot multicentre randomised clinical trial. BMJ Open Sport Exerc Med. 2020 Mar 23;6(1):e000707. doi: 10.1136/bmjsem-2019-000707. eCollection 2020.

  PMID: 32518674 RESULT

Related Links

• Rehabilitation Research for Orthopaedic Conditions (RROC)

MeSH Terms

Conditions

Femoracetabular Impingement

Interventions

Rehabilitation; Physical Therapy Modalities; Exercise Therapy

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services

Limitations and Caveats

This is a pilot study to determine preliminary estimates of treatment effects for movement pattern training and standard rehabilitation. We cannot make definitive statements regarding efficacy of Movement Pattern Training or Standard treatment.

Results Point of Contact

• Title: Marcie Harris-Hayes, PT, DPT, MSCI, Professor, Physical Therapy and Orthopaedic Surgery
• Organization: Washington University School of Medicine

harrisma@wustl.edu

314-286-1435

Study Officials

• Marcie Harris-Hayes, DPT, MSCI

  Washington University School of Medicine

  PRINCIPAL INVESTIGATOR

• Kelley Fitzgerald, PhD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 15, 2016
• First Posted: September 23, 2016
• Study Start: February 4, 2017
• Primary Completion: December 12, 2018
• Study Completion: December 31, 2019
• Last Updated: March 27, 2023
• Results First Posted: May 12, 2020

Record last verified: 2023-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)