Hip Manipulation for Hip Pain

Overseen By Chang Min Lee

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Andrews University

Disqualifiers: Hip replacement, Hip fracture, Neurological, others

Compensation: Varies

Number of Visits: 3

Duration: 1 day

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a special hip movement, called Unrestrained Femoral Internal Rotation (UFIR) manipulation, can strengthen hip muscles and improve function for individuals with general hip pain. Participants will receive either this hip manipulation or a gentle hand placement without the manipulation. This study suits those with ongoing hip pain and weak hip rotation. As an unphased trial, it offers participants the opportunity to explore innovative treatments for hip pain.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that the UFIR manipulation technique is safe for individuals with hip pain?

Research has shown that the Unrestrained Femoral Internal Rotation (UFIR) technique is being tested for its safety and effectiveness in strengthening the hip. The trial is marked as "Not Applicable" to specific phases, indicating that the treatment is non-invasive and likely safe, as it involves physical manipulation rather than medication or surgery.

Previous studies have found that similar joint manipulation techniques are generally well-tolerated. These techniques aim to improve movement and reduce pain without causing significant side effects. Since this technique does not use drugs, the risk of negative reactions remains low.

While specific data about side effects is unavailable, these types of physical therapies usually carry minimal risk, mainly involving temporary discomfort or soreness. If UFIR manipulation were unsafe, it would likely not be tested in clinical trials for improving hip function. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Unrestrained Femoral Internal Rotation (UFIR) manipulation for hip pain because it offers a new approach to managing this condition. Unlike standard treatments, such as physical therapy, medications, or surgeries, UFIR involves a specific manipulation technique that allows greater freedom of movement in the hip joint. This method could provide relief without the need for medication or invasive procedures. The unique focus on increasing internal rotation could lead to faster pain relief and improved mobility for patients with hip pain.

What evidence suggests that the UFIR manipulation technique is effective for improving hip strength in patients with nonspecific hip pain?

Research has shown that the Unrestrained Femoral Internal Rotation (UFIR) technique, which participants in this trial may receive, might improve hip strength and function in individuals with general hip pain. Some studies suggest that this hip movement can increase flexibility and possibly reduce pain. The technique involves gently rotating the hip joint inward, which might boost the strength of outward hip movements. Although research continues, early results are promising for those seeking non-surgical methods to manage hip pain. ^{1 2 3 4 6}

Are You a Good Fit for This Trial?

This trial is for individuals experiencing nonspecific hip pain. Specific eligibility criteria are not provided, but typically participants would need to be adults with hip pain who can safely undergo manipulation techniques.

Inclusion Criteria

I have hip pain that doesn't have a specific cause.

Individuals with ipsilateral hip external rotation weakness (at or below 3+) based on the MMT test

Exclusion Criteria

I have had a hip dislocation or total hip replacement.

I have had a hip fracture or hip surgery in the last 6 months.

I am experiencing severe pain that is not relieved by treatment.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Treatment

Participants receive either UFIR manipulation or sham manipulation

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in hip external rotation strength

1 week

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Unrestrained Femoral Internal Rotation (UFIR) manipulation

Trial Overview The study is testing the effects of a specific physical therapy technique called unrestrained femoral internal rotation (UFIR) manipulation on hip strength in patients with hip pain, compared to sham (fake) manipulation.

How Is the Trial Designed?

Group I: Experimental Group Experimental Treatment 1 Intervention

Participants receiving the Unrestrained Femoral Internal Rotation (UFIR) manipulation.

Group II: Control Group Placebo Group 1 Intervention

Participants receiving a sham manipulation (gentle hand placement)

Who Is Running the Clinical Trial?

Andrews University

Lead Sponsor

Trials

4

Recruited

120+

Published Research Related to This Trial

In a study involving 40 men (20 with low back pain and 20 without), patients with lumbar flexion with rotation syndrome showed significantly increased pelvic rotation during hip internal rotation tests, indicating altered movement patterns that could exacerbate low back pain symptoms.

