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Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to evaluate patient-reported outcomes as well as lower extremity and trunk muscle function in patients with long-standing hip and groin pain, in comparison with matched, healthy controls. It was hypothesized that patients with long-standing hip and groin pain would report more deficiency on the Copenhagen Hip and Groin Outcome Score (HAGOS) and have worse outcomes on performance-based measures than healthy controls.

Methods

Nineteen patients with long-standing hip and groin pain and 19 healthy, activity level-, age-, gender-, and weight-matched controls were assessed with the HAGOS for self-reported outcomes, and a parallel squat (w/kg), single-leg triple jump (cm), single-leg rise (n), barbell roll-out (% of height), and plank test (s) for performance-based measures. Independent sample t test was performed to assess between-group differences. The paired t test was used to analyse between-limb differences in unilateral performance tasks.

Results

The patients had worse scores than the controls in all HAGOS subscales (p ≤ 0.001), while no statistically significant differences were observed for any performance measure between groups or between symptomatic and non-symptomatic limbs.

Conclusions

Despite significant self-reported functional limitations on the HAGOS, there were no significant differences between groups in performance-based strength or power measures. The results of this study highlight the need to identify performance-based measures, sensitive to functional deficiencies in patients with long-standing hip and groin pain in order to complement the clinical picture obtained by patient-reported outcomes such as the HAGOS.

Level of evidence

III.

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References

  1. American College of Sports M (2009) American College of Sports edicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 41(3):687–708

    Article  Google Scholar 

  2. Bent NP, Wright CC, Rushton AB, Batt ME (2009) Selecting outcome measures in sports medicine: a guide for practitioners using the example of anterior cruciate ligament rehabilitation. Br J Sports Med 43(13):1006–1012

    Article  CAS  PubMed  Google Scholar 

  3. Charlton PC, Bryant AL, Kemp JL, Clark RA, Crossley KM, Collins NJ (2015) Single-leg squat performance is impaired 1–2 years after hip arthroscopy. PM R. doi:10.1016/j.pmrj.2015.07.004

    PubMed  Google Scholar 

  4. Clarsen B, Myklebust G, Bahr R (2013) Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire. Br J Sports Med 47(8):495–502

    Article  PubMed  Google Scholar 

  5. Comfort P, McMahon JJ (2015) Reliability of maximal back squat and power clean performances in inexperienced athletes. J Strength Cond Res 29(11):3089–3096

    Article  PubMed  Google Scholar 

  6. Diamond LE, Dobson FL, Bennell KL, Wrigley TV, Hodges PW, Hinman RS (2015) Physical impairments and activity limitations in people with femoroacetabular impingement: a systematic review. Br J Sports Med 49(4):230–242

    Article  PubMed  Google Scholar 

  7. Diamond LE, Wrigley TV, Hinman RS, Hodges PW, O’Donnell J, Takla A, Bennell KL (2015) Isometric and isokinetic hip strength and agonist/antagonist ratios in symptomatic femoroacetabular impingement. J Sci Med Sport. doi:10.1016/j.jsams.2015.10.002

    PubMed  Google Scholar 

  8. Hegedus EJ, McDonough SM, Bleakley C, Baxter D, Cook CE (2015) Clinician-friendly lower extremity physical performance tests in athletes: a systematic review of measurement properties and correlation with injury. Part 2–the tests for the hip, thigh, foot and ankle including the star excursion balance test. Br J Sports Med 49(10):649–656

    Article  PubMed  Google Scholar 

  9. Hegedus EJ, Stern B, Reiman MP, Tarara D, Wright AA (2013) A suggested model for physical examination and conservative treatment of athletic pubalgia. Phys Ther Sport 14(1):3–16

    Article  PubMed  Google Scholar 

  10. Jansen JA, Mens JM, Backx FJ, Kolfschoten N, Stam HJ (2008) Treatment of longstanding groin pain in athletes: a systematic review. Scand J Med Sci Sports 18(3):263–274

    Article  CAS  PubMed  Google Scholar 

  11. Jansen JA, Mens JM, Backx FJ, Stam HJ (2008) Diagnostics in athletes with long-standing groin pain. Scand J Med Sci Sports 18(6):679–690

    Article  CAS  PubMed  Google Scholar 

  12. Kemp JL, Schache AG, Makdissia M, Pritchard MG, Sims K, Crossley KM (2014) Is hip range of motion and strength impaired in people with hip chondrolabral pathology? J Musculoskelet Neuronal Interact 14(3):334–342

    CAS  PubMed  Google Scholar 

  13. Maffiuletti NA (2010) Assessment of hip and knee muscle function in orthopaedic practice and research. J Bone Joint Surg Am 92(1):220–229

    Article  PubMed  Google Scholar 

  14. Martin HD, Kelly BT, Leunig M, Philippon MJ, Clohisy JC, Martin RL, Sekiya JK, Pietrobon R, Mohtadi NG, Sampson TG, Safran MR (2010) The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists. Arthroscopy 26(2):161–172

    Article  PubMed  Google Scholar 

  15. Mosler AB, Agricola R, Weir A, Holmich P, Crossley KM (2015) Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med 49(12):810

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nuzzo JL, Mayer JM (2013) Body mass normalization for isometric tests of muscle endurance. J Strength Cond Res 27(7):2039–2045

