The effects of therapeutic exercises and education to parents on weight bearing, range of motion, joint stability, and disease complications in 4-10-year-old children with congenital hip dysplasia

Abolmohamadi, Nazila; Latifi, Sepideh; Miri, Hadi

doi:10.22059/sshr.2024.371443.1122

The effects of therapeutic exercises and education to parents on weight bearing, range of motion, joint stability, and disease complications in 4-10-year-old children with congenital hip dysplasia

Document Type : Research Paper

Authors

Nazila Abolmohamadi ¹

Sepideh Latifi ²

Hadi Miri ³

¹ Department of Sport Sciences, Raja University, Qazvin, Iran.

² Department of Sport Injuriy and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran

³ Department of Physical Education and Sport Sciences, Amirkabir University of Technology, Tehran, Iran

10.22059/sshr.2024.371443.1122

Abstract

Background: Late diagnosis and treatment of congenital hip dysplasia (CHD) can cause many problems in a person's daily life.
Aim: Therefore, the present study aimed to investigate and compare the effect of therapeutic exercises and education on parents’ weight bearing, range of motion, joint stability, and disease complications in 4-10-year-old children with congenital hip dysplasia.
Materials and Methods: This semi-experimental study was conducted with a pre-test and post-test design on 40 children with CHD in two groups of 20 people: therapeutic exercises and education. The training program of the therapeutic exercises group was done on a middle day for 8 weeks from 60 to 90 min in each session. Also in the training group, parents were taught about the correct methods of sitting, standing, and lying down. Before and after the intervention, the subjects were evaluated by the researcher in terms of performance indicators. These indicators were evaluated with specialized tests (weight bearing with standing flexion test, range of motion with stork test, and joint stability with sitting test). The analysis of variance was used to compare the differences between groups in terms of the effect on the indicators.
Results: Based on the findings, the difference between the two groups of therapeutic exercises and education to parents was significant in weight-bearing and range of motion (P=0.000 and P=0.000), but in hip joint stability and disease complications, no significant difference was observed (P=0.269 and P=0.163).
Conclusion: Considering the greater effectiveness of the therapeutic exercises, it is suggested to design a codified program in the physical education program of U10 children to correct skeletal abnormalities, especially hip dysplasia.

Keywords

congenital hip dysplasia

education for parents

joint stability

range of motion

therapeutic exercises

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[2] Clarke NM, Taylor CC, Judd J. “Diagnosis and management of developmental hip dysplasia”. Paediatrics and Child Health. 2016; 26(6): 252-256. doi: https://doi.org/10.1016/j.paed.2016.02.002.

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[4] Ömeroglu, H. “Treatment of developmental dysplasia of the hip with the Pavlik harness in children under six months of age: Indications, results and failures”. Journal of Children's Orthopaedics. 2018; 12(4): 308-316. doi: https://doi.org/10.1302/1863-2548.12.180055.

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[12] Graf R. “Hip sonography: background; technique and common mistakes; results; debate and politics; challenges”. Hip International. 2017; 27(3): 215-219. doi: https://doi.org/10.5301/hipint.5000514.

[13] Mamouri GH, Khatami F, Hamedi AB. “Congenital dislocation of the hip in newborns in the city of Mashhad”. Iranian Journal of Medical Sciences. 2015; 28(3): 127-130. doi: https://pesquisa.bvsalud.org/portal/resource/pt/emr-62286.

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[15] Bhuyan BK. “Outcome of one-stage treatment of developmental dysplasia of hip in older children”. Indian Journal of Orthopaedics. 2012; 46(5): 548-555. doi: https://link.springer.com/article/10.4103/0019-5413.101035.

[16] Merckaert SR, Pierzchala K, Bregou A, Zambelli PY. “Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study”. Journal of Orthopaedic Surgery and Research. 2019; 14(1): 1-7. doi: https://doi.org/10.1186/s13018-019-1441-1.

[17] Lewandowska A, Ratuszek-Sadowska D, Kuczma M, Kuczma W, Simińska J, Hagner W. “Physiotherapeutic treatment in patients with hip dysplasia”. Journal of Education, Health and Sport. 2018; 8(9): 1622-1628.

[18] McClure P, Podeszwa DA. “Hip click in the neonate: should i be concerned?”. Pediatric Annals. 2016; 45(4): e122-e127. doi: https://doi.org/10.3928/00904481-20160310-02.

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[20] Sakellariou VI, Christodoulou M, Sasalos G, Babis GC. (2014). Reconstruction of the acetabulum in developmental dysplasia of the hip in total hip replacement. Archives of Bone and Joint Surgery. 2014; 2(3): 130. doi: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225014/.

[21] Harris JD, Lewis BD, Park KJ. “Hip dysplasia”. Clinics in Sports Medicine. 2021; 40(2): 271-288. doi: https://doi.org/10.1016/j.csm.2020.11.004.

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[27] Storer SK, Skaggs DL. “Developmental dysplasia of the hip”. American Family Physician. 2006; 74(8), 1310-1316. doi: https://www.aafp.org/pubs/afp/issues/2006/1015/p1310.html/1000.

