Movement pattern training compared with standard strengthening and flexibility among patients with hip-related groin pain: results of a pilot multicentre randomised clinical trial

Study designPilot, multicentre randomised clinical trial (RCT).ObjectivesAssess viability of performing a definitive RCT and compare preliminary effects of movement pattern training (MoveTrain) and strengthening/flexibility (Standard) to improve function in people with chronic hip-related groin pain (HRGP).BackgroundTo determine the best physical therapist-led intervention for patients with HRGP, we must understand treatment effects of different treatment modes.MethodsForty-six patients (17M:29F; 29±5.3 years; body mass index 25.6±6.3 kg/m2) with HRGP were randomised. MoveTrain included task-specific training to optimise biomechanics during daily tasks. Standard included strengthening/flexibility. Treatment included 10 visits/12 weeks and home exercise programme (HEP). Primary outcomes for feasibility were recruitment, retention, treatment adherence and treatment fidelity. Secondary outcomes were patient-reported function (Hip disability and Osteoarthritis Outcome Score (HOOS)), lower extremity kinematics and hip muscle strength.ResultsWe achieved target recruitment, and retention was excellent (91%). Patient session attendance was high (93%); however, reported HEP adherence (62%) was lower than expected. Physical therapists’ adherence to treatment protocols was high (90%). Patients demonstrated high treatment receipt; 91% of exercises performed were rated independent. Both groups demonstrated clinically important improvements in function (HOOS) and muscle strength; however, there were no between-group differences (HOOS subscales, p≥0.13, strength, p≥0.34). Compared with Standard, MoveTrain demonstrated greater reductions in hip adduction (p=0.016) and pelvic drop (p=0.026) during a single leg squat. No adverse events were noted.ConclusionOur experience in completing this RCT confirmed that a larger, multicentre RCT is feasible and highlighted modifications we will implement to optimise the future RCT.Trial registration numberNCT02913222.

Download Full-text

Effects of a home-exercise programme in childhood survivors of acute lymphoblastic leukaemia on physical fitness and physical functioning: results of a randomised clinical trial

Supportive Care in Cancer ◽

10.1007/s00520-019-05131-2 ◽

2019 ◽

Vol 28 (7) ◽

pp. 3171-3178 ◽

Cited By ~ 1

Author(s):

Jahn Dubery Manchola-González ◽

Caritat Bagur-Calafat ◽

Montserrat Girabent-Farrés ◽

Josep Ricard Serra-Grima ◽

Roser Álvarez Pérez ◽

...

Keyword(s):

Clinical Trial ◽

Physical Fitness ◽

Acute Lymphoblastic Leukaemia ◽

Physical Functioning ◽

Lymphoblastic Leukaemia ◽

Randomised Clinical Trial ◽

Exercise Programme ◽

Home Exercise ◽

Home Exercise Programme ◽

Childhood Survivors

Download Full-text

The Effects of Home Exercise in Older Women With Vertebral Fractures: A Pilot Randomized Controlled Trial

Physical Therapy ◽

10.1093/ptj/pzz188 ◽

2020 ◽

Vol 100 (4) ◽

pp. 662-676 ◽

Cited By ~ 2

Author(s):

Jenna C Gibbs ◽

Caitlin McArthur ◽

John D Wark ◽

Lehana Thabane ◽

Samuel C Scherer ◽

...

Keyword(s):

Vertebral Fractures ◽

Functional Performance ◽

Physical Therapist ◽

Controlled Trial ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Feasibility Trial ◽

Home Exercise ◽

Intention To Treat ◽

Patient Reported

Abstract Background Regular exercise is advocated in osteoporosis guidelines to prevent fractures. Few studies have evaluated the effect of exercise on functional performance, posture, and other outcomes that are important to patients after vertebral fractures. Objective This pilot study will explore the effect of home exercise versus control on functional performance, posture, and patient-reported outcome measures. Design This study was a parallel 2-arm pilot feasibility trial with 1:1 randomization to exercise or attentional control groups. Setting This study took place in 5 Canadian and 2 Australian academic or community hospitals/centers. Participants This study included 141 women ≥65 years of age with radiographically confirmed vertebral fractures. Intervention A physical therapist delivered exercise and behavioral counseling in 6 home visits over 8 months and monthly calls. Participants were to exercise ≥3 times weekly. Controls received equal attention. Measurements Functional performance, posture, quality of life, pain, and behavior-change outcomes were assessed at baseline and after 6 (questionnaires only) and 12 months. Adherence to exercise was assessed by calendar diary. All t tests examined between-group mean differences (MD) in change from baseline in intention-to-treat and per-protocol analyses. Results There was a small effect of exercise on 5 times sit-to-stand test versus control (MD = −1.58 [95% CI = −3.09 to −0.07], intention-to-treat; MD = −1.49 [95% CI = −3.12 to 0.16], per-protocol). There were no other major or statistically significant MDs for any other measured outcomes after follow-up. Adherence declined over time. Limitations Treatment effects on variables may have been underestimated due to multiple comparisons and underpowered analyses. Conclusions Our exploratory estimate of the effect of exercise on functional leg muscle strength was consistent in direction and magnitude with other trials in individuals with vertebral fractures. Declining adherence to home exercise suggests that strategies to enhance long-term adherence might be important in future confirmatory trials.

