Exercise Rehabilitation for Hip-related Pain and Dysfunction in Student Circus Arts Performers

Exercise Rehabilitation for Hip-related Pain and Dysfunction in Full Time Student Circus Arts Performers: a Pilot Trial

Hip injuries are reported to account for 71% and 29% of all injuries reported in female and male performers, respectively, at the National Institute of Circus Arts. There are no reports on hip pathology in circus performers, nor are there any reported exercise interventions for hip pain in circus performers.

This study aims to:

To assess the effect of an exercise rehabilitation program on patient-reported outcome measures, hip strength and range of movement, and functional assessments in circus arts students with clinically and radiologically diagnosed hip pain-related disorders.

Participants will undertake a 12-week strength exercise protocol that has been specifically designed to focus on hip rehabilitation appropriate for circus performance. Expected outcome: Improvements in patient reported outcome measure (PROM) scores and an increase in function, strength and hip range of movement in people with hip pain

Study Overview

• Status: Recruiting
• Conditions: Hip Dysplasia; Femoro Acetabular Impingement
• Intervention / Treatment: Other: Hip Exercise Program

• Study Type: Interventional
• Enrollment (Anticipated): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Australia
  • Victoria
    • Hawthorn, Victoria, Australia, 3122
      • Recruiting
      • Swinburne University of Technology
      • Contact: Dr C Ganderton, PhD; Phone Number: +61 3 9214 3539; Email: cganderton@swin.edu.au

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 35 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 3-month history hip/groin pain +/- symptoms including clicking, giving way, locking, or catching, one or more of a positive
• positive FADIR pain provocation test
• positive HEER test (hip extension and external rotation)
• positive prone instability test
• imaging to support a pathological hip (e.g., CAM morphology, hip dysplasia)

Exclusion Criteria:

• OA degree >1 on classification of Tönnis
• Centre Edge-angle <10 degrees
• Legg-Calvé-Perthes or epiphysiolysis
• history of hip joint surgery or significant hip trauma (fracture +/- dislocation)
• neurologic motor deficit (lower limb power, strength or reflex deficit)
• hip pain from a lumbar origin (positive passive straight leg raise, combined lumbar extension and rotation)
• connective tissue disorder (e.g., Ehlers-danlos or Marfan syndrome)
• pregnancy or breastfeeding.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Hip Exercise Program; A 12-week strength exercise protocol has been specifically designed to focus on hip rehabilitation appropriate for circus performance.