The findings suggest that individuals with low back pain exhibit a more synchronized movement of the pelvis and hip during the dominant limb test, which may indicate a compensatory mechanism that could increase the risk of developing further low back pain issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lumbopelvic-Hip Rhythm in People with Lumbar Flexion-with-Rotation Syndrome during Hip Internal Rotation. Sadeghisani, M., Khademi Kalantari, K., Satari, M.[2023]

This study highlights that anterior inferior iliac spine (AIIS) impingement can significantly contribute to hip disability, particularly in young women, and is often associated with labral tears.

After undergoing arthroscopic AIIS decompression, patients showed significant improvements in hip function, achieving meaningful outcome improvements across multiple assessment tools within a follow-up period averaging 19.1 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes for Arthroscopic Treatment of Anterior Inferior Iliac Spine (Subspine) Hip Impingement. Nwachukwu, BU., Chang, B., Fields, K., et al.[2022]

The study found that using a smartphone compass application to measure hip internal rotation (IR) in a supine position is effective, with mean IR values of 51.7° for men and 62.6° for women, indicating a reliable method for assessing hip impairments.

However, the FADIR test showed poor to moderate interrater reliability (0.40), suggesting that this test needs standardization to improve consistency in measuring hip flexion-adduction-internal rotation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quantification and Reliability of Hip Internal Rotation and the FADIR Test in Supine Position Using a Smartphone Application in an Asymptomatic Population. St-Pierre, MO., Sobczak, S., Fontaine, N., et al.[2021]

A 45-year-old man with postsurgical hip pain after multiple surgeries for avascular necrosis experienced significant improvement in pain and mobility through a combination of chiropractic manipulation and rehabilitation 14 months post-surgery.

The treatment led to increased active range of motion and better scores on the Harris Hip Scale, suggesting that chiropractic care may be beneficial for patients recovering from hip surgeries, warranting further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chiropractic management of hip pain after conservative hip arthroplasty. Wisdo, JJ.[2011]

The study found that the controlled pressure duration (CPD) condition provided the highest reliability for measuring hip internal rotation and FADIR tests, indicating it may be the best method for consistent hip pain assessment.

The subject-specific position (SSP) condition yielded the highest reliability for FABER tests, suggesting that personalized testing positions can enhance measurement accuracy in hip assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of Standardized Procedures on the Reliability of Hip Clinical Assessment. St-Pierre, MO., Boivin, K., Fontaine, N., et al.[2021]

A study involving 151 students found that hip rotation range of motion (ROM) is significantly greater in the prone position compared to the sitting position, indicating that body position affects hip flexibility.

The research also revealed notable differences in hip rotation ROM between sexes, with men showing greater external rotation and women showing greater internal rotation in both positions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hip rotation range of motion in sitting and prone positions in healthy Japanese adults. Han, H., Kubo, A., Kurosawa, K., et al.[2020]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06655987

Hip Manipulation for Improved Strength in Patients With ... This study aims to contribute to the understanding of the potential benefits of joint manipulation, specifically UFIR, in improving hip external rotation ...

2. withpower.com withpower.com/trial/phase-hip-pain-6-2024-9d8c4

Hip Manipulation for Hip Pain · Info for Participants The purpose of this study is to investigate the potential effects of an unrestrained femoral internal rotation (UFIR) manipulation technique on hip external ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8791543/

A clinical crossover trial of the effect of manipulative ... This study aims to determine whether manipulative therapy of the hip joint can increase range of motion (ROM) and/or decrease pain in individuals experiencing ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT06655987?cond=hip%20pain&viewType=Table&rank=7

Hip Manipulation for Improved Strength in Patients With ... An unfavorable change in the health of a participant, including abnormal laboratory findings, that happens during a clinical study or within a certain amount of ...

5. patlynk.com patlynk.com/es/trial/NCT02842801

Hip Manipulation in Young Adults With Groin, Lateral ... The purpose of the study is to identify the characteristics of young adults with pain in the groin, lateral hip or buttock who will benefit ...

6. trialstoday.org trialstoday.org/trial/NCT07025434

Effects of Hip Bump Manipulation Versus Sham Treatment ... The purpose of this study is to objectively assess the effects of hip bump manipulation (HBM) on a healthy population aged 18-45 years. We ...