Physical and functional outcomes following multidisciplinary residential rehabilitation for prearthritic hip pain among young active UK military personnel

Russell J Coppack, James L Bilzon, Andrew K Wills, Ian M McCurdie, Laura K Partridge, Alastair M Nicol, Alexander N Bennett, Russell J Coppack, James L Bilzon, Andrew K Wills, Ian M McCurdie, Laura K Partridge, Alastair M Nicol, Alexander N Bennett

Abstract

Background: There are no studies describing the clinical outcomes of a residential, multidisciplinary team (MDT) rehabilitation intervention for patients with prearthritic hip pain. The aim of this cohort study was to describe the functional and physical outcomes of multidisciplinary residential rehabilitation for UK military personnel with prearthritic hip pain.

Methods: Participants (N=40) with a mean age of 33 years referred to a specialist residential rehabilitation centre completed a comprehensive multidisciplinary residential intervention. The main outcome measures were mean pain, physical function (modified shuttle test (MST) and Y-balance test), hip range of motion (HROM) and a patient-reported outcome measure (The Copenhagen Hip and Groin Outcome Score, HAGOS). All scores for symptomatic hips were taken at baseline and post-treatment.

Results: There were improvements in the Y-balance test and HROM following rehabilitation. There were significant improvements in mean difference (T1-to-T2) for Y-balance scores (15.8 cm, 95% CI 10.7 to 20.9, p<0.001), HROM (6.5° increase in hip flexion, 95% CI 4.6 to 9.4, p<0.001) and hip internal rotation (4.6°, 95% CI 2.7 to 6.6, p<0.001). Scores for HAGOS, pain, MST and functional activity assessment showed no improvement.

Conclusions: Among UK military personnel with prearthritic hip pain, MDT residential rehabilitation resulted in improvements in a functional Y-balance test, hip flexion and internal rotation. The study suggests short-term benefits across some outcomes for the current UK military approach to MDT residential rehabilitation.

Keywords: Hip; Intervention efficacy; Physiotherapy; Rehabilitation; Young.

Figures

Figure 1
Figure 1
UK Defence Rehabilitation Hip Pain Care Pathway. AP anteroposterior; DMRC, Defence Medical Rehabilitation Centre; FAI, femoroacetabular impingement; MDT, multidisciplinary team; PCRF, primary care rehabilitation facility.
Figure 2
Figure 2
Y-balance test. From a single-leg stance the participant reaches the freely moveable limb along a line in the anterior (A), posterolateral (B) and posteromedial (C) directions.
Figure 3
Figure 3
Participants (N=40) mean Copenhagen Hip and Groin Outcome Score (HAGOS) pre-to-post treatment. Total score for each subscale is summed and transformed such that 100=best score (no problems) and 0=worst score (extreme problems). Data are presented as mean (95% CI).

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