Other: Hip Exercise Program; The exercise intervention is being implemented 3 times per week. Two sessions can be completed at home by the participant, and one session per week will be attended by a physiotherapist that will monitor exercise technique and progress the exercise program for each participant. The exercise protocol has been specifically designed to focus on hip rehabilitation appropriate for circus performance. The exercise program will involve hip strength exercises in the sagittal, coronal and transverse planes using weights and elastic bands (Theraband). It will also include trunk strength and postural correction exercises to address swayback posture which is a common clinical presentation in those with hip dysplasia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Copenhagen Hip and Groin Outcome Score (HAGOS)	Patient Reported Outcome Measure, score on 0-100 scale, with zero representing extreme hip and/or groin problems and 100 representing no hip and/or groin problems.	Baseline
The Copenhagen Hip and Groin Outcome Score (HAGOS)	Patient Reported Outcome Measure, score on 0-100 scale, with zero representing extreme hip and/or groin problems and 100 representing no hip and/or groin problems.	3-months
The Copenhagen Hip and Groin Outcome Score (HAGOS)	Patient Reported Outcome Measure, score on 0-100 scale, with zero representing extreme hip and/or groin problems and 100 representing no hip and/or groin problems.	6-months
The Copenhagen Hip and Groin Outcome Score (HAGOS)	Patient Reported Outcome Measure, score on 0-100 scale, with zero representing extreme hip and/or groin problems and 100 representing no hip and/or groin problems.	9-months
International Hip Outcome Tool (iHOT-12)	Patient Reported Outcome Measure, scored using a visual analog scale from 0 to 100, with a score of 100 being the best function and least amount of symptoms	Baseline
International Hip Outcome Tool (iHOT-12)	Patient Reported Outcome Measure scored using a visual analog scale from 0 to 100, with a score of 100 being the best function and least amount of symptoms	3-months
International Hip Outcome Tool (iHOT-12)	Patient Reported Outcome Measure scored using a visual analog scale from 0 to 100, with a score of 100 being the best function and least amount of symptoms	6-months
International Hip Outcome Tool (iHOT-12)	Patient Reported Outcome Measure scored using a visual analog scale from 0 to 100, with a score of 100 being the best function and least amount of symptoms	9-months
European Quality of life questionnaire (EQ-5D-5L)	Patient Reported Outcome Measure	Baseline
European Quality of life questionnaire (EQ-5D-5L)	Patient Reported Outcome Measure	3-months
European Quality of life questionnaire (EQ-5D-5L)	Patient Reported Outcome Measure	6-months
European Quality of life questionnaire (EQ-5D-5L)	Patient Reported Outcome Measure	9-months
Tampa Scale of Kinesiophobia (TSK)	Patient Reported Outcome Measure	Baseline
Tampa Scale of Kinesiophobia (TSK)	Patient Reported Outcome Measure	3-months
Tampa Scale of Kinesiophobia (TSK)	Patient Reported Outcome Measure	6-months
Tampa Scale of Kinesiophobia (TSK)	Patient Reported Outcome Measure	9-months
Hip Strength assessment	Strength of hip abduction, adduction, sitting hip flexion at 90deg, prone extension with knee extended, prone external and internal rotation will be measured using a hand-held dynamometer.	Baseline
Hip Strength assessment	Strength of hip abduction, adduction, sitting hip flexion at 90deg, prone extension with knee extended, prone external and internal rotation will be measured using a hand-held dynamometer.	9-months
Hip Range of Motion	Hip flexion, Hip internal rotation and external rotation will be measured using an inclinometer	Baseline
Hip Range of Motion	Hip flexion, Hip internal rotation and external rotation will be measured using an inclinometer	9-months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional movement screen Y-balance test	This will measure a circus performers capacity to stand on one leg and reach their opposite leg as far as possible forwards, backwards and sideways. This provides a measure of both strength and flexibility, has been used in prior hip research, and shown to have excellent intra and inter-rater reliability.	Baseline
Functional movement screen Y-balance test	This will measure a circus performers capacity to stand on one leg and reach their opposite leg as far as possible forwards, backwards and sideways. This provides a measure of both strength and flexibility, has been used in prior hip research, and shown to have excellent intra and inter-rater reliability.	9-months
Single leg Hop for distance	The distance of a participant hop will be measured, taking off and landing on the same foot, maintaining their balance for about 2-3 seconds on landing. The best of three hops will be recorded.	Baseline
Single leg Hop for distance	The distance of a participant hop will be measured, taking off and landing on the same foot, maintaining their balance for about 2-3 seconds on landing. The best of three hops will be recorded.	9-months
Trunk Muscle Endurance Test	The duration of a side-plank will be recorded in seconds/minutes. The test will be ceased after 3 minutes.	Baseline
Trunk Muscle Endurance Test	The duration of a side-plank will be recorded in seconds/minutes. The test will be ceased after 3 minutes.	9-months
One leg rise test	The number of sit to stand movements on a single leg performed from a starting position where the knee is at 90deg will be recorded. The test will be ceased if the participant reaches 50 one leg rises.	Baseline
One leg rise test	The number of sit to stand movements on a single leg performed from a starting position where the knee is at 90deg will be recorded. The test will be ceased if the participant reaches 50 one leg rises.	9-months

Collaborators and Investigators

• Sponsor: Swinburne University of Technology
• Collaborators: National Institute of Circus Arts

Study record dates

Study Major Dates

• Study Start (Actual): March 28, 2023
• Primary Completion (Anticipated): March 30, 2024
• Study Completion (Anticipated): March 30, 2024

Study Registration Dates

• First Submitted: January 4, 2023
• First Submitted That Met QC Criteria: January 15, 2023
• First Posted (Actual): January 18, 2023

Study Record Updates

• Last Update Posted (Actual): May 12, 2023
• Last Update Submitted That Met QC Criteria: May 11, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Congenital Abnormalities; Joint Diseases; Musculoskeletal Diseases; Hip Injuries; Musculoskeletal Abnormalities; Joint Dislocations; Hip Dislocation; Developmental Dysplasia of the Hip; Hip Dislocation, Congenital; Femoracetabular Impingement
• Other Study ID Numbers: SwinburneUT

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No