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10. Stratified care in hip arthroscopy:can we predict successful and unsuccessful outcomes? Development and external temporal validation of multivariable prediction models

Author

Ishøi, Lasse, Thorborg, Kristian, Kallemose, Thomas, Kemp, Joanne L., Reiman, Michael P., Nielsen, Mathias Fabricius, Hölmich, Per, Ishøi, Lasse, Thorborg, Kristian, Kallemose, Thomas, Kemp, Joanne L., Reiman, Michael P., Nielsen, Mathias Fabricius, and Hölmich, Per

Abstract

Objective Although hip arthroscopy is a widely adopted treatment option for hip-related pain, it is unknown whether preoperative clinical information can be used to assist surgical decision-making to avoid offering surgery to patients with limited potential for a successful outcome. We aimed to develop and validate clinical prediction models to identify patients more likely to have an unsuccessful or successful outcome 1 year post hip arthroscopy based on the patient acceptable symptom state. Methods Patient records were extracted from the Danish Hip Arthroscopy Registry (DHAR). A priori, 26 common clinical variables from DHAR were selected as prognostic factors, including demographics, radiographic parameters of hip morphology and self-reported measures. We used 1082 hip arthroscopy patients (surgery performed 25 April 2012 to 4 October 2017) to develop the clinical prediction models based on logistic regression analyses. The development models were internally validated using bootstrapping and shrinkage before temporal external validation was performed using 464 hip arthroscopy patients (surgery performed 5 October 2017 to 13 May 2019). Results The prediction model for unsuccessful outcomes showed best and acceptable predictive performance on the external validation dataset for all multiple imputations (Nagelkerke R 2 range: 0.25-0.26) and calibration (intercept range: -0.10 to -0.11; slope range: 1.06-1.09), and acceptable discrimination (area under the curve range: 0.76-0.77). The prediction model for successful outcomes did not calibrate well, while also showing poor discrimination. Conclusion Common clinical variables including demographics, radiographic parameters of hip morphology and self-reported measures were able to predict the probability of having an unsuccessful outcome 1 year after hip arthroscopy, while the model for successful outcome showed unacceptable accuracy. The externally validated prediction model can be used to support clinical evaluatio

Published
2023

12. Contributors

Author

Altchek, David W., primary, Angeline, Michael, additional, Ashton, Jeff, additional, Bennett, Jolene, additional, Besselink, Allan, additional, Bhatia, Sanjeev, additional, Bolgla, Lori A., additional, Brotzman, S. Brent, additional, Brumitt, Jason, additional, Butler, David S., additional, Camarillo, R. Matthew, additional, Casillas, Mark M., additional, Clark, Bridget, additional, Caughran, Alexander T., additional, D’Amato, Michael, additional, Davies, George J., additional, Duke, Michael, additional, Durall, Christopher J., additional, Ellenbecker, Todd S., additional, Farr, Brian K., additional, Field, Larry D., additional, Fitzgerald, G. Kelley, additional, Frank, Rachel M., additional, Garabekyan, Tigran, additional, Ghodadra, Neil S., additional, Giangarra, Charles E., additional, Gilliland, Charles Andrew, additional, Guido, John A., additional, Hardin, J. Allen, additional, Hardy, Maureen A., additional, Hewett, Timothy E., additional, Holmes, Clayton F., additional, Hoogenboom, Barbara J., additional, Irrgang, James J., additional, Jacobs, Margaret, additional, Jadgchew, R. Jason, additional, James, David A., additional, Jasko, John J., additional, Jenk, Drew, additional, Kibler, W. Ben, additional, Kidd, Theresa M., additional, Kiesel, Kyle, additional, Kim, Jonathan Yong, additional, Lawrance, Scott E., additional, Levinson, Michael, additional, Lodha, Sameer, additional, Loudon, Janice K., additional, Louw, Adriaan, additional, Lynch, Joseph R., additional, Manske, Robert C., additional, Matava, Matthew J., additional, Mazloom, Sean, additional, McMullen, John, additional, Meftah, Morteza, additional, Meira, Erik P., additional, Meister, Keith, additional, Miller, Scott T., additional, Moore, Josef H., additional, Nguyen, Donald, additional, Nigrini, Cullen M., additional, Novotny, Steven R., additional, O’Brien, Michael J., additional, Ozgur, Sinan Emre, additional, Paterno, Mark V., additional, Pitts, Ryan T., additional, Pontillo, Marisa, additional, Porter, Andrew S.T., additional, Powell, Christie C.P., additional, Prohaska, Daniel, additional, Provencher, Matthew T., additional, Puentedura, Emilio “Louie”, additional, Ranawat, Amar S., additional, Ranawat, Anil S., additional, Reagan, James T., additional, Reider, Bruce, additional, Reiman, Michael P., additional, Resler, Amy G., additional, Riemann, Bryan, additional, Rogers, Toby, additional, Romeo, Anthony A., additional, Romeyn, Richard, additional, Rosenthal, Michael D., additional, Savoie, Felix H., additional, Schroeder, Suzanne Zadra, additional, Sciascia, Aaron, additional, Shelbourne, K. Donald, additional, Smith, Jace R., additional, Southard, Damien, additional, Stephenson, Ken, additional, Stevens, Faustin R., additional, Stovak, Mark, additional, Tyler, Timothy F., additional, Van Thiel, Geoffrey S., additional, Wagner, Mark, additional, Wilcox, Reg B., additional, and Woods, Daniel, additional

