Movement pattern training compared with standard strengthening and flexibility among patients with hip-related groin pain: results of a pilot multicentre randomised clinical trial

Harris‐Hayes, Marcie; Steger-May, Karen; Bove, Allyn M; Foster, Stefanie N; Mueller, Michael J.; Clohisy, John C.; Fitzgerald, G. Kelley

doi:10.1136/bmjsem-2019-000707

Cited by 17 publications

(44 citation statements)

References 31 publications

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“…This was a cross-sectional study designed to use baseline data from a pilot multisite randomized clinical trial for patients with HRGP. 16 Only patients enrolled at the Washington University site were included in the current study as additional funding allowed for collection of 3D kinematic data. Data collection occurred at The Movement Science Research Center at Washington University in St. Louis, Missouri.…”

Section: Methods Designmentioning

confidence: 99%

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

Foster¹,

Harris²,

Hastings³

et al. 2021

Journal of Sport Rehabilitation

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Context: The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. Objective: To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Design: Cross-sectional Setting: Academic medical center. Patients: A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated. Intervention: None. Main Outcome Measures: Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Results: Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Conclusions: Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

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Section: Methods Designmentioning

confidence: 99%

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

Foster¹,

Harris²,

Hastings³

et al. 2021

Journal of Sport Rehabilitation

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“…We completed a pilot, multicenter RCT (ClinicalTrials.gov: NCT02913222) comparing two PT-led interventions for HRGP, movement pattern training (MoveTrain) and traditional strength and flexibility training (Standard) to establish feasibility of completing a definitive trial. 8 We established feasibility and reported that both strategies resulted in clinically significant improvements in patientreported function and hip muscle strength immediately after treatment. 8 The MoveTrain group also demonstrated an improvement in lower extremity movement patterns.…”

Section: Introductionmentioning

confidence: 98%

“…A growing body of evidence suggests that PT-led intervention can decrease pain and improve function among patients with HRGP. [6][7][8][9][10][11][12][13][14] Most studies report short-term outcomes only and do not report if effects are sustained past the active treatment phase. Only two studies report outcomes 1 year or greater after treatment completion among patients with HRGP who participated in rehabiltation.…”

Section: Introductionmentioning

confidence: 99%

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

Harris‐Hayes

Steger-May

Bove

et al. 2021

Journal Orthopaedic Research

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Evidence related to physical therapist-led intervention for patients with chronic hiprelated 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.

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“…Considering that the specific effects of stretching in recovery of GPI are not well known, allied to the lack of consensus in existing research and reduced statistical power of some individual studies [24,25], a systematic review may provide a summary of evidence and promote better informed clinical practice [26,27]. Recent, high-quality reviews on recovery from GPI are available [1,8,[10][11][12]14], but these were broad-scope works, considering a plethora of interventions, thus reinforcing our criticisms concerning the lack of assessment of unimodal interventions and consequently a poor knowledge of the effectiveness of each specific component of an intervention.…”

Section: Introductionmentioning

confidence: 99%

Stretching for Recovery from Groin Pain or Injury in Athletes: A Critical and Systematic Review

Afonso

Claudino

Fonseca

et al. 2021

JFMK

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Stretching is usually used as part of rehabilitation protocols for groin pain or injury, but its specific contribution to and within multimodal recovery protocols is unclear. Our goal was to systematically review the effects of stretching for the recovery from groin pain or injury. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, with eligibility criteria defined according to PICOS: (Participants) athletes with groin pain or injuries; (Interventions) interventions with stretching as the differentiating factor; (Comparators) comparators not applying stretching; (Outcomes) symptom remission or improvement and/or time to return to sport and/or return to play; (Study design) randomized controlled trials. Searches were performed on 26 March 2021, in CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus, and Web of Science, with no limitations regarding language or date, and no filters. Of 117 retrieved results, 65 were duplicates and 49 were excluded at the screening stage. The three articles eligible for full-text analysis failed to comply with one or more inclusion criteria (participants, intervention and/or comparators). We then went beyond the protocol and searched for non-randomized trials and case series, but no intervention was found where stretching was the differentiating factor. We found no trials specifically assessing the effects of stretching on recovery or improvement of groin pain or injury in athletes. Currently, the efficacy of these interventions is unknown, and more research is warranted.

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Movement pattern training compared with standard strengthening and flexibility among patients with hip-related groin pain: results of a pilot multicentre randomised clinical trial

Cited by 17 publications

References 31 publications

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

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

Stretching for Recovery from Groin Pain or Injury in Athletes: A Critical and Systematic Review

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