Physiotherapy for painful and hypomobile hip joints. Theoretical considerations and a trial comparing standard to forceful manual traction mobilization
Master thesis
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https://hdl.handle.net/1956/23878Utgivelsesdato
2005Metadata
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Sammendrag
Objectives: To compare the effectiveness of forceful manual traction mobilization treatment to standard mobilization of unknown forces in patients with hip pain and hypomobility in private physiotherapy practise, and to deduce these results into other important health measures reported in the literature. Design: Prospective rater-blinded block randomised controlled trial (RCT) with 2 parallel treatment groups. Participants: In the experiment group (n = 10) and control group (n = 9) the mean (standard deviation) age was 59 (12). The clients were recruited from waiting lists of outpatient clinics. Interventions: Both groups received 12 weeks of exercise, information, and manual traction mobilization. In the innovative group the traction force was progressed up to 800 N. Main outcome measure: HOOS-t, a variable comprised of pain, stiffness, function and hip-related quality of life on the disease specific Hip disability and Osteoarthritis Outcome Score (HOOS). Results: The participants receiving forceful mobilization showed large superior clinical treatment effect on HOOS-t by improvement ≥ 20 point on a 0 – 100 scale where responders/non-responders were 6/10 and 0/9 in the forceful and standard therapy group, respectively (P = 0.011). The effect on pain was very large (OR = 32), and there were no adverse effects. Conclusions: These findings indicate treatment by forceful traction mobilization to be clearly superior to standard mobilization, in addition to other conservative therapies for these patients in primary care. General practitioners are suggested to refer to this treatment. Indirect evidence suggests effect in Participation, Utility (Health Related Quality of Life) and Costs. Politicians are asked to afford financial incitements for this approach.