Published
2018
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26. Effects of dynamic warm-up with and without a weighted vest on lower extremity power performance of high school male athletes

Author

Reiman, Michael P., Peintner, Ashley M., Boehner, Amber L., Cameron, Cori N., Murphy, Jessica R., and Carter, John W.

Subjects
Teenage athletes -- Health aspects, Teenage athletes -- Physiological aspects, Stretching exercises -- Health aspects, Stretching exercises -- Demographic aspects, Stretching exercises -- Equipment and supplies, Muscle strength -- Health aspects, Extremities (Anatomy) -- Health aspects, Health, Sports and fitness
Abstract

Reiman, MP, Peintner, AM, Boehner, AL, Cameron, CN, Murphy, JR, and Carter, JW. Effects of dynamic warm-up with and without a weighted vest on lower extremity power performance of high school male athletes. J Strength Cond Res 24(12): 3387-3395, 2010--This study examined lower extremity power performance, using the Margaria-Kalamen Power Test, after a dynamic warm-up with (resisted) and without (nonresisted) a weighted vest. Sixteen (n = 16) high school male football players, ages 14-18 years, participated in 2 randomly ordered testing sessions. One session involved performing the team's standard dynamic warm-up while wearing a vest weighted at 5% of the individual athlete's body weight before performing 3 trials of the Margaria-Kalamen Power Test. The second session involved performing the same dynamic warm-up without wearing a weighted vest before performing 3 trials of the Margaria-Kalamen Power Test. The warm-up performed by the athletes consisted of various lower extremity dynamic movements over a 5-minute period. No significant difference was found in power performance between the resisted and nonresisted dynamic warm-up protocols (p > 0.05). The use of a dynamic warm-up with a vest weighted at 5% of the athlete's body weight was not advantageous for increasing lower extremity power output in this study. The results of this study suggest that resisted dynamic warm-up protocols may not augment the production of power performance in high school football players. KEY WORDS anaerobic performance, resisted warm-up, football, postactivation, potentiation, Margaria-Kalamen Power Test

Published
2010

27. Reliability of alternative trunk endurance testing procedures using clinician stabilization vs. traditional methods

Author

Reiman, Michael P., Krier, Amber D., Nelson, Julie A., Rogers, Michael A., Stuke, Zachariah O., and Smith, Barbara S.

