Comparison of Joint Mobilization and Movement Pattern Training for Hip-Related Groin Pain: Ancillary Analysis to Assess 12-Month Outcomes of a Pilot Randomized Clinical Trial

Abstract

OBJECTIVE: We compared 2 interventions for chronic hip-related groin pain (HRGP), joint mobilization (JtMob), and movement pattern training (MoveTrain), to determine if treatment effects observed immediately after treatment were sustained 12 months after treatment completion. DESIGN: Ancillary analysis of parallel-group, pilot randomized clinical trial. METHODS: Patients with HRGP, aged 18 to 40 years, were randomized to JtMob or MoveTrain. Outcomes included the Hip Disability and Osteoarthritis Outcome Score (HOOS), movement assessment, and pain pressure threshold. Treatment included 10 visits over 12 weeks. JtMob included physical therapist-provided manual techniques using standardized criteria to determine techniques and parameters. MoveTrain included task-specific instruction to correct impaired movement patterns displayed during tasks. Extended follow-up was completed at 6 months (HOOS) and 12 months (HOOS, movement assessment, pain pressure threshold). Data were analyzed with a repeated-measures analysis of variance with baseline value as a covariate; patient as a random effect; and treatment group, visit, and group by visit interaction as fixed effects. RESULTS: Thirty-three patients were randomized and 29 (88%) provided posttreatment data. Previously, we reported that both groups reported improved HOOS, and MoveTrain displayed improved hip/pelvis kinematics immediately after treatment compared to baseline. At extended follow-up, there were no between-group differences in change in outcomes between posttreatment and extended follow-up ( P>.09), after adjusting for baseline, indicating that treatment effects immediately after treatment were maintained at 12 months. CONCLUSIONS: JtMob or MoveTrain may result in improvements in patient-reported pain and function that persist 12 months after treatment completion. Future, larger studies are needed to confirm these preliminary results. JOSPT Open 2024;2(1):49-59. Epub 13 December 2023. doi:10.2519/josptopen.2023.1020