Exercise in patients with acetabular retroversion and excessive anterior pelvic tilt: A feasibility and intervention study

Anders Falk Brekke*, Søren Overgaard, Bo Redder Mussmann, Erik Poulsen, Anders Holsgaard-Larsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Background: Acetabular retroversion is associated with femoroacetabular impingement syndrome (FAIS). Anterior pelvic tilt enhances risk of FAIS. Objectives: To investigate feasibility and change in patient-reported symptoms of a home-based exercise intervention in patients with acetabular retroversion and excessive anterior pelvic tilt, in comparison with a prior control period. Design: Prospective intervention study. Methods: Patients (18–40 years) not eligible for surgery, with radiographic signs of acetabular retroversion and excessive anterior pelvic tilt were recruited. An 8-week control period was followed by an 8-week training period. The home-based intervention consisted of education and exercises for core stability, muscle strengthening and stretching for reducing anterior pelvic tilt. Feasibility assessments were dropout (≤10%), adherence (≥75% of sessions), exercise-related pain, and adverse events. Primary outcome was change in the Copenhagen Hip and Groin Outcome Score (HAGOS) pain-subscale. Pelvic tilt was measured by EOS scanning. Results: Forty-two patients (93% female, mean age 22.2 ± 4.2 years) were included. Dropout rate was 7% and satisfactory adherence was demonstrated by 85%. Exercise-related pain and adverse events were acceptable. Between-period mean change score for HAGOS-PAIN was 5.2 points (95% CI: −0.3–10.6) and −1.6° (95% CI: −3.9–0.7) of anterior pelvic tilt. Patients responding positively (≥10 points) (n = 10, 26%), had pre-exercise moderate pain (HAGOS-PAIN 47.5–70 points). Conclusions: Current exercise intervention was feasible. However, we found no clinically relevant changes in self-reported hip-related pain or anterior pelvic tilt. Post hoc responder analysis revealed that patients with moderate pain at baseline might benefit from this exercise.

Original languageEnglish
Article number102613
JournalMusculoskeletal Science and Practice
Volume61
Number of pages7
ISSN2468-7812
DOIs
Publication statusPublished - Oct 2022

Keywords

  • Exercise
  • FAIS
  • Femoroacetabular impingement
  • Non-surgical treatment
  • Pain

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