Subjects
Strengthening exercises -- Research, Health, Sports and fitness
Abstract

The purpose of this study was to determine if a modified (MOD) testing method for previously established trunk endurance testing for flexion and extension is a reliable alternative. Fifty subjects were tested with the standard (ST) testing procedure and an MOD testing procedure on separate testing occasions 1 week apart. The testing procedure order and method of assessments were randomly selected and implemented. The MOD testing procedure used a clinician to provide stabilization as opposed to the ST method of belt stabilization. Interrater reliability for MOD procedures was 0.97 for extension and 0.93 for flexion. Correlation of the MOD procedure to the ST procedure was found to be 0.90 and 0.84 for extension and flexion, respectively. From this testing, it can be concluded in a sample of normal college-aged subjects that an MOD testing method for trunk flexion and extension endurance can reliably be used as compared with the previously accepted ST testing methods. From a practical application standpoint, this allows the use of an MOD testing procedure to be implemented in athletic training rooms and weight rooms that may not have appropriate tables for the ST testing and the fact that the MOD testing procedure will most likely require less time commitment and greater efficiency with testing of large groups of subjects. KEY WORDS upper torso, trunk flexion, trunk extension

Published
2010

30. Maximal hip muscle strength and rate of torque development 6–30 months after hip arthroscopy for femoroacetabular impingement syndrome:A cross-sectional study

Author

Ishøi, Lasse, Thorborg, Kristian, Kemp, Joanne L., Reiman, Michael P., Hölmich, Per, Ishøi, Lasse, Thorborg, Kristian, Kemp, Joanne L., Reiman, Michael P., and Hölmich, Per

Abstract

Objectives: Reduced sports function is often observed after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Impaired muscle strength could be reasons for this. We aimed to investigate hip muscle strength after hip arthroscopy for FAIS and its association with sports function and participation. Design: Cross-sectional study. Methods: We included 45 patients (34 males; mean age: 30.6 ± 5.9 years) after unilateral hip arthroscopy for FAIS (mean follow-up [range]: 19.3 [9.8–28.4] months). Maximal isometric hip muscle strength (Nm/kg) including early- (0–100 ms) and late-phase (0–200 ms) rate of torque development (Nm∗kg−1∗s−1) for adduction, abduction, flexion, and extension was measured with an externally fixated handheld dynamometer and compared between operated and non-operated hip. Associations between muscle strength and self-reported sports function and return to sport were investigated. Results: For maximal hip muscle strength, no between-hip differences were observed for adduction, abduction, flexion, and extension (p ≥ 0.102). For rate of torque development, significantly lower values were observed for the operated hip in flexion at both 0–100 ms (mean difference: 1.58 Nm∗kg−1∗s−1, 95% CI [0.39; 2.77], p = 0.01) and 0–200 ms (mean difference: 0.72 Nm∗kg−1∗s−1, 95% CI [0.09; 1.35], p = 0.027). Higher maximal hip extension strength was significantly associated with greater ability to participate fully in preinjury sport at preinjury level (odds ratio: 17.71 95% CI [1.77; 177.60]). Conclusions: After hip arthroscopy for FAIS subjects show limited impairments in maximal and explosive hip muscle strength between operated and non-operated hip. Higher muscle strength was positively associated with higher sports function and ability to participate in sport.

Published
2021

31. Infographic. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018

Author

Reiman, Michael P., Agricola, Rintje, Kemp, Joanne L., Heerey, Joshua J., Weir, Adam, Van Klij, Pim, Kassarjian, Ara, Mosler, Andrea B., Ageberg, Eva, Hölmich, Per, Warholm, Kristian Marstrand, Griffin, Damian, Mayes, Sue, Khan, Karim M., Crossley, Kay M., Bizzini, Mario, Bloom, Nancy, Casartelli, Nicola C., Diamond, Laura E., Di Stasi, Stephanie, Drew, Michael, Friedman, Daniel J., Freke, Matthew, Glyn-Jones, Sion, Gojanovic, Boris, Harris-Hayes, Marcie, Hunt, Michael A., Impellizzeri, Franco M., Ishøi, Lasse, Jones, Denise M., King, Matthew G., Lawrenson, Peter R., Leunig, Michael, Lewis, Cara L., Mathieu, Nicolas, Moksnes, Håvard, Risberg, May Arna, Scholes, Mark J., Semciw, Adam I., Serner, Andreas, Thorborg, Kristian, Virgile, Adam, Wörner, Tobias, Dijkstra, H. Paul, Reiman, Michael P., Agricola, Rintje, Kemp, Joanne L., Heerey, Joshua J., Weir, Adam, Van Klij, Pim, Kassarjian, Ara, Mosler, Andrea B., Ageberg, Eva, Hölmich, Per, Warholm, Kristian Marstrand, Griffin, Damian, Mayes, Sue, Khan, Karim M., Crossley, Kay M., Bizzini, Mario, Bloom, Nancy, Casartelli, Nicola C., Diamond, Laura E., Di Stasi, Stephanie, Drew, Michael, Friedman, Daniel J., Freke, Matthew, Glyn-Jones, Sion, Gojanovic, Boris, Harris-Hayes, Marcie, Hunt, Michael A., Impellizzeri, Franco M., Ishøi, Lasse, Jones, Denise M., King, Matthew G., Lawrenson, Peter R., Leunig, Michael, Lewis, Cara L., Mathieu, Nicolas, Moksnes, Håvard, Risberg, May Arna, Scholes, Mark J., Semciw, Adam I., Serner, Andreas, Thorborg, Kristian, Virgile, Adam, Wörner, Tobias, and Dijkstra, H. Paul

