PDF(Pubmed)
Abstract：
OBJECTIVE: The objective of this study was to assess the feasibility of completing a randomized clinical trial (RCT) and examine the preliminary effects of 2 interventions for hip-related groin pain (HRGP).
METHODS: In this pilot RCT, patients with HRGP, who were 18 to 40 years old, were randomized (1:1 ratio) to a joint mobilization (JtMob) group or a movement pattern training (MoveTrain) group. Both treatments included 10 supervised sessions and a home exercise program. The goal of JtMob was to reduce pain and improve mobility through peripherally and centrally mediated pain mechanisms. The key element was physical therapist-provided JtMob. The goal of MoveTrain was to reduce hip joint stresses by optimizing the biomechanics of patient-specific tasks. The key element was task-specific instruction to correct abnormal movement patterns displayed during tasks. Primary outcomes were related to future trial feasibility. The primary effectiveness outcome was the Hip Disability and Osteoarthritis Outcome Score. Examiners were blinded to group; patients and treatment providers were not. Data collected at baseline and immediately after treatment were analyzed with analysis of covariance using a generalized linear model in which change was the dependent variable and baseline was the covariate. The study was modified due to the coronavirus disease 2019 (COVID-19) pandemic.
RESULTS: The COVID-19 pandemic affected participation; 127 patients were screened, 33 were randomized (18 to the JtMob group and 15 to the MoveTrain group), and 29 (88%) provided posttreatment data. Treatment session adherence was 85%, and home exercise program component adherence ranged from 71 to 86%. Both groups demonstrated significant mean within-group improvements of ≥5 points on Hip Disability and Osteoarthritis Outcome Score scales. There were no between-group differences in effectiveness outcomes.
CONCLUSIONS: A large RCT to assess the effects of JtMob and MoveTrain for patients with HRGP may be feasible. Preliminary findings suggested that JtMob or MoveTrain may result in improvements in patient-reported pain and activity limitations.
CONCLUSIONS: The COVID-19 pandemic interfered with participation, but a randomized controlled trial may be feasible. Modification may be needed if the trial is completed during future pandemics.
METHODS: In this pilot RCT, patients with HRGP, who were 18 to 40 years old, were randomized (1:1 ratio) to a joint mobilization (JtMob) group or a movement pattern training (MoveTrain) group. Both treatments included 10 supervised sessions and a home exercise program. The goal of JtMob was to reduce pain and improve mobility through peripherally and centrally mediated pain mechanisms. The key element was physical therapist-provided JtMob. The goal of MoveTrain was to reduce hip joint stresses by optimizing the biomechanics of patient-specific tasks. The key element was task-specific instruction to correct abnormal movement patterns displayed during tasks. Primary outcomes were related to future trial feasibility. The primary effectiveness outcome was the Hip Disability and Osteoarthritis Outcome Score. Examiners were blinded to group; patients and treatment providers were not. Data collected at baseline and immediately after treatment were analyzed with analysis of covariance using a generalized linear model in which change was the dependent variable and baseline was the covariate. The study was modified due to the coronavirus disease 2019 (COVID-19) pandemic.
RESULTS: The COVID-19 pandemic affected participation; 127 patients were screened, 33 were randomized (18 to the JtMob group and 15 to the MoveTrain group), and 29 (88%) provided posttreatment data. Treatment session adherence was 85%, and home exercise program component adherence ranged from 71 to 86%. Both groups demonstrated significant mean within-group improvements of ≥5 points on Hip Disability and Osteoarthritis Outcome Score scales. There were no between-group differences in effectiveness outcomes.
CONCLUSIONS: A large RCT to assess the effects of JtMob and MoveTrain for patients with HRGP may be feasible. Preliminary findings suggested that JtMob or MoveTrain may result in improvements in patient-reported pain and activity limitations.
CONCLUSIONS: The COVID-19 pandemic interfered with participation, but a randomized controlled trial may be feasible. Modification may be needed if the trial is completed during future pandemics.
摘要：
目的：本研究的目的是评估完成一项随机临床试验（RCT）的可行性，并研究2种干预措施对髋部相关腹股沟疼痛（HRGP）的初步效果。
方法：在本试点RCT中，18至40岁的HRGP患者，被随机（1：1比例）分配到关节动员（JtMob）组或运动模式训练（MoveTrain）组。两种治疗方法都包括10次监督治疗和家庭锻炼计划。JtMob的目标是通过外周和中枢介导的疼痛机制减轻疼痛并改善活动性。关键因素是物理治疗师提供的联合动员。MoveTrain的目标是通过优化患者特定任务的生物力学来减少髋关节应力。关键要素是针对特定任务的指令，以纠正任务期间显示的异常运动模式。主要结果与未来试验的可行性有关。主要有效性结果是髋关节残疾和骨关节炎结果评分。检查人员对小组不知情；患者和治疗提供者没有。在基线和治疗后立即收集的数据使用广义线性模型进行协方差分析，其中变化是因变量，基线是协变量。由于COVID-19大流行，这项研究得到了修改。
结果：COVID-19大流行影响了参与；筛选了127例患者，33人被随机分配（JtMob组18人，MoveTrain组15人），和29（88％）提供了后处理数据。治疗依从性为85%，家庭锻炼计划组成部分的依从性从71%到86%不等。两组在髋关节残疾和骨关节炎结果评分量表上表现出显著的组内平均改善≥5分。疗效结果无组间差异。
结论：评估JtMob和MoveTrain对HRGP患者的影响的大型RCT可能是可行的。初步研究结果表明，JtMob或MoveTrain可能会改善患者报告的疼痛和活动限制。
结论：COVID-19大流行干扰了参与，但随机对照试验可能是可行的.如果在未来的大流行期间完成试验，则可能需要修改。
方法：在本试点RCT中，18至40岁的HRGP患者，被随机（1：1比例）分配到关节动员（JtMob）组或运动模式训练（MoveTrain）组。两种治疗方法都包括10次监督治疗和家庭锻炼计划。JtMob的目标是通过外周和中枢介导的疼痛机制减轻疼痛并改善活动性。关键因素是物理治疗师提供的联合动员。MoveTrain的目标是通过优化患者特定任务的生物力学来减少髋关节应力。关键要素是针对特定任务的指令，以纠正任务期间显示的异常运动模式。主要结果与未来试验的可行性有关。主要有效性结果是髋关节残疾和骨关节炎结果评分。检查人员对小组不知情；患者和治疗提供者没有。在基线和治疗后立即收集的数据使用广义线性模型进行协方差分析，其中变化是因变量，基线是协变量。由于COVID-19大流行，这项研究得到了修改。
结果：COVID-19大流行影响了参与；筛选了127例患者，33人被随机分配（JtMob组18人，MoveTrain组15人），和29（88％）提供了后处理数据。治疗依从性为85%，家庭锻炼计划组成部分的依从性从71%到86%不等。两组在髋关节残疾和骨关节炎结果评分量表上表现出显著的组内平均改善≥5分。疗效结果无组间差异。
结论：评估JtMob和MoveTrain对HRGP患者的影响的大型RCT可能是可行的。初步研究结果表明，JtMob或MoveTrain可能会改善患者报告的疼痛和活动限制。
结论：COVID-19大流行干扰了参与，但随机对照试验可能是可行的.如果在未来的大流行期间完成试验，则可能需要修改。
