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

Author:

DeMargel Rebecca DORCID,Steger-May Karen,Haroutounian Simon,Zorn Patricia,Cheng Abby,Clohisy John C,Harris-Hayes MarcieORCID

Abstract

AimLittle 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).MethodsThis 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.ResultsData from 33 participants (aged 18–40 years) with HRGP were analysed. Greater depressive symptoms (rs=−0.48, p=0.005), higher MEP during step down (rs=−0.36, p=0.040) and squat (rs=−0.39, p=0.024), and greater central sensitisation (rs=−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.ConclusionsIn patients with HRGP seeking non-operative management, greater depressive symptoms and MEP are independently associated with worse self-perceived hip function.Trial registration numberNCT03959319

Funder

Program in Physical Therapy at Washington University School of Medicine

Paris Patla Musculoskeletal Grant from the Foundation for Physical Therapy Research

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institutes of Health (NIH) through Washington University’s Institute of Clinical and Translational Sciences Grant from the National Center for Advancing Translational Sciences

Publisher

BMJ

Subject

Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine

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