Published
2021

32. How Many Patients Achieve an Acceptable Symptom State After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Cross-sectional Study Including PASS Cutoff Values for the HAGOS and iHOT-33

Author

Ishøi, Lasse, Thorborg, Kristian, Ørum, Marie G., Kemp, Joanne L., Reiman, Michael P., Hölmich, Per, Ishøi, Lasse, Thorborg, Kristian, Ørum, Marie G., Kemp, Joanne L., Reiman, Michael P., and Hölmich, Per

Abstract

Background: Hip arthroscopy is a viable treatment for femoroacetabular impingement syndrome (FAIS). Clinically relevant improvements in hip function and pain after surgery are often reported, but it is less clear how many patients achieve an acceptable symptom state (Patient Acceptable Symptom State [PASS]). Purpose: To investigate the proportion of patients who achieved a PASS 12 to 24 months after hip arthroscopy and to determine the cutoff scores of the 2 recommended and valid patient-reported outcome measures (the subscales of the Copenhagen Hip and Groin Outcome Score [HAGOS] and the International Hip Outcome Tool—33 [iHOT-33]) for which patients are most likely to achieve PASS. Study Design: Cohort study; Level of evidence, 3. Methods: Eligible study patients were identified in the Danish Hip Arthroscopy Registry. An electronic questionnaire was used to collect data on PASS, HAGOS, and iHOT-33 12 to 24 months after surgery. PASS was measured using an anchor question. Receiver operating characteristic curve analyses were applied to identify the PASS cutoff values of HAGOS and iHOT-33 scores. Results: A total of 137 individuals (mean age at surgery, 35.4 ± 9.4 years) were included in the study at a mean follow-up of 18.5 ± 3.2 months after surgery. At follow-up, 64 individuals (46.7%; 95% CI, 38.6-55.1) reported PASS. Higher HAGOS and iHOT-33 values were observed for participants who reported PASS compared with those who did not report PASS (Cohen d ≥ 1.06; P <.001). Cutoff scores for HAGOS subscales (42.5-82.5) and iHOT-33 (67.00) showed excellent to outstanding discriminative ability in predicting PASS (area under the curve, 0.82-0.92). Conclusion: In total, 46% of individuals having hip arthroscopy for FAIS achieved PASS at 12 to 24 months of follow-up. Patients who achieved PASS had statistically significant and substantially better self-reported hip function compared with those who did not achieve PASS. Cutoff values at HAGOS subscales and iHOT-33 sho

Published
2021

36. Nonoperative and operative management of snapping scapula

Author

Manske, Robert C., Reiman, Michael P., and Stovak, Mark L.

