Efficacy of an Exercise Program for Patients With Femoro-acetabular Impingement
Primary Purpose
Femoracetabular Impingement
Status
Unknown status
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Exercise Group
Sponsored by
About this trial
This is an interventional treatment trial for Femoracetabular Impingement focused on measuring non-surgical treatment, exercise
Eligibility Criteria
Inclusion Criteria:
- Diagnosed with symptomatic FAI
- at least 3 months of groin pain
- increased pain with hip rotation
- an alpha angle greater than 60 degrees on multiplane imaging
- labral tear on MRI
- Tonnis grade of 0 or 1
Exclusion Criteria:
- diagnosed health problems other than FAI interfering with capacity to accomplish the exercise program
- previous hip surgery on the affected side
- surgery will happen within 6 months
Sites / Locations
- The Ottawa HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Exercise Group
Control Group
Arm Description
The group who will exercise to manage pain.
The group who will not take part in any exercises and only have to do assessments.
Outcomes
Primary Outcome Measures
iHOT-33
International Hip Outcome Tool-33, disease-specific function. Each answer will be measured on a scale of 100mm and the mean of the 33 questions will be taken as a final score. A higher score indicates a better quality of life.
Secondary Outcome Measures
EQ-5D-5L
Generic quality of life, the scores for each question are summed up for a total with a higher score being a better quality of life.
Pelvic and hip biomechanics (Femoral head displacement)
Displacement of the femoral head center from the neutral position (measured in degrees)
Pelvic and hip biomechanics (Coverage of femoral head)
Coverage of the femoral head provided by the acetabular margin (measured in degrees)
Pelvic and hip biomechanics (Acetabular rim and femoral neck distance)
the closest distance between the acetabular rim and the femoral neck (measured in mm)
Number of participants that receive hip surgery
If the participant has hip surgery in the time frame
Full Information
NCT ID
NCT03949127
First Posted
April 14, 2019
Last Updated
June 22, 2021
Sponsor
Ottawa Hospital Research Institute
Collaborators
Canadian Orthopaedic Foundation
1. Study Identification
Unique Protocol Identification Number
NCT03949127
Brief Title
Efficacy of an Exercise Program for Patients With Femoro-acetabular Impingement
Official Title
Efficacy of a Non-surgical Treatment Protocol for Patients With Symptomatic Femoro-acetabular Impingement: a Randomized Controlled Trial
Study Type
Interventional
2. Study Status
Record Verification Date
June 2021
Overall Recruitment Status
Unknown status
Study Start Date
September 6, 2019 (Actual)
Primary Completion Date
December 2022 (Anticipated)
Study Completion Date
December 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ottawa Hospital Research Institute
Collaborators
Canadian Orthopaedic Foundation
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to examine whether using an exercise regime on people with femoroacetabular impingement (FAI) can help reduce pain and improve function. Also, it examines whether the exercise regime will help prevent the worsening of hip cartilage deterioration.
Detailed Description
A significant proportion of adults from ages 18 to 50 have a deformity in the neck of their femur. This can be painful and is called a femoroacetabular impingement (FAI), and could lead to ones cartilage being destroyed and possibly lead to osteoarthritis of the hip. People with this deformity in their femur have been found to move their hips differently when doing tasks such as walking, squatting or climbing stairs compared to those without this problem. The investigators are testing whether exercise that targets this difference in movement can help reduce pain, improve function and prevent cartilage damage. There will recruit 84 patients with divided into 2 groups. 42 patients will do a 8 week exercise program on strengthening muscles responsible for extending the hip and stretching muscles that are associated with flexing the hip. The intensity of the program will change with visits to the physiotherapist through the course of their exercise program. This research hopes to develop an innovative, non-surgical, low-cost, highly feasible and accessible intervention for patients with FAI.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Femoracetabular Impingement
Keywords
non-surgical treatment, exercise
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
There will be two groups, one will be the exercise group and one will be used as a control group.
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
84 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Exercise Group
Arm Type
Experimental
Arm Description
The group who will exercise to manage pain.
Arm Title
Control Group
Arm Type
No Intervention
Arm Description
The group who will not take part in any exercises and only have to do assessments.
Intervention Type
Other
Intervention Name(s)
Exercise Group
Intervention Description
The group who will meet a physiotherapist who will show them strengthening and stretching muscles associated with pelvic tilt.
