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Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018
  1. Andrea Britt Mosler1,
  2. Joanne Kemp1,
  3. Matthew King1,
  4. Peter R Lawrenson2,
  5. Adam Semciw1,
  6. Matthew Freke2,
  7. Denise M Jones1,
  8. Nicola C Casartelli3,4,
  9. Tobias Wörner5,
  10. Lasse Ishøi6,
  11. Eva Ageberg7,
  12. Laura E Diamond8,
  13. Michael A Hunt9,
  14. Stephanie Di Stasi10,
  15. Michael P Reiman11,
  16. Michael Drew12,
  17. Daniel Friedman13,
  18. Kristian Thorborg6,
  19. Michael Leunig14,
  20. Mario Bizzini15,
  21. Karim M Khan16,
  22. Kay M Crossley1,
  23. Rintje Agricola17,
  24. Nancy Bloom18,19,
  25. Hendrik Paul Dijkstra20,21,
  26. Damian Griffin22,23,
  27. Boris Gojanovic24,
  28. Marcie Harris-Hayes18,19,
  29. Joshua J Heerey1,
  30. Per Hölmich6,
  31. Franco M Impellizzeri25,
  32. Ara Kassarjian26,
  33. Kristian Marstrand Warholm27,
  34. Sue Mayes1,28,
  35. Håvard Moksnes29,
  36. May Arna Risberg30,31,
  37. Mark J Scholes1,
  38. Andreas Serner20,
  39. Pim van Klij17,
  40. Cara L Lewis32
  1. 1 La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
  2. 2 School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia
  3. 3 Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
  4. 4 Laboratory of Exercise and Health, ETH, Zurich, Switzerland
  5. 5 Department of Health Sciences, Lund University, Lund, Sweden
  6. 6 Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
  7. 7 Department of Health Sciences, Lund University, Lunds, Sweden
  8. 8 Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland Griffith University, School of Allied Health Sciences, Gold Coast, Queensland, Australia
  9. 9 Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  10. 10 Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA
  11. 11 Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
  12. 12 University of Canberra Research into Sport and Exercise (UCRISE), University of Canberra, Canberra, Australian Capital Territory, Australia
  13. 13 Monash School of Medicine, Melbourne, Victoria, Australia
  14. 14 Department of Orthopaedics, Schulthess Klinik, Zürich, Switzerland
  15. 15 Schulthess Clinic Human Performance Lab, Zurich, Switzerland
  16. 16 Family Practice and Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
  17. 17 Department of Orthopaedic Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
  18. 18 Physical Therapy, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
  19. 19 Orthopaedic Surgery, Washington University School of Medicine in St Louis, Saint Louis, Missouri, USA
  20. 20 ASPETAR Orthopedic and Sports Medicine Hospital, Doha, Qatar
  21. 21 Department of Continuing Education, University of Oxford, Oxford, UK
  22. 22 Warwick Orthopaedics, University of Warwick, Coventry, UK
  23. 23 Warwick Medical School, University of Warwick, Coventry, UK
  24. 24 Sports Medicine, SportAdo consultation, University Hospital of Lausanne (CHUV) Multidisciplinary Unit of Adolescent Health, Lausanne, Switzerland
  25. 25 Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
  26. 26 Elite Sports Imaging, SL, Madrid, Spain
  27. 27 Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
  28. 28 The Australian Ballet, Southbank, Victoria, Australia
  29. 29 Oslo Sports Trauma Research Center, Oslo, Norway
  30. 30 Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  31. 31 Division of Orthopedic Surgery, Oslo University Hospital, Oslos, Norway
  32. 32 Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
  1. Correspondence to Dr Andrea Britt Mosler, La Trobe Sport and Exercise Medicine Research Centre, La Trobe University College of Science Health and Engineering, Bundoora, VIC 3086, Australia; abmosler{at}


Hip-related pain can significantly impact quality of life, function, work capacity, physical activity and family life. Standardised measurement methods of physical capacity of relevance to young and middle-aged active adults with hip-related pain are currently not established. The aim of this consensus paper was to provide recommendations for clinical practice and research on standardised measurement methods of physical capacity in young and middle-aged active adults with hip-related pain. Four areas of importance were identified: (1) clinical measures (range of motion, muscle strength, functional impairments), (2) laboratory-based measures (biomechanics and muscle function (muscle activity, size and adiposity)), (3) physical activity, and (4) return to sport/performance. The literature was reviewed, and a summary circulated to the working group to inform discussion at the consensus meeting. The working group developed clinical and research recommendations from the literature review, which were further discussed and modified within the working group at the consensus meeting. These recommendations were then presented to all 38 International Hip-related Pain Research Network (IHiPRN) participants for further discussion, refinement and consensus voting. Therefore, the recommendations voted on were based on a combination of current evidence and expert opinion. The consensus meeting voted on 13 recommendations, six of which were clinically orientated, and seven more research specific. We recommended that clinicians working with young and middle-aged active adults with hip-related pain assess strength using objective methods of measurement, and clinically assess performance of functional tasks, including walking and running. Physical activity should be quantified using both self-reported and objective measures, and patient expectations of recovery should be quantified prior to treatment. It was recommended that return to physical activity (including sport and occupation) be quantified, and sport-specific activities should be assessed prior to return to sport. The IHiPRN participants were uncertain regarding recommendations for range of motion assessment. Research recommendations were that the measurement properties of range of motion, strength and functional performance tests be investigated, reported and improved in both clinical and research settings. Reporting of movement-related parameters (biomechanics and muscle function) should be standardised and the relationship among movement-related parameters, symptoms, function, quality of life, and intra-articular and imaging findings should be investigated. Quantification of return to physical activity (including sport and occupational demands) is required in future research, and the return to sport continuum should be used. Future research is required to determine the best criteria for rehabilitation progression and return to physical activity following hip-related pain management.

  • Groin
  • Consensus statement
  • Strength
  • Biomechanics
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  • Correction notice This article has been corrected since it published Online First. The author details have been amended.

  • Contributors All authors were fully involved in the preparation and completion of the manuscript. Each author has read and concurs with the content in this manuscript. This material has not and will not be submitted for publication elsewhere.

  • Funding ABM is supported by NHMRC (Australia; ECF 1156674).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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