Subjects
Athletes -- Injuries, Athletes -- Care and treatment, Scapula -- Injuries, Scapula -- Care and treatment, Health, Sports and fitness
Published
2004

39. Contributors

Author

Altchek, David W., primary, Angeline, Michael, additional, Bennett, Jolene, additional, Besselink, Allan, additional, Bhatia, Sanjeev, additional, Bolgla, Lori A., additional, Brewington, Dana C., additional, Brotzman, S. Brent, additional, Brumitt, Jason, additional, Burchill, Gae, additional, Butler, David S., additional, Callamaro, Donna Ryan, additional, Camarillo, R. Matthew, additional, Casillas, Mark M., additional, Clark, Bridget, additional, Cox, Kara, additional, D'Amato, Michael, additional, Davies, George J., additional, Duke, Michael, additional, Durall, Christopher J., additional, Ellenbecker, Todd S., additional, Farr, Brian K., additional, Field, Larry D., additional, Fitzgerald, G. Kelley, additional, Frank, Rachel M., additional, Garabekyan, Tigran, additional, Ghodadra, Neil S., additional, Giangarra, Charles E., additional, Guido, John A., additional, Hardin, J. Allen, additional, Hardy, Maureen A., additional, Hewett, Timothy E., additional, Holmes, Clayton F., additional, Hoogenboom, Barbara J., additional, Irrgang, James J., additional, Jacobs, Margaret, additional, Jadgchew, R. Jason, additional, James, David A., additional, Jenk, Drew, additional, Johnson, Derrick, additional, Jupiter, Jesse B., additional, Kibler, W. Ben, additional, Kidd, Theresa M., additional, Kiesel, Kyle, additional, Kim, Jonathan Yong, additional, Lawrance, Scott E., additional, Levinson, Michael, additional, Lodha, Sameer, additional, Loudon, Janice K., additional, Louw, Adriaan, additional, Manske, Robert C., additional, Matava, Matthew J., additional, Mazloom, Sean, additional, McMullen, John, additional, Meftah, Morteza, additional, Meira, Erik P., additional, Meister, Keith, additional, Miller, Scott T., additional, Nguyen, Donald, additional, Nigrini, Cullen M., additional, O'Brien, Michael J., additional, Paterno, Mark V., additional, Pitts, Ryan T., additional, Pontillo, Marisa, additional, Porter, Andrew S.T., additional, Powell, Christie C.P., additional, Provencher, Matthew T., additional, Puentedura, Emilio “Louie”, additional, Ranawat, Amar S., additional, Ranawat, Anil S., additional, Reider, Bruce, additional, Reiman, Michael P., additional, Resler, Amy G., additional, Ring, David, additional, Rogers, Toby, additional, Romeo, Anthony A., additional, Romeyn, Richard, additional, Savoie, Felix H., additional, Schroeder, Suzanne Zadra, additional, Sciascia, Aaron, additional, Shelbourne, K. Donald, additional, Stephenson, Ken, additional, Stevens, Faustin R., additional, Stovak, Mark, additional, Tyler, Timothy F., additional, Van Thiel, Geoffrey S., additional, Wagner, Mark, additional, Wilcox, Reg B., additional, and Woods, Daniel, additional

Published
2011
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43. Infographic. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018

Author

Reiman, Michael P, primary, Agricola, Rintje, additional, Kemp, Joanne L, additional, Heerey, Joshua J, additional, Weir, Adam, additional, van Klij, Pim, additional, Kassarjian, Ara, additional, Mosler, Andrea B, additional, Ageberg, Eva, additional, Hölmich, Per, additional, Warholm, Kristian Marstrand, additional, Griffin, Damian, additional, Mayes, Sue, additional, Khan, Karim M, additional, Crossley, Kay M, additional, Bizzini, Mario, additional, Bloom, Nancy, additional, Casartelli, Nicola C, additional, Diamond, Laura E, additional, Di Stasi, Stephanie, additional, Drew, Michael, additional, Friedman, Daniel J, additional, Freke, Matthew, additional, Glyn-Jones, Sion, additional, Gojanovic, Boris, additional, Harris-Hayes, Marcie, additional, Hunt, Michael A, additional, Impellizzeri, Franco M, additional, Ishøi, Lasse, additional, Jones, Denise M, additional, King, Matthew G, additional, Lawrenson, Peter R, additional, Leunig, Michael, additional, Lewis, Cara L, additional, Mathieu, Nicolas, additional, Moksnes, Håvard, additional, Risberg, May Arna, additional, Scholes, Mark J, additional, Semciw, Adam I, additional, Serner, Andreas, additional, Thorborg, Kristian, additional, Virgile, Adam, additional, Wörner, Tobias, additional, and Dijkstra, H Paul, additional