Primary Outcome Measure Information:
Title
iHOT-33
Description
International Hip Outcome Tool-33, disease-specific function. Each answer will be measured on a scale of 100mm and the mean of the 33 questions will be taken as a final score. A higher score indicates a better quality of life.
Time Frame
Change in Baseline before exercise program and 1 year afterwards
Secondary Outcome Measure Information:
Title
EQ-5D-5L
Description
Generic quality of life, the scores for each question are summed up for a total with a higher score being a better quality of life.
Time Frame
Change in Baseline before exercise program and 1 year afterwards
Title
Pelvic and hip biomechanics (Femoral head displacement)
Description
Displacement of the femoral head center from the neutral position (measured in degrees)
Time Frame
Change in Baseline before exercise program and 1 year afterwards
Title
Pelvic and hip biomechanics (Coverage of femoral head)
Description
Coverage of the femoral head provided by the acetabular margin (measured in degrees)
Time Frame
Change in Baseline before exercise program and 1 year afterwards
Title
Pelvic and hip biomechanics (Acetabular rim and femoral neck distance)
Description
the closest distance between the acetabular rim and the femoral neck (measured in mm)
Time Frame
Change in Baseline before exercise program and 1 year afterwards
Title
Number of participants that receive hip surgery
Description
If the participant has hip surgery in the time frame
Time Frame
Change in Baseline before exercise program and 1 year afterwards
10. Eligibility
Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosed with symptomatic FAI
at least 3 months of groin pain
increased pain with hip rotation
an alpha angle greater than 60 degrees on multiplane imaging
labral tear on MRI
Tonnis grade of 0 or 1
Exclusion Criteria:
diagnosed health problems other than FAI interfering with capacity to accomplish the exercise program
previous hip surgery on the affected side
surgery will happen within 6 months
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lissa Pacheco, PhD (c)
Phone
613-737-8920
Email
lipacheco@ohri.ca
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Beaule, MD, FRCSC
Organizational Affiliation
Ottawa Hospital Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Ottawa Hospital
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Beaule, MD, FRCSC
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
27011797
Citation
Khanna V, Beaule PE. Defining structural abnormalities of the hip joint at risk of degeneration. J Hip Preserv Surg. 2014 Sep 6;1(1):12-20. doi: 10.1093/jhps/hnu004. eCollection 2014 Jul.
Results Reference
background
PubMed Identifier
24481825
Citation
Khanna V, Caragianis A, Diprimio G, Rakhra K, Beaule PE. Incidence of hip pain in a prospective cohort of asymptomatic volunteers: is the cam deformity a risk factor for hip pain? Am J Sports Med. 2014 Apr;42(4):793-7. doi: 10.1177/0363546513518417. Epub 2014 Jan 30.
Results Reference
background
PubMed Identifier
25246442
Citation
Diamond LE, Dobson FL, Bennell KL, Wrigley TV, Hodges PW, Hinman RS. Physical impairments and activity limitations in people with femoroacetabular impingement: a systematic review. Br J Sports Med. 2015 Feb;49(4):230-42. doi: 10.1136/bjsports-2013-093340. Epub 2014 Sep 22.
Results Reference
background
PubMed Identifier
20962194
Citation
Hack K, Di Primio G, Rakhra K, Beaule PE. Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am. 2010 Oct 20;92(14):2436-44. doi: 10.2106/JBJS.J.01280.
Results Reference
background
PubMed Identifier
25842248
Citation
Peters CL. Mild to Moderate Hip OA: Joint Preservation or Total Hip Arthroplasty? J Arthroplasty. 2015 Jul;30(7):1109-12. doi: 10.1016/j.arth.2015.02.046. Epub 2015 Mar 25.
Results Reference
background
PubMed Identifier
25913231
Citation
Beaule PE, Singh A, Poitras S, Parker G. Surgical Dislocation of the Hip for the Treatment of Pre-Arthritic Hip Disease. J Arthroplasty. 2015 Sep;30(9):1502-5. doi: 10.1016/j.arth.2015.04.009. Epub 2015 Apr 11.
