A Pre-Operative Exercise Intervention Can Be Safely Delivered to People with Femoroacetabular Impingement and Improve Clinical and Biomechanical Outcomes.

Purpose: This study aimed to investigate the effects of a pre-hip arthroscopy exercise intervention on hip strength, pain, and function in individuals with femoroacetabular impingement (FAI). Methods: A total of 20 individuals with FAI completed a 10-week, partially supervised exercise programme; this included three phases of increasing resistance and functionality, consisting of four to six exercises per phase. Hip strength in all six directions; hip pain; function, as measured by the Hip disability and Osteoarthritis Outcome Score (HOOS); and objective physical function, as measured by the Timed Stair Climb test, were determined before and after the intervention. Results: Maximum isometric hip strength significantly increased in abduction (p=0.008), adduction (p=0.021), and internal rotation (p=0.006) at follow-up. Increases in flexion, extension, and external rotation strength did not reach statistical significance. Self-reported HOOS pain (p<0.01) and activities of daily living sub-scale scores (p<0.01) significantly improved at follow-up. Timed Stair Climb times (p<0.001) also significantly decreased at follow-up. Conclusion: A 10-week exercise programme can be safely completed by adults with FAI before surgery, and statistically significant changes in strength, function, and self-reported clinical outcomes can be achieved.

Objectif : examiner les effets d'un programme d'intervention préopératoire sur la force, la douleur et la fonction des hanches chez les personnes souffrant d'un conflit fémoro-acétabulaire (CFA). Méthodologie : vingt personnes atteintes d'un CFA ont participé à un programme d'exercice de 10 semaines partiellement supervisé, composé de trois phases de quatre à six exercices de résistance et de fonctionnalité croissantes. La force des hanches dans les six directions, la douleur et la fonction ont été mesurées à l'aide du Hip Disability and Osteoarthritis Outcome Score (score du pronostic d'incapacité et d'arthrose de la hanche) (HOOS) et la fonction physique objective a été mesurée par le test de l'escalier, avant et après l'intervention. Résultats : au suivi, une augmentation statistiquement significative de la force isométrique maximale a été observée pour l'abduction (p=0,008), l'adduction (p=0,021) et la rotation interne (p=0,006). En revanche, l'augmentation de la flexion, de l'extension et de la force de rotation externe n'était pas significative. Les scores des sous-échelles du HOOS pour la douleur autodéclarée (p<0,01) et les activités quotidiennes (p<0,01) ont aussi augmenté de façon significative. Quant aux temps au test de l'escalier (p<0,001) ils ont diminué de façon significative. Conclusion : l'étude démontre qu'un programme d'exercice de 10 semaines peut être suivi de façon sécuritaire par des adultes atteints d'un CFA avant la chirurgie et qu'il peut permettre d'améliorer de façon significative la force, la fonction et les résultats cliniques autodéclarés.

Validation of the Fitbit One activity monitor device during treadmill walking.

OBJECTIVES: In order to quantify the effects of physical activity such as walking on chronic disease, accurate measurement of physical activity is needed. The objective of this study was to determine the validity and reliability of a new activity monitor, the Fitbit One, in a population of healthy adults. DESIGN: Cross-sectional study. METHODS: Thirty healthy adults ambulated at 5 different speeds (0.90, 1.12, 1.33, 1.54, 1.78 m/s) on a treadmill while wearing three Fitbit One activity monitors (two on the hips and one in the pocket). The order of each speed condition was randomized. Fitbit One step count output was compared to observer counts and distance output was compared to the calibrated treadmill output. Two-way repeated measures ANOVA, concordance correlation coefficients, and Bland and Altman plots were used to assess validity and intra-class correlation coefficients (ICC) were used to assess reliability. RESULTS: No significant differences were noted between Fitbit One step count outputs and observer counts, and concordance was substantial (0.97-1.00). Inter-device reliability of the step count was high for all walking speeds (ICC ≥ 0.95). Percent relative error was less than 1.3%. The distance output of the Fitbit One activity monitors was significantly different from the criterion values for each monitor at all speeds (P<0.001) and exhibited poor concordance (0.0-0.05). Inter-device reliability was excellent for all treadmill speeds (ICC ≥ 0.90). Percent relative error was high (up to 39.6%). CONCLUSIONS: The Fitbit One activity monitors are valid and reliable devices for measuring step counts in healthy young adults. The distance output of the monitors is inaccurate and should be noted with caution.

Kinematic and kinetic differences during walking in patients with and without symptomatic femoroacetabular impingement.

BACKGROUND: Femoroacetabular impingement is a common hip pathology resulting in pain and impaired physical function. However, very little is known about gait differences between those with and without femoroacetabular impingement. Thus, the purpose of this study was to compare three-dimensional gait kinematics and kinetics between those with femoroacetabular impingement and a healthy, pain-free control group. METHODS: Three-dimensional gait analysis was conducted on 30 individuals with symptomatic femoroacetabular impingement scheduled for surgery and 30 pain-free controls. Spatiotemporal and peak hip kinematics and joint moments were compared between the two groups. Ensemble averages were also calculated for kinematic and kinetic profiles across the gait cycle in all three planes of movement for visual inspection. FINDINGS: Participants with femoroacetabular impingement walked slower and with significantly smaller cadences than those in the control group. Kinematically, the impingement group exhibited significantly less peak hip extension, adduction and internal rotation during stance, with effect sizes ranging from 0.48 (adduction) to 1.00 (internal rotation). Finally, those with FAI exhibited significantly less peak external hip flexion (effect size=0.52) and external rotation (effect size=0.85) moments than the control group. INTERPRETATION: Individuals with femoroacetabular impingement exhibit differences in gait kinematics in all planes of motion compared to those with without FAI. These findings support the need for focused neuromuscular reconditioning across all movement directions in this patient group.