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Hip pain in the front of the hip is common and can make daily activities and sports difficult. One frequent cause is femoroacetabular impingement, also known as hip impingement.
This clinical trial is studying whether adding ultrasound-guided percutaneous electrolysis - a minimally invasive physiotherapy technique that uses a fine needle and a small electrical current - to a program of specific exercises works better than doing the exercises alone.
Participants will be randomly assigned to one of two groups:
The study will last five weeks. Researchers will measure pain, hip movement, and hip function at the beginning, after one week, and after four weeks. They will also record any side effects.
The main goal is to find out if adding percutaneous electrolysis helps reduce hip pain and improve function more than exercise alone. This pilot study will help determine if this technique could be a safe and effective non-surgical treatment option for people with pain in the front of the hip.
Femoroacetabular impingement is a common cause of anterior hip pain in young and middle-aged adults. This condition involves abnormal mechanical contact between the proximal femur and the acetabular rim, which can lead to labral damage, cartilage injury, and pain. Soft tissue structures, particularly the iliopsoas tendon and its relationship with the anterior capsulolabral complex, frequently contribute to the symptoms.
Ultrasound-guided percutaneous electrolysis is a minimally invasive technique used in physiotherapy. It involves the application of a controlled galvanic current through a fine needle inserted under ultrasound guidance into targeted soft tissues, with the aim of reducing pain and promoting tissue repair.
This randomized pilot clinical trial will compare the effectiveness and safety of ultrasound-guided percutaneous electrolysis combined with a therapeutic exercise program versus the same therapeutic exercise program alone in participants with anterior hip pain compatible with femoroacetabular impingement.
Eligible participants will be randomly allocated to one of two parallel groups.
Both groups will follow a standardized home-based exercise program focused on hip mobility, gluteal strengthening, core stability, and controlled hip flexor activation. The experimental group will additionally receive two sessions of ultrasound-guided percutaneous electrolysis, performed one week apart.
Primary and secondary outcomes will include pain intensity during provocative tests, hip range of motion to the first onset of pain, and self-reported hip function. All outcome assessments will be conducted by a blinded evaluator at baseline, one week, and four weeks after the first intervention session. Adverse events will be systematically recorded.
The results of this pilot study will provide preliminary evidence regarding the potential additive benefit of percutaneous electrolysis to exercise therapy and will inform the design and sample size calculation of future larger-scale randomized controlled trials
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Percutenous electrolysis + therapeutic exercise | Experimental | Participants receive ultrasound-guided percutaneous electrolysis combined with a therapeutic exercise program |
|
| Therapeutic exercise | Active Comparator | Participants receive a therapeutic exercise program without additional invasive intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound-guided percutaneous needle electrolysis | Other | Ultrasound-guided percutaneous needle electrolysis will be applied to the iliopsoas region targeting hyperechoic fibrotic tissue near the anterior hip joint. The procedure will be performed using a sterile needle under real-time ultrasound guidance with a long-axis in-plane approach from lateral to medial. Electrical current will be delivered with parameters of 2.5 mA for 3 seconds, with a total of 3 applications per session. Two sessions will be performed, one at baseline and one after 7 days. The intervention will be carried out by a physiotherapist with specific training in invasive techniques. |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Numeric Rating Scale (NRS) pain score during provocative hip tests | Average pain intensity measured with the Numeric Rating Scale (NRS 0-10, where 0 = no pain and 10 = worst pain imaginable) during three standardized provocative tests: Straight Leg Raise (SLR), Flexion-Adduction-Internal Rotation (FADIR), and Hip-External Rotation-Flexion-Ceiling (HEC). The mean of the three scores is calculated to obtain a global measure of provoked anterior hip pain. | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric Rating Scale (NRS) pain during SLR test | Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Straight Leg Raise (SLR) test. | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Numeric Rating Scale (NRS) pain during FADIR test |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Guillermo Gallardo López | Contact | +34656769214 | guillermo.gallardolopez@usp.ceu.es |
| Name | Affiliation | Role |
|---|---|---|
| Guillermo Gallardo Lopez | CEU SP University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fisioterapia La Moraleja | Recruiting | Alcobendas | Madrid | 28109 | Spain |
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| Therapeutic exercise program | Behavioral | Participants will perform a home-based therapeutic exercise program focused on lumbopelvic stability, hip strength, and controlled mobility. Exercises include glute bridge, bird dog, isometric hip flexion, and controlled hip flexion mobility. The program consists of 3 sets of 10 repetitions per exercise, performed 3 to 4 times per week over a 4-week period. Exercises will be performed within pain-free ranges and adjusted according to individual tolerance. Initial instruction will be provided by a physiotherapist, with follow-up supervision at one week and four weeks. |
|
Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Flexion-Adduction-Internal Rotation (FADIR) test. |
| Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Numeric Rating Scale (NRS) pain during HEC test | Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Hip-External Rotation-Flexion-Ceiling (HEC) test. | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Hip flexion range of motion to first onset of pain (P1) | Passive hip flexion range of motion measured with a clinical goniometer until the first onset of pain (P1). | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Hip external rotation range of motion to first onset of pain (P1) | Passive hip external rotation range of motion measured with a clinical goniometer until the first onset of pain (P1). | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Hip internal rotation range of motion to first onset of pain (P1) | Passive hip internal rotation range of motion measured with a clinical goniometer until the first onset of pain (P1). | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Hip function and quality of life (Hip Outcome Tool-12, iHOT-12Sv) | Self-reported hip function and quality of life were assessed using the validated Spanish version of the International Hip Outcome Tool-12 (iHOT-12Sv). The iHOT-12 is a patient-reported outcome measure consisting of 12 items, each scored on a visual analog scale ranging from 1 to 100, where higher scores indicate better hip function and fewer symptoms. The overall score is calculated as the mean of the 12 items, resulting in a total score ranging from 0 to 100. | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| Adverse events | Incidence and type of adverse events. | Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2) |
| ID | Term |
|---|---|
| D057925 | Femoracetabular Impingement |
| D010146 | Pain |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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