Results Reference
background
PubMed Identifier
23357224
Citation
Speirs AD, Beaule PE, Rakhra KS, Schweitzer ME, Frei H. Increased acetabular subchondral bone density is associated with cam-type femoroacetabular impingement. Osteoarthritis Cartilage. 2013 Apr;21(4):551-8. doi: 10.1016/j.joca.2013.01.012. Epub 2013 Jan 26.
Results Reference
background
PubMed Identifier
28259463
Citation
Speirs AD, Beaule PE, Huang A, Frei H. Properties of the cartilage layer from the cam-type hip impingement deformity. J Biomech. 2017 Apr 11;55:78-84. doi: 10.1016/j.jbiomech.2017.02.007. Epub 2017 Feb 21.
Results Reference
background
PubMed Identifier
23604603
Citation
Carsen S, Moroz PJ, Rakhra K, Ward LM, Dunlap H, Hay JA, Willis RB, Beaule PE. The Otto Aufranc Award. On the etiology of the cam deformity: a cross-sectional pediatric MRI study. Clin Orthop Relat Res. 2014 Feb;472(2):430-6. doi: 10.1007/s11999-013-2990-y.
Results Reference
background
PubMed Identifier
29632694
Citation
Gala L, Khanna V, Rakhra KS, Beaule PE. Does the femoral head/neck contour in the skeletally mature change over time? J Hip Preserv Surg. 2016 Aug 3;3(4):333-337. doi: 10.1093/jhps/hnw022. eCollection 2016 Oct.
Results Reference
background
PubMed Identifier
24115571
Citation
Li X, Majumdar S. Quantitative MRI of articular cartilage and its clinical applications. J Magn Reson Imaging. 2013 Nov;38(5):991-1008. doi: 10.1002/jmri.24313. Epub 2013 Oct 2.
Results Reference
background
PubMed Identifier
26573964
Citation
Anwander H, Melkus G, Rakhra KS, Beaule PE. T1rho MRI detects cartilage damage in asymptomatic individuals with a cam deformity. J Orthop Res. 2016 Jun;34(6):1004-9. doi: 10.1002/jor.23101. Epub 2015 Dec 2.
Results Reference
background
PubMed Identifier
28816897
Citation
Beaule PE, Speirs AD, Anwander H, Melkus G, Rakhra K, Frei H, Lamontagne M. Surgical Correction of Cam Deformity in Association with Femoroacetabular Impingement and Its Impact on the Degenerative Process within the Hip Joint. J Bone Joint Surg Am. 2017 Aug 16;99(16):1373-1381. doi: 10.2106/JBJS.16.00415.
Results Reference
background
PubMed Identifier
27107630
Citation
Fairley J, Wang Y, Teichtahl AJ, Seneviwickrama M, Wluka AE, Brady SRE, Hussain SM, Liew S, Cicuttini FM. Management options for femoroacetabular impingement: a systematic review of symptom and structural outcomes. Osteoarthritis Cartilage. 2016 Oct;24(10):1682-1696. doi: 10.1016/j.joca.2016.04.014. Epub 2016 Apr 20.
Results Reference
background
PubMed Identifier
23419746
Citation
Wall PD, Fernandez M, Griffin DR, Foster NE. Nonoperative treatment for femoroacetabular impingement: a systematic review of the literature. PM R. 2013 May;5(5):418-26. doi: 10.1016/j.pmrj.2013.02.005. Epub 2013 Feb 16.
Results Reference
background
PubMed Identifier
19034598
Citation
Lamontagne M, Kennedy MJ, Beaule PE. The effect of cam FAI on hip and pelvic motion during maximum squat. Clin Orthop Relat Res. 2009 Mar;467(3):645-50. doi: 10.1007/s11999-008-0620-x. Epub 2008 Nov 26.
Results Reference
background
PubMed Identifier
26914331
Citation
Seijas R, Alentorn-Geli E, Alvarez-Diaz P, Marin M, Ares O, Sallent A, Cusco X, Cugat R. Gluteus maximus impairment in femoroacetabular impingement: a tensiomyographic evaluation of a clinical fact. Arch Orthop Trauma Surg. 2016 Jun;136(6):785-9. doi: 10.1007/s00402-016-2428-6. Epub 2016 Feb 25.
