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Meta-Analysis
. 2020 Dec;54(23):1382-1394.
doi: 10.1136/bjsports-2019-101690. Epub 2020 May 6.

Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain

Joanne L Kemp  1 , Andrea B Mosler  2 , Harvi Hart  2   3 , Mario Bizzini  4 , Steven Chang  5 , Mark J Scholes  2 , Adam I Semciw  2   6 , Kay M Crossley  2
Affiliations
Meta-Analysis

Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain

Joanne L Kemp et al. Br J Sports Med. 2020 Dec.

Abstract

Objective: To report the effectiveness of physiotherapist-led interventions in improving pain and function in young and middle-aged adults with hip-related pain.

Design: Systematic review and meta-analysis.

Data sources: A comprehensive, reproducible search strategy was performed on five databases in May 2019. Reference lists and grey literature were also searched.

Eligibility criteria for selecting studies: Population: people aged ≥18 years with hip-related pain (with or without a diagnosis of femoroacetabular impingement syndrome).

Intervention(s): physiotherapist-led interventions for hip pain. Comparators: sham treatment, no treatment or other treatment (eg, hip arthroscopic surgery).

Outcomes: primary outcomes included patient-reported hip pain and function. Secondary outcomes included physical function measures.

Results: 1722 papers were identified. After exclusion criteria were applied, 14 studies were included for analysis. They had varied risk of bias. There were no full-scale placebo-controlled randomised controlled trials (RCTs) of physiotherapist-led treatment. Pooled effects ranged from moderate effects (0.67 (95% CI 0.07 to 1.26)) favouring physiotherapist-led intervention over no treatment post-arthroscopy, to weak effects (-0.32 (95% CI 0.57 to 0.07)) favouring hip arthroscopy over physiotherapist-led treatment.

Conclusion: Physiotherapist-led interventions might improve pain and function in young and middle-aged adults with hip-related pain, however full-scale high-quality RCT studies are required.

Prospero registration number: CRD42018089088.

Keywords: arthroscopy; exercise; hip; physiotherapy; rehabilitation.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart of study inclusion. RCT, randomised controlled trial.
Figure 2
Figure 2
Between-group differences for physiotherapist-led treatment compared with sham/no treatment in non-surgical populations at 3 months follow-up. HOOS, Hip Osteoarthritis and disability Outcome Score; IHOT, International Hip Outcome Tool; QOL, quality of life; SMD, standardised mean difference; total, number of participants.
Figure 3
Figure 3
Between-group differences for physiotherapist-led treatment compared with sham/no treatment in non-surgical populations at 6 weeks follow-up.ADL, Activity of Daily Living; HOOS, Hip Osteoarthritis and disability Outcome Score; HOS, Hip Outcome Score; QOL, quality of life; SMD, standardised mean difference; total, number of participants.
Figure 4
Figure 4
Between-group differences for physiotherapist-led treatment compared with sham/no treatment in posthip arthroscopy populations at 3-month follow-up. HOOS, Hip Osteoarthritis and disability Outcome Score; HOS, Hip Outcome Score; IHOT, International Hip Outcome Tool; SMD, standardised mean difference; total, number of participants.
Figure 5
Figure 5
Between-group differences for physiotherapist-led treatment compared with hip arthroscopy surgery. ADL, Activity of Daily Living; HOS, Hip Outcome Score; IHOT, International Hip Outcome Tool; SMD, standardised mean difference; total, number of participants.
See this image and copyright information in PMC

References

    1. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012;380:2163–96. 10.1016/S0140-6736(12)61729-2 - DOI - PMC - PubMed
    1. Werner J, Hägglund M, Waldén M, et al. UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med 2009;43:1036–40. 10.1136/bjsm.2009.066944 - DOI - PubMed
    1. Werner J, Hägglund M, Ekstrand J, et al. Hip and groin time-loss injuries decreased slightly but injury burden remained constant in men's professional football: the 15-year prospective UEFA elite Club injury study. Br J Sports Med 2019;53:539-546. 10.1136/bjsports-2017-097796 - DOI - PubMed
    1. Mosler AB, Weir A, Eirale C, et al. Epidemiology of time loss groin injuries in a men's professional football League: a 2-year prospective study of 17 clubs and 606 players. Br J Sports Med 2018;52:292–7. 10.1136/bjsports-2016-097277 - DOI - PubMed
    1. Kierkegaard S, Langeskov-Christensen M, Lund B, et al. Pain, activities of daily living and sport function at different time points after hip arthroscopy in patients with femoroacetabular impingement: a systematic review with meta-analysis. Br J Sports Med 2017;51:572–9. 10.1136/bjsports-2016-096618 - DOI - PubMed