Physical Therapy Applications on the Hip and Defined Functional Parameters in Children With Developmental Hip Dysplasia

Inonu University

Status: Not yet enrolling

Conditions: Developmental Dysplasia of the Hip; Exercise

Treatments: Behavioral: Physical Therapy and Rehabilitation Modalities; Behavioral: Conventional Group

Study type: Interventional

Funder types: Other

Identifiers

NCT06007833

2022/3832

Details and patient eligibility

About

The aim of this study was to investigate the effects of physical therapy and rehabilitation applications on the hip and defined functional parameters in children with developmental hip dysplasia.

Full description

Developmental dysplasia of the hip (DDH) is one of the most important factors causing disability in childhood. DDH is the reason for 29% of all primary hip replacements under 60 years of age. The treatment of DDH, which is applied after an average of 12 months of age in infants, becomes difficult due to shortening of the extra-articular soft tissues, acetabular dysplasia, capsular restriction, and increased femoral anteversion. In the treatment of subluxation, dislocation and residual acetabular dysplasia, many pelvic iliac osteotomies are actively applied to increase joint stability and compatibility of the femur acetabulum. The treatment method and physical therapy to be applied in the treatment of DDH vary depending on the age and type of pathology. Therefore, osteotomies can be performed in isolation or in combination with open reduction of the hip and femoral osteotomies. The general opinion about the minimum patient age for iliac osteotomies (Dega osteotomy, Salter innominate) is that it can be done in children who are at walking age. With Dega osteotomy, anterior, lateral and mainly posterior deficiencies are eliminated by changing the acetabular inclination and structure and increasing the grip between the femoral head and the acetabulum.

In the literature, there are studies on the examination of various angular values of the hip (alpha, beta, coverage angle), various classification methods, and whether the postoperative follow-up of children who underwent open, closed reduction and osteotomy requires a reconstructive surgical procedure. No studies have been found on the strength of the hip muscles due to the application of surgical techniques in children with DDH who have weak hip, chorea and lower extremity muscles due to intrauterine and structural conditions. There are no studies on how the affected muscles affect the hip parameters and functional capacities of children with DDH. We think that hip muscle strength, femoral head and anteversion angle, acetabular index, hip adductor muscle tension are important in terms of hip stability and functionality in children aged 2-5 years. Due to the lack of studies in this field in the literature, this study; The aim of this study was to examine the effects of physical therapy and rehabilitation practices on hip and determined functional parameters in children with developmental dysplasia of the hip.

Enrollment: 30 estimated patients

Sex: All

Ages: 2 to 5 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 2-5 years old,
• Diagnosed with developmental hip dysplasia,
• Have not undergone any foot surgery,
• Not having any neurological or rheumatological disease,
• Having sufficient cooperation to understand and correctly apply the tests,
• Patients with informed consent from their families were included.

Exclusion criteria

• Having neurological problems,
• Meningomyelocele (diagnosed with Spina Bifida),
• Mental retardation and uncooperative,
• Children with inflammation, spasticity, spina bifida, arthrocentesis,
• Down syndrome-related dislocation,
• Children who could not obtain informed consent from their families were excluded from the study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

physical therapy and rehabilitation program in addition to conservative treatment

Experimental group

Description:

Orthoses and positioning will be applied to the experimental group as a conservative treatment, following post-surgical plastering. In addition, they will receive a physical therapy and rehabilitation program

Treatment:

Behavioral: Physical Therapy and Rehabilitation Modalities

Conventional Group

Active Comparator group

Description:

As a conservative treatment in the control group, post-surgical plastering followed by orthoses and positioning will be applied

Treatment:

Behavioral: Conventional Group