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Biomechanical and clinical outcomes in response to inpatient multidisciplinary hip and groin rehabilitation in UK military personnel
  1. Richard Allan1,
  2. R P Cassidy1,2,
  3. R J Coppack1,3,
  4. T Papadopoulou2,4 and
  5. A N Bennett1,5
  1. 1Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Stanford-on-Soar, UK
  2. 2Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Stanford-on-Soar, UK
  3. 3Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Bath, Bath, UK
  4. 4British Association of Sport and Exercise Medicine, Doncaster, UK
  5. 5National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
  1. Correspondence to Dr Richard Allan, Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Stanford-on-Soar LE12 5QW, UK; Richard.Allan104{at}mod.gov.uk

Abstract

Introduction Hip and groin related pain is a common complaint among the military population across UK Defence Rehabilitation and addressing associated biomechanical dysfunction is a key treatment goal. Personnel are exposed to complex occupational loads, therefore assessing movement during demanding tasks may expose biomechanical deficits. Observing biomechanical and clinical outcomes in response to treatment is therefore an important consideration. The aims were to examine clinical and biomechanical outcomes prior to (T1) and 12 weeks post (T2) inpatient rehabilitation and explore the influence of pathological subgroup.

Methods Prospective cohort study as part of a clinical service evaluation of 25 patients undergoing treatment for hip and groin related pain. Three-dimensional motion capture (3DM) during a single-leg squat, hip strength and patient-reported outcome measures were collected at T1 and T2.

Results Increased abductor and external rotator strength with reductions in contralateral pelvic drop (1.9°; p=0.041) at T2 on the injured side. Pain reduced by 9.6 mm (p=0.017) but no differences were found for Non-Arthritic Hip Score (NAHS). No statistically significant differences were found between pathological subgroups. Kinematic profiles display variation between diagnostic subgroups and response to treatment.

Conclusion Strength and pain improved with treatment in this service evaluation although biomechanical adaptation and NAHS remain inconclusive. Small and uneven sample size prevents a firm conclusion regarding the effect of pathological subgroupings, however, the data can be considered hypothesis generating for future, larger studies to integrate 3DM for monitoring response to rehabilitation in pathological subgroups to support clinical decision making.

  • musculoskeletal disorders
  • rehabilitation medicine
  • hip
  • sports medicine

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Footnotes

  • Contributors RA, RJC, RPC, TP and ANB were involved in the conception of the work. RA conducted the data collection, analysis and interpretation. RA drafted the article. RPC and TP undertook all clinical work related to the article. RA, RJC, RPC, TP and ANB were involved in the critical revisions of the article. ANB granted final approval of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval CC1 approval was granted for the publication of the findings of this SE (CC1-20200154).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are available to personnel, with the relevant security clearance, working within a UK government organisation. To request the data included in this study, please contact the corresponding author.

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