Improving function in people with hip-related pain: A systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain

Abstract

Objective To report the effectiveness of physiotherapist-led interventions in improving pain and function in young and middle-aged adults with hip-related pain. Design Systematic review and meta-analysis. Data sources A comprehensive, reproducible search strategy was performed on five databases in May 2019. Reference lists and grey literature were also searched. Eligibility criteria for selecting studies Population: people aged ≥18 years with hip-related pain (with or without a diagnosis of femoroacetabular impingement syndrome). Intervention(s): physiotherapist-led interventions for hip pain. Comparators: sham treatment, no treatment or other treatment (eg, hip arthroscopic surgery). Outcomes: primary outcomes included patient-reported hip pain and function. Secondary outcomes included physical function measures. Results 1722 papers were identified. After exclusion criteria were applied, 14 studies were included for analysis. They had varied risk of bias. There were no full-scale placebo-controlled randomised controlled trials (RCTs) of physiotherapist-led treatment. Pooled effects ranged from moderate effects (0.67 (95% CI 0.07 to 1.26)) favouring physiotherapist-led intervention over no treatment post-arthroscopy, to weak effects (-0.32 (95% CI 0.57 to 0.07)) favouring hip arthroscopy over physiotherapist-led treatment. Conclusion Physiotherapist-led interventions might improve pain and function in young and middle-aged adults with hip-related pain, however full-scale high-quality RCT studies are required. PROSPERO registration number CRD42018089088.