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. 2020 May 6;54(23):1382–1394. doi: 10.1136/bjsports-2019-101690

Table 3.

Summary of results of within-group standardised paired differences for physiotherapist-led treatment in non-operative patients (randomised and non-randomised studies)

Study Title Baseline M (SD) PT Prim FU M (SD) PT Within-group SPD (95% CI) for primary outcomes (positive SPD favours postintervention improvement)
Randomised studies
Grant, et al 2017 34 The HAPI ‘Hip Arthroscopy Pre-habilitation
Intervention’ study: does prehabilitation affect the outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement?
Abduction strength 16.6 (11.8
Adduction strength 13.4 (4.8)
Flexion strength 27.3 (23.1)
ER strength 15.3 (5.3)
Knee extension strength 37.1 (23.0)
Abduction strength 20.9 (11.6)
Adduction strength 19.3 (9.9)
Flexion strength 32.9 (16.6)
External rotation strength 19.0 (6.3)
Knee extension strength 49.0 (40.2)
Abduction strength not calculated as follow-up dataset not complete
Adduction strength not calculated as follow-up dataset not complete
Flexion strength not calculated as follow-up dataset not complete
External rotation strength not calculated as follow-up dataset not complete
Knee extension strength not calculated as follow-up dataset not complete
Griffin, et al 2018 7 Hip arthroscopy vs best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial IHOT−33 35.6 (18.2) IHOT−33 49.7 (25) IHOT−33 0.63 (0.46 to 0.79)
Harris−Hayes, et al 201639 Movement pattern training to improve function in people with chronic hip joint pain: a feasibility randomised clinic trial HOOS Symptoms 75.0 (17.0)
HOOS−Pain 78.2 (12.3)
HOOS−ADL 90.7 (9.9)
HOOS−Sport 77.1 (17.5)
HOOS−QOL 65.1 (13.0)
Abduction strength 6.7 (1.8)
ER 0 strength 2.9 (0.9)
ER 90 strength 3.4 (0.8)
Flexion in single leg squat 67.4 (14.0)
Adduction in single leg squat 20.2 (6.6)
IR in single leg squat 2.5 (7.7)
HOOS Symptoms 85.0 (13.6)
HOOS−Pain 81.5 (13.2)
HOOS−ADL 93.5 (10.9)
HOOS SP 84.6 (19.6)
HOOS−QOL 71.3 (18.3)
Abduction strength 7.2 (2.3)
ER 0 strength3.2 (0.8)
ER 90 strength 3.9 (0.9)
Flexion in single leg squat 61.7 (15.9)
Adduction in single leg squat17.6 (5.7)
IR in single leg squat 2.7(6.3)
HOOS Symptoms 0.61 (0.11 to 1.12)
HOOS−Pain 0.25 (−0.22 to 0.72)
HOOS−ADL 0.26 (−0.21 to 0.73)
HOOS SP 0.38 (−0.09 to 0.86)
HOOS−QOL 0.36 (−0.11 to 0.84)
Abduction strength 0.23 (−0.24 to 0.70)
ER 0 strength 0.10 (−0.36 to 0.56)
ER 90 strength 0.78 (0.25 to 1.31)
Flexion in single leg squat 0.36 (0.11 to 0.84)
Adduction in single leg squat 0.40 (−0.08 to 0.88)
IR in single leg squat −0.02 (−0.49 to 0.44)
Kemp et al, 201840 The Physiotherapy for Femoroacetabular Impingement Rehabilitation Study: a pilot randomised controlled trial IHOT 60(26)
HOOS−QOL 54(21)
Adduction strength 0.85 (0.17)
Abduction strength 0.94 (0.23)
Extension 0.92 (0.28)
ER strength0.48 (0.11)
Flexion ROM 109(14)
Single leg hop 1.14 (0.26)
Side bridge 59(42)
IHOT 87(12)
HOOS−QOL 76(13)
Adduction strength 1.1 (0.22)
Abduction strength 1.16 (0.23)
Extension strength 1.17 (0.32)
ER strength 0.57 (0.19)
Flexion ROM 123(9)
Single leg hop 1.34 (0.32)