Results Reference
background
PubMed Identifier
25060073
Citation
Ross JR, Nepple JJ, Philippon MJ, Kelly BT, Larson CM, Bedi A. Effect of changes in pelvic tilt on range of motion to impingement and radiographic parameters of acetabular morphologic characteristics. Am J Sports Med. 2014 Oct;42(10):2402-9. doi: 10.1177/0363546514541229. Epub 2014 Jul 24.
Results Reference
background
PubMed Identifier
23818186
Citation
Nepple JJ, Prather H, Trousdale RT, Clohisy JC, Beaule PE, Glyn-Jones S, Kim YJ. Clinical diagnosis of femoroacetabular impingement. J Am Acad Orthop Surg. 2013;21 Suppl 1:S16-9. doi: 10.5435/JAAOS-21-07-S16.
Results Reference
background
PubMed Identifier
27765733
Citation
Nwachukwu BU, Fields K, Chang B, Nawabi DH, Kelly BT, Ranawat AS. Preoperative Outcome Scores Are Predictive of Achieving the Minimal Clinically Important Difference After Arthroscopic Treatment of Femoroacetabular Impingement. Am J Sports Med. 2017 Mar;45(3):612-619. doi: 10.1177/0363546516669325. Epub 2016 Oct 23.
Results Reference
background
PubMed Identifier
26795448
Citation
Wright AA, Hegedus EJ, Taylor JB, Dischiavi SL, Stubbs AJ. Non-operative management of femoroacetabular impingement: A prospective, randomized controlled clinical trial pilot study. J Sci Med Sport. 2016 Sep;19(9):716-21. doi: 10.1016/j.jsams.2015.11.008. Epub 2016 Jan 6.
Results Reference
background
PubMed Identifier
27900174
Citation
Coppack RJ, Bilzon JL, Wills AK, McCurdie IM, Partridge LK, Nicol AM, Bennett AN. Physical and functional outcomes following multidisciplinary residential rehabilitation for prearthritic hip pain among young active UK military personnel. BMJ Open Sport Exerc Med. 2016 Apr 1;2(1):e000107. doi: 10.1136/bmjsem-2015-000107. eCollection 2016.
Results Reference
background
PubMed Identifier
27117505
Citation
Griffin D, Wall P, Realpe A, Adams A, Parsons N, Hobson R, Achten J, Fry J, Costa M, Petrou S, Foster N, Donovan J. UK FASHIoN: feasibility study of a randomised controlled trial of arthroscopic surgery for hip impingement compared with best conservative care. Health Technol Assess. 2016 Apr;20(32):1-172. doi: 10.3310/hta20320.
Results Reference
background
PubMed Identifier
17906586
Citation
Crawford MJ, Dy CJ, Alexander JW, Thompson M, Schroder SJ, Vega CE, Patel RV, Miller AR, McCarthy JC, Lowe WR, Noble PC. The 2007 Frank Stinchfield Award. The biomechanics of the hip labrum and the stability of the hip. Clin Orthop Relat Res. 2007 Dec;465:16-22. doi: 10.1097/BLO.0b013e31815b181f.
Results Reference
background
PubMed Identifier
25193693
Citation
Kapron AL, Aoki SK, Peters CL, Anderson AE. Subject-specific patterns of femur-labrum contact are complex and vary in asymptomatic hips and hips with femoroacetabular impingement. Clin Orthop Relat Res. 2014 Dec;472(12):3912-22. doi: 10.1007/s11999-014-3919-9. Epub 2014 Sep 6.
Results Reference
background
PubMed Identifier
28654417
Citation
Savic D, Pedoia V, Seo Y, Yang J, Bucknor M, Franc BL, Majumdar S. Imaging Bone-Cartilage Interactions in Osteoarthritis Using [18F]-NaF PET-MRI. Mol Imaging. 2016 Jan 1;15:1-12. doi: 10.1177/1536012116683597.
Results Reference
background
PubMed Identifier
28150180
Citation
Pierannunzii L. Pelvic posture and kinematics in femoroacetabular impingement: a systematic review. J Orthop Traumatol. 2017 Sep;18(3):187-196. doi: 10.1007/s10195-016-0439-2. Epub 2017 Feb 1.
Results Reference
background
Learn more about this trial
Efficacy of an Exercise Program for Patients With Femoro-acetabular Impingement
We'll reach out to this number within 24 hrs