Exercise rehabilitation to improve hip-related pain and quality of life in full-time student circus arts performers: A non-randomised pre-post intervention trial

OBJECTIVE: To examine changes in hip-related pain, quality of life, strength, and functional task performance following a 12-week rehabilitation program (Melbourne Hip Protocol; MHP) in circus arts students with hip-related pain. STUDY DESIGN: Pre-post intervention trial. SETTING: Circus arts training facility. PARTICIPANTS: Vocational and higher education circus arts students with clinically and radiologically diagnosed hip-related pain conditions. MAIN OUTCOME MEASURES: The Copenhagen Hip and Groin Outcome Score (HAGOS), International Hip Outcome Tool 12 (iHOT-12) at baseline, 3, 6, and 10-month follow-up. Hip muscle strength, range and functional task performance at baseline and 3-month follow-up. RESULTS: 28 circus students were included. The largest improvements in HAGOS sub-scale scores were seen in quality of life from baseline to 6-months (adjusted mean difference 10.5 [95%CI 3.1, 17.9], p = 0.001) and 10 months (11.1 [3.6, 18.6], p = 0.001). iHOT-12 baseline scores improved across all three follow-up time points (3-months 10.6 [3.7, 17.4], p < 0.001; 6-months 13.4 [6.5, 20.3], p < 0.001; 10-months 12.9 [6.0, 19.8], p < 0.001). Average and peak hip muscle strength improved in all movements (p < 0.05) except internal rotation (p > 0.05). CONCLUSION: These findings highlight the potential benefits of the proposed structured, semi-supervised rehabilitation program for this unique population and support further investigation in a fully powered RCT. LEVEL OF EVIDENCE: Level 3.