OBJECTIVE: We evaluated the effect of physiotherapist-led treatment with targeted-strengthening (STRENGTH) compared with physiotherapist-led treatment with standardised-stretching (STRETCH) on hip-related quality of life (QOL) and patient-perceived Global Rating of Change (GROC) at 6 months in people with femoroacetabular impingement (FAI) syndrome. METHODS: Assessor-blind, limited disclosure, parallel, superiority randomised controlled trial. Participants aged 18-50 years with FAI syndrome were recruited and randomly allocated (1:1 ratio) to receive 6 months of STRENGTH or STRETCH treatment. Primary outcomes were change in (1) hip-related QOL (International Hip Outcome Tool-33 (iHOT-33, 0-100 points)); and (2) GROC-pain and GROC-function at 6 months. Secondary analysis included dichotomised GROC ('improved' and 'not improved') and hip muscle strength. Analyses were by intention to treat. RESULTS: 154 participants (STRENGTH n=79 (53% women, mean 35 (SD 9) years); STRETCH n=75 (45% women, mean 36 (SD 9) years)) were included. There was no difference between groups for change in hip-related QOL (mean difference (95% CI) 0.2 (-5.9 to 6.3)) or patient-perceived global improvement (GROC-pain 0.2 (-0.2 to 0.7), p=0.23; GROC-function 0.3 (-0.1 to 0.6)) at 6 months. 72% of STRENGTH were improved for GROC-pain (OR 2.36 (1.15 to 4.84)) compared with 52% of STRETCH. STRENGTH had greater improvements than STRETCH in hip strength. Both groups improved in iHOT-33 over 6 months (STRENGTH 19.2 (15.7 to 22.8), STRETCH 20.8 (17.1 to 24.5) points). CONCLUSION: There was no superior physiotherapist-led treatment to improve hip-related QOL in people with FAI syndrome, but secondary analysis indicated that targeted strengthening resulted in greater improvements in perceived pain and hip muscle strength at 6 months. Hip-related QOL improved in both groups by clinically meaningful amounts. TRIAL REGISTRATION NUMBER: ACTRN12617001350314.
Kemp et al. (2026) studied this question.