MOVEMENT PATTERN TRAINING IN PEOPLE WITH INTRA-ARTICULAR, PREARTHRITIC HIP DISORDERS

患有关节内、关节炎前期髋关节疾病的人的运动模式训练

• 批准号: 9354509
• 负责人: G KELLEY FITZGERALD
• 金额: $ 18.62万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-19 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9354509
• 关键词: Activities of Daily Living; Adherence; Aftercare; Biomechanics; Clinical Trials; Control Groups; Degenerative polyarthritis; Disease; Dyskinetic syndrome; Enrollment; Foundations; Functional disorder; Future; Goals; Health Personnel; Hip Joint; Hip Osteoarthritis; Hip region structure; Instruction; Investigational Therapies; Leg; Level of Evidence; Measures; Motion; Movement; Operative Surgical Procedures; Outcome; Outcome Measure; Participant; Patients; Pattern; Positioning Attribute; Preparation; Protocols documentation; Provider; Publishing; Randomized; Randomized Clinical Trials; Rehabilitation therapy; Reporting; Research; Role; Site; Stress; Symptoms; Training; Treatment outcome; Universities; Waiting Lists; Washington; Work; base; comparative effectiveness; design; disability; effective therapy; improved; improved functioning; injury prevention; innovation; prevent; primary outcome; secondary outcome; standard care; treatment effect; treatment group; treatment strategy; trend; trial comparing; young adult

PROJECT SUMMARY/ABSTRACT Significance: Intra-articular, prearthritic hip disorders (PAHD) result in substantial dysfunction in young adults and are proposed precursors to hip osteoarthritis. The number of surgical procedures to treat PAHD has grown exponenitally in the past decade, despite the lack of high level evidence to guide treatment decisions. The potential exists for surgery to become standard treatment before rigorous investigation of treatment options has been completed. This trend may be partially due to a lack of evidence related to rehabilitation. Although some authors believe rehabilitation can improve function in people with PAHD, others state that rehabilitation is contra-indicated and recommend surgery as the best option. There are no published clinical trials to support or refute either opinion, therefore we know little about the comparative effectiveness of rehabilitation. Innovation: Our long term goal is to develop effective treatment strategies for people with PAHD that will improve function and prevent or delay the onset of OA. Movement pattern training is an innovative rehabilitation approach designed to reduce stresses on the hip joint by optimizing the biomechanics of functional tasks through task-specific instruction. Preliminary work suggests that abnormal movement patterns may be associated with PAHD and that movement pattern training may be an effective treatment approach, however comparison to standard rehabilitation has not been completed. Purpose: We will assess the feasibility of conducting a multicenter randomized clinical trial (RCT) to determine the efficacy of movement pattern training compared to standard rehabilitation for people with PAHD. Participants enrolled at Washington University and University of Pittsburgh will be randomized into one of two treatment groups, movement pattern training or standard rehabilitation. In addition to assessing feasibility of the trial, we will obtain preliminary estimates of effect sizes for treatment outcomes in preparation for the future definitive trial. We will compare post-treatment improvements in patient-reported function as measured by the Hip disability and Osteoarthritis Outcome Score and hip adduction motion during functional tasks, a proposed mechanistic factor associated with PAHD. Upon completion of this study, we will be positioned to implement a multicenter RCT to definitively assess the efficacy of movement pattern training. Impact: Ultimately, if movement pattern training is determined to be effective, it will provide a relatively inexpensive alternative to surgical intervention. Further, the theoretical concepts of movement pattern training could be used to possibly serve a role in injury prevention, as well as optimize post-surgical outcomes in those who do require surgery.

项目摘要/摘要 意义：关节内关节炎前期髋关节紊乱(PAHD)会导致年轻人的实质性功能障碍 被认为是髋关节骨性关节炎的先兆。治疗PAHD的外科手术的数量已经增加 在过去十年中呈指数级增长，尽管缺乏高水平的证据来指导治疗决定。这个 在对治疗方案进行严格调查之前，手术有可能成为标准治疗 已经完成了。这一趋势可能部分是由于缺乏与康复有关的证据。虽然 一些作者认为康复可以改善PAHD患者的功能，另一些人则认为康复是 对比性指征和建议手术是最佳选择。没有已发表的临床试验可以支持或支持 驳斥任何一种观点，因此我们对康复的相对有效性知之甚少。 创新：我们的长期目标是为PAHD患者制定有效的治疗策略， 改善功能，预防或延缓骨性关节炎的发病。动作模式训练是一种创新 旨在通过优化髋关节生物力学来减少髋关节应力的康复方法 通过特定任务的指导来完成功能性任务。初步研究表明，异常运动模式 可能与PAHD有关，运动模式训练可能是一种有效的治疗方法， 然而，与标准康复相比，还没有完成。 目的：我们将评估进行多中心随机临床试验(RCT)的可行性，以确定 运动模式训练与标准康复对帕金森病患者的疗效比较。 被华盛顿大学和匹兹堡大学录取的参与者将被随机分为两组 治疗组、动作模式训练或标准康复。除了评估以下项目的可行性外 在试验中，我们将获得治疗结果的效果大小的初步估计，为未来的准备 最终的审判。我们将比较治疗后患者报告的功能的改善，通过 在功能性任务中，髋关节残疾和骨关节炎结果评分和髋关节内收运动。 与PAHD相关的机械因素。在这项研究完成后，我们将能够实施 多中心随机对照试验，明确评估运动模式训练的效果。 影响：最终，如果动作模式训练被确定为有效的，它将提供相对 手术干预的廉价替代方案。进一步，提出了动作模式训练的理论概念 可用于可能在损伤预防中发挥作用，以及优化手术后的结果 需要动手术的人。