BackgroundHip arthroscopies are often used in the treatment of intra-articular hip injuries. Patient-reported outcomes (PRO) are an important parameter in evaluating treatment. It is unclear which PRO questionnaires are specifically available for hip arthroscopy patients. The aim of this systematic review was to investigate which PRO questionnaires are valid and reliable in the evaluation of patients undergoing hip arthroscopy.MethodsA search was conducted in Pubmed, Medline, CINAHL, the Cochrane Library, Pedro, EMBASE and Web of Science from 1931 to October 2010. Studies assessing the quality of PRO questionnaires in the evaluation of patients undergoing hip arthroscopy were included. The quality of the questionnaires was evaluated by the psychometric properties of the outcome measures. The quality of the articles investigating the questionnaires was assessed by the COSMIN list.ResultsFive articles identified three questionnaires; the Modified Harris Hip Score (MHHS), the Nonarthritic Hip Score (NAHS) and the Hip Outcome Score (HOS). The NAHS scored best on the content validity, whereas the HOS scored best on agreement, internal consistency, reliability and responsiveness. The quality of the articles describing the HOS scored highest. The NAHS is the best quality questionnaire. The articles describing the HOS are the best quality articles.ConclusionsThis systematic review shows that there is no conclusive evidence for the use of a single patient-reported outcome questionnaire in the evaluation of patients undergoing hip arthroscopy. Based on available psychometric evidence we recommend using a combination of the NAHS and the HOS for patients undergoing hip arthroscopy.
Measurement of functional performance more than 2 years after ACL reconstruction consists of concentric or isometric strength, the single-leg hop for distance or a combination. The Limb Symmetry Index is used as the main outcome parameter to compare the involved leg with the uninvolved. In all studies the results of men and woman are combined. Based on our findings and previous studies that discussed additional important parameters a more extensive test battery to assess functional performance is suggested.
BackgroundFemoroacetabular impingement has been recognized as a common cause of hip pain and dysfunction, especially in athletes. Femoroacetabular impingement can now be better treated by hip arthroscopy but it is unclear what postoperative rehabilitation of hip arthroscopy should look like. Several rehabilitation protocols have been described, but none presented clinical outcome data. These protocols also differ in frequency, duration and level of supervision. We developed a rehabilitation protocol with supervised physical therapy which showed good clinical results and is considered usual care in our treatment center. However, it is unknown whether, due to the relatively young age and low complication rate of hip arthroscopy patients, rehabilitation based on self-management might lead to similar results. The aims of this pilot study are (1) to determine feasibility and acceptability of the self-management intervention, (2) to obtain a preliminary estimate of the difference in effect between physical therapy aimed at self-management versus usual care physical therapy in patients who undergo hip arthroscopy for femoroacetabular impingement.Methods/DesignThirty participants (aged 18–50 years) scheduled for hip arthroscopy will be included and randomized (after surgery) to either self-management or usual care physical therapy in this assessor-blinded randomized controlled trial. After surgery, the self-management group will perform a home-based exercise program three times a week and will receive physical therapy treatment once every 2 weeks for 14 weeks. The usual care group will receive physical therapy treatment twice a week for 14 weeks and will perform an additional home-based exercise program once a week. Assessment will occur preoperatively and at 6, 14, 26 and 52 weeks after surgery. Primary outcomes are feasibility, acceptability and preliminary effectiveness. Feasibility and acceptability will be determined by the willingness to enroll, recruitment rate, adherence to treatment, patient satisfaction, drop-out rate and adverse events. Preliminary effectiveness will be determined using the following outcomes: the International Hip Outcome Tool 33 and hip functional performance as measured with the Single Leg Squat Test 14 weeks after surgery.DiscussionThe results of this study will be used to help decide on the need, feasibility and acceptability of a large-scale randomized controlled trial.Trial registrationThis protocol was registered with the Dutch Trial Registry (NTR5168) on 8 May 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1222-7) contains supplementary material, which is available to authorized users.
ObjectiveTo determine the intrarater reliability of the Humac NORM isokinetic dynamometer for concentric and eccentric strength tests of knee and shoulder muscles.Results54 participants (50% female, average age 20.9 ± 3.1 years) performed concentric and eccentric strength measures of the knee extensors and flexors, and the shoulder internal and external rotators on two different Humac NORM isokinetic dynamometers, which were situated at two different centers. The knee extensors and flexors were tested concentrically at 60° and 180°/s, and eccentrically at 60° s. Concentric strength of the shoulder internal and external rotators, and eccentric strength of the external rotators were measured at 60° and 120°/s. We calculated intraclass correlation coefficients (ICCs), standard error of measurement, standard error of measurement expressed as a %, and the smallest detectable change to determine reliability and measurement error. ICCs for the knee tests ranged from 0.74 to 0.89, whereas ICC values for the shoulder tests ranged from 0.72 to 0.94. Measurement error was highest for the concentric test of the knee extensors and lowest for the concentric test of shoulder external rotators.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3128-9) contains supplementary material, which is available to authorized users.
Study Design Clinical measurement. Background The Copenhagen Hip and Groin Outcome Score (HAGOS) was developed as a patient-reported outcome measure for young, active individuals with hip and groin pain. Objectives To cross-culturally adapt and validate a Dutch version of the HAGOS. Methods Adaptation and validation were performed according to existing guidelines and the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Physically active (Tegner activity score of greater than 2) adults between 18 and 50 years of age with hip and groin pain (numeric pain score of 1 or greater) were included in the study. Reliability (test-retest, internal consistency) was assessed in clinically stable patients. Construct validity was determined by calculating Spearman correlations between the scores on the HAGOS and scores on the Hip disability and Osteoarthritis Outcome Score and European Quality of Life-5 Dimensions subscales. Fifteen hypotheses were defined a priori. Interpretability was considered good when floor and ceiling effects were present in less than 15% of individuals. Results A Dutch version of the HAGOS was created. Its reliability was tested in 129 individuals and its validity in 194 participants. Test-retest reliability was good (intraclass correlation coefficient = 0.83-0.87). Internal consistency was good (Cronbach α = .81-.92). Construct validity was considered good: 13 of 15 (87%) hypotheses were confirmed. Floor effects (21%) were present for the physical activity subscale. Conclusion The Dutch HAGOS is a reliable and valid patient-reported outcome measure and performs similarly to the original version in its target population. It can be used in clinical as well as research settings. Presence of floor effects should be considered for the physical activity subscale. J Orthop Sports Phys Ther 2018;48(4):299-306. doi:10.2519/jospt.2018.7883.
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