Side bridge 98(35)
IHOT 1.14 (0.53 to 1.75)
HOOS−QOL 1.14 (0.53 to 1.75)
Adduction strength 1.19 (0.57 to 1.81)
Abduction strength 0.91 (0.35 to 1.48)
Extension strength 0.79 (0.24 to 1.33)
ER strength 0.52 (0.01 to 1.03)
Flexion ROM 1.08 (0.49 to 1.68)
Single leg hop 0.65 (0.12 to 1.17)
Side bridge 0.95 (0.38 to 1.53)
Mansell, et al 2018 8 Arthroscopic surgery or physical therapy for patients with femoroacetabular impingement syndrome HOS−ADL 64.6 (14.2)
HOS−Sport 53.2 (16.8)
HOS−ADL 73.1 (37.1)
HOS−Sport 57.1 (29.7)
HOS−ADL 0.26 (−0.06 to 0.57)
HOS−Sport 0.15 (−0.16 to 0.46)
Palmer, et al 2019 41 Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial Hip Flexion ROM 95.7 (19.1)
Hip extension ROM 17.9 (7.9)
Hip Abduction ROM 27.5 (11.9)
Hip adduction ROM 21.6 (7.9)
Hip ER ROM 25.0 (11.8)
Hip IR ROM 24.0 (11.2)
Hip Flexion ROM 99.7 (17.5)
Hip extension ROM 15.7 (8.0)
Hip Abduction ROM 29.6 (11.7)
Hip adduction ROM 23.2 (8.9)
Hip ER ROM 27.4 (9.7)
Hip IR ROM 28.9 (11.2)
Hip Flexion ROM not calculated as follow−up dataset not complete
Hip extension ROM not calculated as follow−up dataset not complete
Hip Abduction ROM not calculated as follow−up dataset not complete
Hip adduction ROM not calculated as follow−up dataset not complete
Hip ER ROM not calculated as follow−up dataset not complete
Hip IR ROM not calculated as follow−up dataset not complete
Smeatham, et al 2017 37 Does treatment by a specialist physiotherapist change pain and function in young adults with symptoms from femoroacetabular impingement? A pilot project for a randomised controlled trial NAHS Total 50.1 (19.1)
HOS−ADL 69 (39)
HOS−Sport 51.5 (19.7)
NAHS Total 62.2 (16.1)
HOS−ADL 90 (27)
HOS−Sport 68 (21.6)
NAHS Total 0.64 (0.09 to 1.20)
HOS−ADL 0.57 (0.03 to 1.12)
HOS−Sport 0.75 (0.18 to 1.33)
Wright, et al 2016 38 Non−operative management of femoroacetabular impingement: a prospective, randomised controlled clinical trial pilot study HOS−ADL 74.3 (13.1)
HOS−Sport 59.4 (18.0)
Depth squat 54.1 (12.5)
Triple hop 11.4 (5.1)
Flexion ROM 100.3 (20.5)
Flexion strength 9.9 (4.2)
HOS−ADL 81.1 (20.3)
HOS−Sport 70.0 (29.3)
Depth squat 43.1 (15.5)
Triple hop 13.3 (5.3)
Flexion ROM 122.4 (18.8)
Flexion strength 13.2 (4.4)
HOS−ADL 0.34 (−0.37 to 1.05)
HOS−Sport 0.37 (−0.35 to 1.08)
Depth squat 0.69 (0.08 to 1.46)
Triple hop 0.32 (−0.39 to 1.04)
Flexion ROM 1.00 (0.15 to 1.84)
Flexion strength 0.68 (−0.08 to 1.45)
Non−randomised studies
Coppack, et al 2016 30 Physical and functional outcomes following multidisciplinary residential rehabilitation for prearthritic hip pain among young active UK military personnel HAGOS Pain 37.7 (20.9)
HAGOS Symptoms 45.8 (23.2)
HAGOS ADL 32.2 (24.1)
HAGOS Sport 51.0 (28.1)
HAGOS PA 84.7 (24.9)
HAGOS QOL 69.5 (24.0)
Y BALANCE 240.5 (26.9)
Flexion ROM 110.2 (24.3)
IR ROM 25.2 (13.7)
HAGOS Pain 35.1 (23.7)
HAGOS Symptoms 46.3 (24.2)
HAGOS ADL 31.0 (24.7)
HAGOS Sport 48.5 (28.6)
HAGOS PA 77.5 (31.2)
HAGOS QOL 64.9 (23.3)
Y BALANCE 256.3 (20.8)
Flexion ROM 116.7 (23.3)
IR ROM 29.8 (12.4)
HAGOS Pain −0.11 (−0.42 to 0.19)
HAGOS Symptoms 0.02 (−0.29 to 0.33)
HAGOS ADL −0.05 (−0.36 to 0.26)
HAGOS Sport −0.09 (−0.40 to 0.22)
