Personal factors and baseline function in patients undergoing non-operative management for chronic hip-related groin pain: a cross-sectional study

Rebecca D DeMargel; Karen Steger-May; Simon Haroutounian; Patricia Zorn; Abby Cheng; John C Clohisy; Marcie Harris-Hayes

doi:10.1136/bmjsem-2023-001685

Personal factors and baseline function in patients undergoing non-operative management for chronic hip-related groin pain: a cross-sectional study

BMJ Open Sport Exerc Med. 2023 Nov 3;9(4):e001685. doi: 10.1136/bmjsem-2023-001685. eCollection 2023.

Authors

Rebecca D DeMargel¹, Karen Steger-May², Simon Haroutounian³, Patricia Zorn⁴, Abby Cheng⁵, John C Clohisy⁵, Marcie Harris-Hayes^{1

5}

Affiliations

¹ Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri, USA.
² Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri, USA.
³ Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St Louis, Missouri, USA.
⁴ Patricia Zorn Center for Physical Therapy and Spine Rehabilitation, St Louis, Missouri, USA.
⁵ Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.

Abstract

Aim: Little is known about the relationship between personal factors and perception of hip-related function among patients with chronic hip-related groin pain (HRGP) seeking non-operative management. This analysis was performed to determine if depressive symptoms, central sensitisation, movement evoked pain (MEP), pressure hypersensitivity and activity level were associated with patients' perception of hip-related function, represented by the International Hip Outcome Tool (iHOT-33).

Methods: This cross-sectional study used baseline data from a pilot randomised clinical trial. Participants had anterior hip symptoms for at least 3 of the past 12 months reproduced on examination. Depressive symptoms, central sensitisation and activity level were quantified with self-report questionnaires. MEP was assessed during step down and squat. Pain pressure threshold (PPT) was used to assess pressure hypersensitivity. Statistical analysis was performed to assess bivariate association between variables and independent association of variables with iHOT-33.

Results: Data from 33 participants (aged 18-40 years) with HRGP were analysed. Greater depressive symptoms (r_s=-0.48, p=0.005), higher MEP during step down (r_s=-0.36, p=0.040) and squat (r_s=-0.39, p=0.024), and greater central sensitisation (r_s=-0.33, p=0.058) were associated with lower (worse) iHOT-33 scores. Greater depressive symptoms (β=-0.47, 95% CI -0.76 to -0.17; p=0.003) and higher MEP during squat (β=-0.38, 95% CI -0.68 to -0.08; p=0.014) accounted for 37% of variability in iHOT-33. After adjusting for depressive symptoms and MEP, PPT, central sensitisation symptoms and activity level were not associated iHOT-33.

Conclusions: In patients with HRGP seeking non-operative management, greater depressive symptoms and MEP are independently associated with worse self-perceived hip function.

Trial registration number: NCT03959319.

Keywords: Hip; Orthopaedics; Physical Therapy; Rehabilitation; Sports medicine.

Associated data

ClinicalTrials.gov/NCT03959319

Abstract

Associated data

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