The feasibility and acceptability of a six-month progressive exercise therapy and patient education intervention for patients with hip dysplasia ineligible for periacetabular osteotomy

Background and objectives
To evaluate feasibility and acceptability of exercise and patient education for patients with hip dysplasia ineligible for surgery.

Design
Feasibility study.

Methods
Feasibility covered inclusion, retention, and mechanisms of changes (MC). MC were measured with Hip and Groin Outcome Score (HAGOS), hip strength, Y-balance test, and hop for distance test (HDT) over a six-month period. Acceptability covered adherence, expectations, perceptions, benefits and harms. Inclusion and retention were additionally evaluated in six patients following usual care over three months as part of a pilot phase.

Results
Thirty of 32 were included (median age: 30 years); six were lost to follow-up. Twenty-four patients improved mean 11 (95%CI: 5-17) HAGOS pain points, improvements in all subscales were 1-11 points. Mean hip abduction strength improved 0.2 (95%CI: 0.04-0.4) Nm/kg, similar to flexion and extension. Median Y-balance test improvements: anterior: 70 (IQR: 64-74) to 75 (IQR: 72-80) centimeters; posteromedial: 104 (IQR: 94-112) to 119 (IQR: 112-122) centimeters and posterolateral: 98 (IQR: 89-109) to 116 (IQR: 108-121) centimeters (p<.001). Median improvement in HDT was: 37 (IQR: 30-44) to 52 (IQR: 45-58) centimeters (p<.001). Patients adhered to 84% of scheduled sessions (1581:1872), expectations were met, and perceptions were characterised by high self-efficacy for exercise. Benefits were reported with no serious harm. In the pilot phase, six of six patients were included with one lost to follow-up.

Conclusion
Patients with hip dysplasia are willing to be included for exercise and patient education, with acceptable retention. MC were found through improvements in pain, strength and function.