Effects of a hip brace on biomechanics and pain in people with femoroacetabular impingement. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Newcomb, Nicolas R.A.; Wrigley, Tim V.; Hinman, Rana S.; Kasza, Jessica; Spiers, Libby; O'Donnell, John; Bennell, Kim L.
• Is Part Of: Journal of science and medicine in sport. Volume 21:Issue 2(2018)
• Page Start: 111
• Page End: 116
• Publication Date: 2018-02
• Subjects: Femoroacetabular impingement -- Conservative therapy -- Biomechanics -- FAI -- Orthosis -- Brace; Sports sciences -- Periodicals; Sports medicine -- Periodicals; Exercise -- Physiological aspects -- Periodicals; Sports -- physiology -- Periodicals; Sports Medicine -- Periodicals; Sportgeneeskunde; 617.102705
• DOI: 10.1016/j.jsams.2017.09.185
• Languages: English
• ISSNs: 1440-2440

Abstract

Abstract: Objectives: This study evaluates whether hip bracing in patients with femoroacetabular impingement (FAI) (a) immediately reduces range of hip internal rotation, flexion, adduction, and pain during functional tasks; and (b) improves patient-reported outcomes when worn daily over 4 weeks. Design: Within-participant design followed by a case series. Methods: Twenty-five adults with symptomatic FAI underwent 3D kinematic assessment with and without a hip brace during single-leg squat, double-leg squat, stair ascent, and stair descent. A subset of this population (n = 17) continued to wear the brace daily for 4-weeks. A linear mixed statistical model was used to assess pain and kinematic differences between the braced and unbraced conditions at baseline testing. Patient-reported outcomes (NRS pain, iHot-33 and HAGOS questionnaires) at 4-weeks were compared to baseline using paired t-tests. Results: Bracing resulted in significant but small reductions in peak hip flexion ranging between 5.3° (95% CI 0.8°–9.7°) and 5.6° (95% CI 1.1°–10.0°), internal rotation ranging between 2.5° (95% CI 0.6°–4.4°) and 6.4° (95% CI 4.5°–8.2°), and adduction ranging between 2.2° (95% CI 0.5°–3.8°) and 3.3° (95% CI 1.6°–5.0°) during all tasks, except flexion during single-leg squat, compared with the unbraced condition; pain was not significantly improved with the brace. Bracing over four weeks did not significantly change patient-reported outcomes. Conclusions: Bracing subtly limited impinging hip movements during functional tasks, but did not immediately reduce pain or improve patient-reported clinical outcomes after 4 weeks in a young adult cohort with long-standing FAI.