The HAPI ‘Hip Arthroscopy Pre-habilitation Intervention’ study: does pre-habilitation affect outcomes in patients undergoing hip arthroscopy for femoro-acetabular impingement?

Abstract

The purpose of this randomized prospective comparative controlled pilot study was to determine whether specific patient exercises done pre-hip arthroscopy surgery for femoro-acetabular impingement affected post-operative recovery. Between October 2013 and June 2014, 6 males and twelve females over the age of eighteen, who were listed for hip arthroscopy for femoro-acetabular impingement, were randomized into two groups. A hip-specific, 8-week home exercise programme was given to the experimental group before their surgery. The control group was given no instruction on exercise before surgery. All participants followed the same rehabilitation programme after surgery. Outcome measures were assessed at set time intervals. Hand held dynamometry was used to assess muscle strength, and the EQ-5D-5 L Score and the Non-Arthritic Hip Score were utilized. Sixteen participants completed the study (eight controls: mean age 41.75 years and eight intervention: mean age 37.5 years). A mixed ANCOVA analysis compared the treatment groups taking baseline values into account. A statistically significant difference was found between the treatment groups for knee extension strength on both operative (P = 0.05) and non-operative sides (P = 0.002), hip flexor strength operative side (P = 0.02) and for EQ-5D-5 L health (P = 0.03), in favour of the intervention group. There was no significant difference between the treatment groups for the other measures, although some tended towards significance. This small pilot study has been designed to aid the further research and the differences between the groups found in these results may inform future larger scale studies.

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

“…As such, other exercise-based treatments including functional and movement pattern retraining, stretching and ROM exercises could be considered, although the level of evidence to support this is insufficient. Importantly, all studies containing an exercise-based physiotherapist-led treatment showed positive within-group change at follow-up assessment 4 5 12 14–16. The most effective type of exercise, dose of exercise and progression of exercise is not yet known.…”

Surgical Treatment of Labral Tears: Debridement, Repair, Reconstruction

“…Once the diagnosis is established, a trial of non-operative management with NSAIDs and focused physical therapy is attempted for 4 to 6 weeks. There are limited downside and risk to this approach as it can also serve as pre-habilitation prior to arthroscopy [19]. While physical therapy has its role in FAIS and patients do demonstrate improvement in their symptoms, it has been shown with randomized controlled trials that arthroscopic management of FAI can exceed the minimum clinically significant difference when compared with physiotherapy [20••, 21••].…”

Application of exercised-based pre-rehabilitation in perioperative period of patients with gastric cancer

“…On this basis, the concept of pre-habilitation was put forward [8, 9, 10, 11]. Recent study had found that multi-modal pre-rehabilitation programs were more effective than single-modal pre-rehabilitation programs [12, 13]. The area of pre-habilitation involved tumor surgery, sports injury, and bone injury.…”