Proposal for a physiotherapy treatment in patients with Femoro-Acetabular Impingement
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Abstract
Purpose
Femoro-Acetabular Impingement (FAI) is a common cause of hip pain, that can affect a wide range of patients. The primary purpose of this study is to propose a physiotherapy treatment based on the literature concerning patients with recent diagnosis of FAI, and evaluate his effectiveness, regarding the reduction of symptoms and the improvement of hip function. This study is connected to a recently published work1, done by a multidisciplinary team of San Marcello Pistoiese hospital, with the final aim of identifying early this condition and starting a physiotherapeutic prevention program in order to delay as much as possible the use of more invasive treatment strategies.
Materials and methods
Sixteen patients with FAI, 4 males and 12 females, met the eligibility criteria and were enrolled in the study. The treatment protocol used, based on the strengthening and stretching of hip muscles as well as improving core stability, was established following a survey conducted on studies already published in the literature. The outcome measures used to evaluate the effectiveness of the treatment were: the measurement of Passive Range of Motion (pROM) e Active Passive Range of Motion (aROM), in flexion, abduction, internal and external rotation, of the hip affected by FAI; the Numerical Rating Scale (NRS); a Patient-Reported Outcome, the Hip Outcome Score-ADL (HOS-ADL). All the previously mentioned measures were collected at the beginning of the study (T1), at the end of the planned physiotherapeutic intervention (T2) and during a 4-month follow up (T3).
Results
The analysis showed a significant reduction in pain, both between T0 and T1, and between T1 and T2 (p < 0,05). The articular range of all the movements considered, both passive and active, increased significantly (p < 0,05) at the end of treatment (T1); after 4 months (T2), a further improvement in flexion (passive and active) and in active abduction, and a reduction in internal rotation (passive and active), were statistically significant (p < 0,05). Regarding the HOS-ADL, there was a significant increase (p < 0,05) in both the primary and secondary scores at the end of treatment (T1); at the follow-up, the secondary score further increased significantly (p<0,05).
Conclusions
The physiotherapy treatment proposed was well tolerated by the patients and led to very positive results, which seems to be maintained even months after its conclusion. These results should encourage future studies on a larger sample and with a longer follow up, which could lead to more solid conclusions.
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References
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