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Physiotherapist-led treatment for young to middle-aged active adults with hip-related pain: consensus recommendations from the International Hip-related Pain Research Network, Zurich 2018
  1. Joanne L Kemp1,
  2. May Arna Risberg2,
  3. Andrea Mosler3,
  4. Marcie Harris-Hayes4,5,
  5. Andreas Serner6,
  6. Håvard Moksnes7,
  7. Nancy Bloom8,
  8. Kay M Crossley9,
  9. Boris Gojanovic10,11,
  10. Michael A Hunt12,
  11. Lasse Ishøi13,
  12. Nicolas Mathieu14,
  13. Sue Mayes15,
  14. Mark James Scholes16,
  15. Mo Gimpel17,
  16. Daniel Friedman18,
  17. Eva Ageberg19,
  18. Rintje Agricola20,
  19. Nicola C Casartelli21,
  20. Laura E Diamond22,
  21. Hendrik Dijkstra23,
  22. Stephanie Di Stasi24,
  23. Michael Drew25,26,
  24. Matthew Freke27,
  25. Damian Griffin28,
  26. Joshua James Heerey29,30,
  27. Per Hölmich31,
  28. Franco M Impellizzeri32,
  29. Denise M Jones33,
  30. Ara Kassarjian34,35,
  31. Karim M Khan36,
  32. Matthew G King37,
  33. Peter R Lawrenson38,
  34. Michael Leunig39,
  35. Cara L Lewis40,
  36. Kristian Marstrand Warholm41,
  37. Michael P Reiman42,
  38. Adam Semciw43,
  39. Kristian Thorborg31,
  40. Pim van Klij44,
  41. Tobias Wörner45,
  42. Mario Bizzini46
  1. 1La Trobe Sports Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
  2. 2Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  3. 3La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
  4. 4Physical Therapy, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
  5. 5Orthopaedic Surgery, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
  6. 6Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  7. 7Oslo Sports Trauma Research Center, Oslo, Norway
  8. 8Physical Therapy, Washington University, St. Louis, Missouri, USA
  9. 9La Trobe University—Bundoora Campus, Bundoora, Victoria, Australia
  10. 10Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Geneva, Switzerland
  11. 11Sports Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  12. 12Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  13. 13Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center-Copenhagen (SORC-C), Hvidovre, Denmark
  14. 14Physiotherapy, HES-SO Valais, University of Applied Sciences Western Switzerland, Leukerbad, Valais, Switzerland
  15. 15Medical, The Australian Ballet, Southbank, Victoria, Australia
  16. 16La Trobe Sports Exercise Medicine Research Centre, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
  17. 17Performance Science, Southampton Football Club, Southampton, Hampshire, UK
  18. 18Monash School of Medicine, Monash University, Melbourne, Victoria, Australia
  19. 19Sport Sciences, Health Sciences, Lund, Sweden
  20. 20Orthopaedics, Erasmus Medical Centre, Rotterdam, Netherlands
  21. 21Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
  22. 22School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
  23. 23Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
  24. 24Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  25. 25Department of Physiotherapy, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
  26. 26Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
  27. 27School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
  28. 28Warwick Orthopaedics, University of Warwick, Coventry, Warwick, UK
  29. 29La Trobe University Sports and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
  30. 30Latrobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
  31. 31Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
  32. 32Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
  33. 33La Trobe Sport and Exercise Medicine Research Centre, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
  34. 34Musculoskeletal Radiology, Corades, LLC, Brookline, Massachusetts, USA
  35. 35Musculoskeletal Radiology, Corades LLC, Majadahonda, Madrid, Spain
  36. 36Family Practice & Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
  37. 37Rehabilitation, Nutrition and Sport, La Trobe University, Bundoora, Victoria, Australia
  38. 38School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia
  39. 39Department of Orthopaedics, Schulthess Klinik, Zurich, Switzerland
  40. 40Physical Therapy & Athletic Training, Boston University, Boston, Massachusetts, USA
  41. 41Ortopeadic Surgery, Oslo University Hospital, Oslo, Norway
  42. 42Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
  43. 43La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
  44. 44Department of Orthopaedic Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
  45. 45Lunds Universitet, Lund, Sweden
  46. 46Research Department, FIFA Medical Assessment and Research Centre (F-MARC), Zurich, Switzerland
  1. Correspondence to Dr Joanne L Kemp, La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Vic, Australia; j.kemp{at}latrobe.edu.au

Abstract

The 1st International Hip-related Pain Research Network meeting discussed four prioritised themes concerning hip-related pain in young to middle-aged adults: (1) diagnosis and classification of hip-related pain; (2) patient-reported outcome measures for hip-related pain; (3) measurement of physical capacity for hip-related pain; (4) physiotherapist-led treatment for hip-related pain. Thirty-eight expert researchers and clinicians working in the field of hip-related pain attended the meeting. This manuscript relates to the theme of physiotherapist-led treatments for hip-related pain. A systematic review on the efficacy of physiotherapist-led interventions for hip-related pain (published separately) was conducted and found that strong evidence for physiotherapist-led treatments was lacking. Prior to the meeting, draft consensus recommendations for consideration in the meeting were also developed based on the systematic review. The draft consensus recommendations were presented to all of the meeting participants via email, at least 1 week prior to the meeting. At the meeting, these recommendations were discussed, revised and voted on. Six recommendations for clinical practice and five recommendations for research were included and all gained consensus. Recommendations for clinical practice were that (i) Exercise-based treatments are recommended for people with hip-related pain. (ii) Exercise-based treatment should be at least 3 months duration. (iii) Physiotherapist-led rehabilitation after hip surgery should be undertaken. (iv) Patient-reported outcome measures, measures of physical impairment and measures of psychosocial factors should be used to monitor response to treatment. (v) Physical activity (that may include sport) is recommended for people with hip-related pain. (vi) Clinicians should discuss patient expectations, use shared-decision making and provide education. Recommendations for research were (i) Reporting of exercise programmes: Exercise descriptors such as load magnitude, number of repetitions and sets, duration of whole programme, duration of contractile element of exercise, duration of one repetition, time under tension, rest between repetitions, range of motion through which the exercise is performed, and rest between exercise sessions should be reported. (ii) Research should investigate the optimal frequency, intensity, time, type, volume and progression of exercise therapy. (iii) Research should examine the effect of patient education in people with hip-related pain. (iv) Research should investigate the effect of other treatments used in people with hip-related pain (for example: manual therapy, medications, injections). (v) Research should examine the impact of comorbidities and social determinants on treatment effectiveness in people with hip-related pain. Clinicians and researchers working with young to middle-aged active adults with hip-related pain may use these consensus recommendations to guide, develop, test and implement individualised, evidence-based physiotherapist-led rehabilitation programmes.

  • hip
  • physiotherapy
  • consensus statement
  • exercise
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Footnotes

  • Twitter @JoanneLKemp, @AndreaBMosler, @MHarrisHayes, @aserner, @HMoksnes, @drsportsante, @LasseIshoei, @MarkScholes85, @MoGimpel, @ddfriedman, @EvaAgeberg, @RintjeAgricola, @NicCasartelli, @lauradiamond05, @_mickdrew, @DamianGriffin, @JHeerey, @francoimpell, @mattgmking1, @ProfCaraLewis, @MikeReiman, @ASemciw, @KThorborg, @Wuninho

  • Contributors The concept was developed by JK, AM, KMC, KMK, CLL and MB. All authors contributed to the material presented and approved the final version of the manuscript.

  • Funding Dr Kemp is supported by an NHMRC (Australia) ECF 1119971.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available on request

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