Will You Get What You Want? Treatment Goals and Expectations of Patients With Femoroacetabular Impingement Syndrome Regarding Physical Therapist–Led Treatment
Diogo Almeida Gomes, Denise Jones, Mark Scholes, Andrea Mosler, Joshua Heerey, Sally Coburn, Richard Johnston, Michael Girdwood, Marcella Ferraz Pazzinatto, Joanne Kemp
Abstract
OBJECTIVE: To (1) investigate the goals and expectations of participants enrolled in a clinical trial of physical therapist–led treatment for femoroacetabular impingement (FAI) syndrome and (2) explore associations between their expectations and self-reported hip burden and kinesiophobia. DESIGN: Cross-sectional study. METHODS: Data from 150 participants with FAI syndrome who participated in a clinical trial were analyzed. Participants described their most important treatment goal and the expectation of achieving this goal throughout physical therapy treatment. The 33-item International Hip Outcome Tool (iHOT-33) subscales were used to assess self-reported hip burden. The Tampa Scale of Kinesiophobia was used to assess kinesiophobia. Participant goals were qualitatively analyzed using content analysis. Linear regression was used to explore associations between patient expectations and the iHOT-33 and Tampa Scale of Kinesiophobia scores. RESULTS: Participants with FAI syndrome reported goals relating to exercise (52%), improving activities of daily living quality (23%), improving physical function (15%), and reducing pain (10%). Negative expectations regarding physical therapist–led treatment were reported by 68% of the participants. Those with negative expectations reported worse scores for the iHOT-total score (mean difference = 12 points; 95% confidence interval [CI], 4 to 19) and the iHOT-symptoms (mean difference = 14 points; 95% CI, 7 to 21) and iHOT-social (mean difference = 11 points; 95% CI, 2 to 21) subscale scores, compared to those with positive expectations. Treatment expectations were not associated with the iHOT-sport and iHOT-job subscale scores and Tampa Scale of Kinesiophobia scores ( P>.05). CONCLUSION: Patients with FAI syndrome had a generally negative expectation of physical therapist–led treatment. There was a mismatch between patients’ goals and current treatment approaches. Participants with FAI syndrome and negative expectations reported worse quality of life, symptoms, and social concerns compared to those with positive expectations. J Orthop Sports Phys Ther 2024;54(7):486-498. Epub 6 June 2024. doi:10.2519/jospt.2024.12473