HAGOS PA −0.25 (−0.56 to 0.07)
HAGOS QOL −0.19 (−0.50 to 0.12)
Y BALANCE 0.63 (0.29 to 0.97)
Flexion ROM 0.27 (−0.05 to 0.58)
IR ROM 0.34 (0.03 to 0.66)
Emara, et al 2011 31 Conservative treatment for mild femoroacetabular impingement HHS 72(6)
NAHS 72(4)
VAS 6 (1)
Flexion ROM 95.0 (0.4)
Extension ROM 4.0 (1.6)
Abduction ROM 37.0 (0.4)
Adduction ROM 17.0 (7.0)
ER in flexion ROM 28.5 (0.5)
ER in extension ROM 25.3 (0.3)
IR in flexion ROM 9.4 (0.3)
IR in extension ROM 15.8 (0.4)
HHS 91(4)
NAHS 90(5)
VAS 3 (1)
Flexion ROM 88.0 (3.5)
Extension ROM 3.7 (2.2)
Abduction ROM 36.0 (1.4)
Adduction ROM 17.0 (9.0)
ER in flexion ROM 28.4 (1.2)
ER in extension ROM 24.5 (1.0)
IR in flexion ROM 11.3 (0.5)
IR in extension ROM 15.7 (0.7)
HHS 3.52 (2.65 to 4.38)
NAHS 3.85 (2.91 to 4.78)
VAS 2.94 (2.19 to 3.68)
Flexion ROM −2.07 (−2.64 to −1.50)
Extension ROM −0.15 (−0.47 to 0.17)
Abduction ROM –0.78 (−1.15 to −0.41)
Adduction ROM 0.00 (−0.32 to 0.32)
ER in flexion ROM −0.09 (−0.41 to 0.23)
ER in extension ROM −0.88 (−1.26 to −0.50)
IR in flexion ROM 4.27 (3.24 to 5.29)
IR in extension ROM −0.16 (−0.48 to 0.16)
Guenther, et al 2017 35 A pre−operative exercise intervention can be safely delivered to people withfemoroacetabular impingement and improve clinical and biomechanical outcomes HOOS Symptoms 56.1 (13.2)
HOOS−Pain 64.1 (12.3)
HOOS−ADL 73.0 (14.4)
HOOS−Sport 51.7 (12.2)
HOOS−QOL 35.3 (17.2)
Abduction strength 1.53 (0.35)
Adduction strength 1.40 (0.38)
Extension strength 1.81 (0.46)
Flexion strength 1.89 (0.45)
ER strength 0.75 (0.23)
IR strength 0.76 (0.36)
Timed stair climb test 2.96 (0.66)
HOOS Symptoms 63.9 (14.6)
HOOS−Pain 72.5 (12.3)
HOOS−ADL 83.4 (11.0)
HOOS−Sport 63.4 (14.0)
HOOS−QOL 42.8 (22.0)
Abduction strength 1.67 (0.34)
Adduction strength 1.53 (0.39)
Extension strength 1.93 (0.50)
Flexion strength 2.04 (0.43)
ER strength 0.77 (0.18)
IR strength 0.89 (0.36)
Timed stair climb test 2.61 (0.46)
HOOS Symptoms
HOOS−Pain
HOOS−ADL
HOOS−Sport
HOOS−QOL
Abduction strength 0.39 (−0.07 to 0.84)
Adduction strength 0.32 (−0.13 to 0.77)
Extension strength 0.24 (−0.21 to 0.68)
Flexion strength 0.33 (−0.12 to 0.78)
ER strength 0.09 (−0.35 to 0.53)
IR strength0.35 (−0.10 to 0.80)
Timed stair climb test 0.57 (0.10 to 1.05)
Hunt, et al 2012 32 Clinical outcomes analysis of conservative and surgical treatment of patients with clinical indications of pre−arthritic, intra−articular hip disorders HHS 61.3±13
WOMAC 29.2±16
NAHS 63.2±14
HHS 78.9±14
WOMAC 13.5±14
NAHS 81.6±12
HHS 1.26 (0.76 to 1.77)
WOMAC 1.01 (0.54 to 1.47)
NAHS 1.36 (0.84 to 1.89)

ADL, activity of daily living; ER, external rotation; FU, follow-up time point; HAGOS, Copenhagen Hip and Groin Outcome Score; HHS, Harris Hip Score; HOOS, Hip Osteoarthritis and disability Outcome Score; IR, internal rotation; M, mean SD; MCS, emotional function subscale; NAHS, Non-Arthritic Hip Score; NPRS, Numeric Pain Rating Scale; NR, not reported; PA, physical activity; PCS, physical function subscale; PT, physiotherapy/physical therapy; QOL, quality of life; ROM, range of motion; SF-12, Short Form-12 Questionnaire; SMD, standardised mean difference; VAS, Visual Analogue Scale.