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UBC Theses and Dissertations

Clinical and biomechanical changes following a pre-operative muscle strengthening intervention for people with femoroacetabular impingement Guenther, Jerrad


Introduction: Femoroacetabular impingement (FAI) is a pathomechanical process of the hip joint that has been linked to the early development of hip osteoarthritis. FAI morphology usually progresses gradually and can limit the ability of individuals to engage in sports and causes pain during activities of daily living. These impairments can lead to loss of range of motion, muscle weakness and altered walking biomechanics. Currently, surgery is the common treatment, however little is known about the effects of muscle strengthening in this population. Based on the results of similar programs in other pathologies, muscle strengthening may alleviate this muscle weakness and hip pain. Our goal was to investigate the effects of a pre-surgical hip muscle strengthening intervention on hip strength, pain and function in those with FAI. Methods: This was a within subject, pre-test – post-test intervention study examining the effects of a 10-week hip muscle strengthening program in 20 individuals (18 males) with FAI before hip surgery. Clinical outcomes including maximum isometric hip strength, hip pain and physical function were collected before and after the strengthening intervention. During the intervention, participants progressed through three phases of increasing resistance and functionality as they received a bilateral hip strengthening program consisting of 4-6 exercises per phase. Results: Maximum isometric hip strength significantly increased in abduction (p=0.008), adduction (p=0.021) and internal rotation (p=0.006) at follow-up. Flexion, extension and external rotation strength changes did not reach significance. Self-reported HOOS pain subscale scores (p<0.01), HOOS ADL scores (p<0.01) and NRS pain scores (p<0.001) significantly improved at follow-up. Objective function measured by the Timed Stair Climb (p<0.001) also significantly improved at follow-up. Conclusion: Findings from this study showed that a 10-week hip muscle strengthening program could be safely completed by adults with FAI and that statistically significant changes in clinical and biomechanical outcomes were achieved. Findings of this study can improve our understanding of FAI and may be useful for clinicians for preventive, treatment and maintenance purposes.

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