More is Not Always Better: Association Between Hip Range of Motion and Symptom Severity in FAI Syndrome

Overview

• Study Focus: Association between hip range of motion (ROM) and symptom severity in femoroacetabular impingement (FAI) syndrome.
• Key Finding: Less hip flexion ROM is linked with worse symptoms; internal/external rotation ROM has limited or no association.

Background

• FAI syndrome is a common cause of hip pain, affecting physical activity and quality of life.
• Characterized by altered femoral/acetabular shape leading to bony contact in hip movement.
• Restricted hip ROM is a common target in FAI treatment; reduced ROM correlates with symptom severity.

Objectives

• Main Goals:
  • Examine the link between hip flexion/rotation ROM and symptom severity in FAI patients.
  • Determine if ROM measures can identify patients with severe symptoms.

Methods

• Design: Cross-sectional study using data from 150 FAI syndrome patients.
• Measurements:
  • Hip flexion, internal/external rotation ROM via digital inclinometer.
  • Symptom severity via iHOT-Symptoms subscale.
• Analysis: Multivariable fractional polynomial analyses and ROC curves.

Results

• Hip Flexion ROM:
  • Smaller ROM associated with worse iHOT-Symptoms scores (p < 0.01; R2 = 0.242).
  • Best discriminative cut-off: 107 degrees (sensitivity 92%, specificity 52%).
• Hip Internal Rotation ROM: Weak association (p = 0.01; R2 = 0.033).
• Hip External Rotation ROM: No significant association (p = 0.06).

Conclusion

• Reduced hip flexion ROM linked with severe symptoms; ROM < 107 degrees increases symptom likelihood.
• Hip rotation ROM measures lack clinical relevance in symptom severity.

Implications for Treatment

• Interventions to improve hip flexion ROM (107-120 degrees) may reduce symptom severity.
• Emphasizing hip flexion over rotation ROM in rehabilitation may be more beneficial.

Limitations

• Cross-sectional design limits causal inference.
• Potential influence of other hip morphologies not assessed.

References

• Studies examining hip impairments in FAI and their impact on ROM and symptom severity.

This summary provides an organized analysis of the study findings, examining the relationship between hip ROM and symptom severity in patients with FAI syndrome, crucial for developing targeted therapeutic interventions.