PT  - JOURNAL ARTICLE
AU  - Enda King
AU  - Andrew Franklyn-Miller
AU  - Chris Richter
AU  - Eamon O’Reilly
AU  - Mark Doolan
AU  - Kieran Moran
AU  - Siobhan Strike
AU  - Éanna Falvey
TI  - Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients
AID  - 10.1136/bjsports-2016-097089
DP  - 2018 Aug 01
TA  - British Journal of Sports Medicine
PG  - 1054--1062
VI  - 52
IP  - 16
4099  - http://bjsm.bmj.com/content/52/16/1054.short
4100  - http://bjsm.bmj.com/content/52/16/1054.full
SO  - Br J Sports Med2018 Aug 01; 52
AB  - Background Clinical assessments and rehabilitation in athletic groin pain (AGP) have focused on specific anatomical structures and uniplanar impairments rather than whole body movement.Objective To examine the effectiveness of rehabilitation that targeted intersegmental control in patients with AGP and to investigate post rehabilitation changes in cutting biomechanics.Methods Two hundred and five patients with AGP were rehabilitated focusing on clinical assessment of intersegmental control, linear running and change of direction mechanics in this prospective case series. Hip and Groin Outcome Score (HAGOS) was the primary outcome measure. Secondary measures included pain-free return to play rates and times, pain provocation on squeeze tests and three-dimensional (3D) biomechanical analysis during a 110° cutting manoeuvre.Results Following rehabilitation, patients demonstrated clinically relevant improvements in HAGOS scores (effect size (ES): 0.6–1.7). 73% of patients returned to play pain-free at a mean of 9.9 weeks (±3.5). Squeeze test values also improved (ES: 0.49–0.68). Repeat 3D analysis of the cutting movement demonstrated reductions in ipsilateral trunk side flexion (ES: 0.79) and increased pelvic rotation in the direction of travel (ES: 0.76). Changes to variables associated with improved cutting performance: greater centre of mass translation in the direction of travel relative to centre of pressure (ES: 0.4), reduced knee flexion angle (ES: 0.3) and increased ankle plantar flexor moment (ES: 0.48) were also noted.Conclusions Rehabilitation focused on intersegmental control was associated with improved HAGOS scores, high rates of pain-free return to sporting participation and biomechanical changes associated with improved cutting performance across a range of anatomical diagnoses seen in AGP.