Download Full-text

A comparison of two treatment protocols in the management of exercise-associated postural hypotension: a randomised clinical trial

British Journal of Sports Medicine ◽

10.1136/bjsm.2010.071951 ◽

2010 ◽

Vol 45 (14) ◽

pp. 1113-1118 ◽

Cited By ~ 15

Author(s):

C. Anley ◽

T. Noakes ◽

M. Collins ◽

M. P. Schwellnus

Keyword(s):

Clinical Trial ◽

Postural Hypotension ◽

Randomised Clinical Trial ◽

Treatment Protocols

Download Full-text

Patient-reported Quality of Life in Patients with Primary Metastatic Prostate Cancer Treated with Androgen Deprivation Therapy with and Without Concurrent Radiation Therapy to the Prostate in a Prospective Randomised Clinical Trial; Data from the HORRAD Trial

European Urology ◽

10.1016/j.eururo.2020.08.023 ◽

2020 ◽

Author(s):

Liselotte Boevé ◽

Maarten C.C.M. Hulshof ◽

Paul C.M.S. Verhagen ◽

Jos W.R. Twisk ◽

Wim P.J. Witjes ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Clinical Trial ◽

Radiation Therapy ◽

Metastatic Prostate Cancer ◽

Clinical Trial Data ◽

Randomised Clinical Trial ◽

Trial Data ◽

Patient Reported

Download Full-text

Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain?A randomised clinical trial

British Journal of Sports Medicine ◽

10.1136/bjsports-2016-096988 ◽

2017 ◽

Vol 52 (10) ◽

pp. 659-666 ◽

Cited By ~ 39

Author(s):

Jean-Francois Esculier ◽

Laurent Julien Bouyer ◽

Blaise Dubois ◽

Pierre Fremont ◽

Lynne Moore ◽

...

Keyword(s):

Clinical Trial ◽

Functional Limitations ◽

Randomised Clinical Trial ◽

Exercise Programme ◽

Patellofemoral Pain ◽

Primary Component ◽

Gait Retraining ◽

Significant Group ◽

Vertical Loading ◽

Group Time

DesignSingle-blind randomised clinical trial.ObjectiveTo compare the effects of three 8-week rehabilitation programmes on symptoms and functional limitations of runners with patellofemoral pain (PFP).MethodsSixty-nine runners with PFP were randomly assigned to one of three intervention groups: (1) education on symptoms management and training modifications (education); (2) exercise programme in addition to education (exercises); (3) gait retraining in addition to education (gait retraining). Symptoms and functional limitations were assessed at baseline (T0), and after 4, 8 and 20 weeks (T4, T8 and T20) using the Knee Outcome Survey of the Activities of Daily Living Scale (KOS-ADLS) and visual analogue scales (VASs) for usual pain, worst pain and pain during running. Lower limb kinematics and kinetics during running, and isometric strength were also evaluated at T0 and T8. The effects of rehabilitation programmes were assessed using two-way analysis of variance.ResultsNo significant group × time interactions (p<0.447) were found for KOS-ADLS and VASs. All three groups showed similar improvements at T4, T8 and T20 compared with T0 (p<0.05). Only the exercises group increased knee extension strength following rehabilitation (group × time: p<0.001) and only the gait retraining group (group × time: p<0.001) increased step rate (+7.0%) and decreased average vertical loading rate (−25.4%).ConclusionEven though gait retraining and exercises improved their targeted mechanisms, their addition to education did not provide additional benefits on symptoms and functional limitations. Appropriate education on symptoms and management of training loads should be included as a primary component of treatment in runners with PFP.Trial registration numberClinicalTrials.gov (NCT02352909).

Download Full-text