Published
2020
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46. Patient-reported outcome measures for hip-related pain: a review of the available evidence and a consensus statement from the International Hip-related Pain Research Network, Zurich 2018

Author

Impellizzeri, Franco M, primary, Jones, Denise M, additional, Griffin, Damian, additional, Harris-Hayes, Marcie, additional, Thorborg, Kristian, additional, Crossley, Kay M, additional, Reiman, Michael P, additional, Scholes, Mark James, additional, Ageberg, Eva, additional, Agricola, Rintje, additional, Bizzini, Mario, additional, Bloom, Nancy, additional, Casartelli, Nicola C, additional, Diamond, Laura E, additional, Dijkstra, Hendrik Paulus, additional, Di Stasi, Stephanie, additional, Drew, Michael, additional, Friedman, Daniel Jonah, additional, Freke, Matthew, additional, Gojanovic, Boris, additional, Heerey, Joshua J, additional, Hölmich, Per, additional, Hunt, Michael A, additional, Ishøi, Lasse, additional, Kassarjian, Ara, additional, King, Matthew, additional, Lawrenson, Peter R, additional, Leunig, Michael, additional, Lewis, Cara L, additional, Warholm, Kristian Marstrand, additional, Mayes, Sue, additional, Moksnes, Håvard, additional, Mosler, Andrea Britt, additional, Risberg, May Arna, additional, Semciw, Adam, additional, Serner, Andreas, additional, van Klij, Pim, additional, Wörner, Tobias, additional, and Kemp, Joanne, additional

Published
2020
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47. Contributors

Author

Allen, Diane D., primary, Bookstein, Nancey A., additional, Cahalin, Lawrence P., additional, Chiarello, Cynthia, additional, Clayton-Krasinski, Debra, additional, Bello-Haas, Vanina Dal, additional, Dekerlegand, Jennifer, additional, Dekerlegand, Robert L., additional, Durall, Christopher J., additional, Dutton, Lisa L., additional, Edelstein, Joan E., additional, Elokda, Ahmed Samir, additional, Everix, Donna K., additional, Fieback, Linda, additional, Gibson, Ginny, additional, Grieve, Susan, additional, Hamm, Rose Little, additional, Helgeson, Kevin, additional, Ibrahim, Mohamed, additional, Iwasaki, Debra H., additional, Klepper, Susan, additional, Lepak, L. Vince, additional, Manske, Robert C., additional, Merrell, Victoria, additional, Mets, Tom, additional, Paterson, Martha, additional, Perme, Christiane, additional, Peterson, Brian K., additional, Pryde, Julie A., additional, Quinn, Lori, additional, Reiman, Michael P., additional, Scarborough, Pamela, additional, Selinger, Amy, additional, Spangler, Lynda L., additional, Sparks-Defriese, Bonnie J., additional, Tecklin, Jan Stephen, additional, Tyner, Toni, additional, Ward, R. Scott, additional, and Wellmon, Robert, additional

Published
2007
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50. 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

Author

Kemp, Joanne, Risberg, May Arna, Mosler, Andrea, Harris-Hayes, Marcie, Serner, Andreas, Moksnes, Håvard, Bloom, Nancy, Crossley, Kay, Gojanovic, Boris, Hunt, Michael A, Ishøi, Lasse, Mathieu, Nicolas, Mayes, Susan, Scholes, Mark, Gimpel, Mo, Friedman, Daniel, Ageberg, Eva, Agricola, Rintje, Casartelli, Nicola C, Diamond, Laura E, Dijkstra, Hendrik, Stasi, Stephanie Di, Drew, Michael, Freke, Matthew, Griffin, Damian, Heerey, Joshua, Hölmich, Per, Impellizzeri, Franco M, Jones, Denise, Kassarjian, Ara, Khan, Karim M, King, Matthew, Lawrenson, Peter, Leunig, Michael, Lewis, Cara L, Warholm, Kristian Marstrand, Reiman, Michael P, Semciw, Adam, Thorborg, Kristian, Klij, Pim Van, Wörner, Tobias, and Bizzini, Mario

Subjects
musculoskeletal diseases, 110317 Physiotherapy, FOS: Clinical medicine
Abstract

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. 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.

Published
2020
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