    Article  PubMed  Google Scholar 

  17. Orchard JW (2015) Men at higher risk of groin injuries in elite team sports: a systematic review. Br J Sports Med 49(12):798–802

    Article  PubMed  Google Scholar 

  18. Reid A, Birmingham TB, Stratford PW, Alcock GK, Giffin JR (2007) Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Phys Ther 87(3):337–349

    Article  PubMed  Google Scholar 

  19. Sansone M, Ahlden M, Jonasson P, Thomee C, Sward L, Ohlin A, Baranto A, Karlsson J, Thomee R (2016) Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2-year follow-up. Scand J Med Sci Sports. doi:10.1111/sms.12641

    PubMed  Google Scholar 

  20. Schellenberg KL, Lang JM, Chan KM, Burnham RS (2007) A clinical tool for office assessment of lumbar spine stabilization endurance: prone and supine bridge maneuvers. Am J Phys Med Rehabil 86(5):380–386

    Article  PubMed  Google Scholar 

  21. Sheppard JM, Cormack S, Taylor KL, McGuigan MR, Newton RU (2008) Assessing the force-velocity characteristics of the leg extensors in well-trained athletes: the incremental load power profile. J Strength Cond Res 22(4):1320–1326

    Article  PubMed  Google Scholar 

  22. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49

    Google Scholar 

  23. Thomee R, Jonasson P, Thorborg K, Sansone M, Ahlden M, Thomee C, Karlsson J, Baranto A (2014) Cross-cultural adaptation to Swedish and validation of the Copenhagen Hip and Groin Outcome Score (HAGOS) for pain, symptoms and physical function in patients with hip and groin disability due to femoro-acetabular impingement. Knee Surg Sports Traumatol Arthrosc 22(4):835–842

    Article  PubMed  Google Scholar 

  24. Thorborg K, Branci S, Stensbirk F, Jensen J, Holmich P (2014) Copenhagen hip and groin outcome score (HAGOS) in male soccer: reference values for hip and groin injury-free players. Br J Sports Med 48(7):557–559

    Article  PubMed  Google Scholar 

  25. Thorborg K, Holmich P, Christensen R, Petersen J, Roos EM (2011) The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med 45(6):478–491

    Article  CAS  PubMed  Google Scholar 

  26. Thorborg K, Serner A, Petersen J, Madsen TM, Magnusson P, Holmich P (2011) Hip adduction and abduction strength profiles in elite soccer players: implications for clinical evaluation of hip adductor muscle recovery after injury. Am J Sports Med 39(1):121–126

    Article  PubMed  Google Scholar 

  27. Thorborg K, Tijssen M, Habets B, Bartels EM, Roos EM, Kemp J, Crossley KM, Holmich P (2015) Patient-reported outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence. Br J Sports Med 49(12):812

    Article  CAS  PubMed  Google Scholar 

  28. Thorlund JB, Aagaard P, Roos EM (2010) Thigh muscle strength, functional capacity, and self-reported function in patients at high risk of knee osteoarthritis compared with controls. Arthritis Care Res (Hoboken) 62(9):1244–1251

    Article  Google Scholar 

  29. Thorstensson CA, Petersson IF, Jacobsson LT, Boegard TL, Roos EM (2004) Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis 5 years later. Ann Rheum Dis 63(4):402–407

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Walden M, Hagglund M, Ekstrand J (2015) The epidemiology of groin injury in senior football: a systematic review of prospective studies. Br J Sports Med 49(12):792–797

    Article  PubMed  Google Scholar 

  31. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan KM, Lovell G, Meyers WC, Muschaweck U, Orchard J, Paajanen H, Philippon M, Reboul G, Robinson P, Schache AG, Schilders E, Serner A, Silvers H, Thorborg K, Tyler T, Verrall G, de Vos RJ, Vuckovic Z, Holmich P (2015) Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med 49(12):768–774

    Article  PubMed  PubMed Central  Google Scholar 

  32. Werner J, Hagglund M, Walden M, Ekstrand J (2009) UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med 43(13):1036–1040

    Article  CAS  PubMed  Google Scholar 

  33. Wikstrom EA, Tillman MD, Chmielewski TL, Cauraugh JH, Naugle KE, Borsa PA (2009) Self-assessed disability and functional performance in individuals with and without ankle instability: a case control study. J Orthop Sports Phys Ther 39(6):458–467

    Article  PubMed  Google Scholar 

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Author notes

    Authors and Affiliations

    1. Department of Health Sciences, Lund University, Lund, Sweden

      Tobias Wörner, Haraldur B. Sigurðsson, Anders Pålsson, Ioannis Kostogiannis & Eva Ageberg

    2. Department of Clinical Sciences, Orthopaedics, Skåne University Hospital, Lund, Sweden

      Ioannis Kostogiannis

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    1. Tobias Wörner
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    2. Haraldur B. Sigurðsson
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    Correspondence to Tobias Wörner.

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    Tobias Wörner, Haraldur B. Sigurðsson have contributed equally to this work.

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    Wörner, T., Sigurðsson, H.B., Pålsson, A. et al. Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls. Knee Surg Sports Traumatol Arthrosc 25, 101–107 (2017). https://doi.org/10.1007/s00167-016-4101-6

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