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[29] Hartig-Andreasen C, Søballe K, Troelsen A. “The role of the acetabular labrum in hip dysplasia: a literature overview”. Acta Orthopaedical. 2013; 84(1): 60-64. doi: https://doi.org/10.3109/17453674.2013.765626.

[30] Li J, Rai S, Ze R, Tang X, Liu R, Hong P. “Enhanced recovery care versus traditional non-ERAS care following osteotomies in developmental dysplasia of the hip in children: a retrospective case-cohort study”. BMC Musculoskeletal Disorders. 2020; 21(1): 1-7. doi: https://doi.org/10.1186/s12891-020-03243-z.

[31] Pollet V, Percy V, Prior HJ. “Relative risk and incidence for developmental dysplasia of the hip”. The Journal of Pediatrics. 2017; 181: 202-207. doi: https://doi.org/10.1016/j.jpeds.2016.10.017.

[32] Thomas SRYW. “A review of long-term outcomes for late presenting developmental hip dysplasia”. The Bone & Joint Journal. 97(6): 729-733. doi: https://doi.org/10.1302/0301-620X.97B6.35395.

Volume 16, Issue 1
January 2024
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Sport Sciences and Health Research

The effects of therapeutic exercises and education to parents on weight bearing, range of motion, joint stability, and disease complications in 4-10-year-old children with congenital hip dysplasia

[1] Ibrahim MM, Smit K. “Anatomical description and classification of hip dysplasia”. In Hip Dysplasia. Springer, Cham. 2020.

[2] Clarke NM, Taylor CC, Judd J. “Diagnosis and management of developmental hip dysplasia”. Paediatrics and Child Health. 2016; 26(6): 252-256. doi: https://doi.org/10.1016/j.paed.2016.02.002.

[3] Zajonz D, Strobel S, Wojan M, von der Höh N, Brandmaier P, Josten C, ... Heyde CE. “Pavlik harness for the treatment of congenital hip dysplasia types D III and IV”. Der Orthopade. 2016; 45(1): 72-80. doi: 10.1007/s00132-015-3171-3.

[4] Ömeroglu, H. “Treatment of developmental dysplasia of the hip with the Pavlik harness in children under six months of age: Indications, results and failures”. Journal of Children's Orthopaedics. 2018; 12(4): 308-316. doi: https://doi.org/10.1302/1863-2548.12.180055.

[5] Lange AE, Lange J, Ittermann T, Napp M, Krueger PC, Bahlmann H,... Heckmann M. “Population-based study of the incidence of congenital hip dysplasia in preterm infants from the Survey of Neonates in Pomerania (SNiP)”. BMC Pediatrics. 2017; 17(1): 1-7. doi: 10.1186/s12887-017-0829-5.

[8] Tönnis D. Congenital Dysplasia and Dislocation of the Hip in Children and Adults. Springer Science & Business Media. 2012.

[9] Schwend RM, Shaw BA, Segal LS. (2014). “Evaluation and treatment of developmental hip dysplasia in the newborn and infant”. Pediatric Clinics of North America. 2014; 61(6): 1095-1107. doi: https://doi.org/10.1016/j.pcl.2014.08.008.

[10] Agarwal A, Gupta N. “Risk factors and diagnosis of developmental dysplasia of hip in children”. Journal of Clinical Orthopaedics and Trauma. 2012; 3(1): 10-14. doi: https://doi.org/10.1016/j.jcot.2011.11.001.

[11] Terjesen T, Horn J. “Management of late-detected DDH in children under three years of age: 49 children with follow-up to skeletal maturity”. Bone & Joint Open. 2020; 1(4): 55-63. doi: https://doi.org/10.1302/2633-1462.14.BJO-2019-0005.R1.

[12] Graf R. “Hip sonography: background; technique and common mistakes; results; debate and politics; challenges”. Hip International. 2017; 27(3): 215-219. doi: https://doi.org/10.5301/hipint.5000514.

[13] Mamouri GH, Khatami F, Hamedi AB. “Congenital dislocation of the hip in newborns in the city of Mashhad”. Iranian Journal of Medical Sciences. 2015; 28(3): 127-130. doi: https://pesquisa.bvsalud.org/portal/resource/pt/emr-62286.

[14] Sørensen H, Nielsen DB, Jacobsen JS, Søballe K, Mechlenburg I. “Isokinetic dynamometry and gait analysis reveal different hip joint status in patients with hip dysplasia”. Hip Int. 2019; 29: 215-21. doi: https://doi.org/10.1177/1120700018773401.

[15] Bhuyan BK. “Outcome of one-stage treatment of developmental dysplasia of hip in older children”. Indian Journal of Orthopaedics. 2012; 46(5): 548-555. doi: https://link.springer.com/article/10.4103/0019-5413.101035.

[16] Merckaert SR, Pierzchala K, Bregou A, Zambelli PY. “Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study”. Journal of Orthopaedic Surgery and Research. 2019; 14(1): 1-7. doi: https://doi.org/10.1186/s13018-019-1441-1.

[17] Lewandowska A, Ratuszek-Sadowska D, Kuczma M, Kuczma W, Simińska J, Hagner W. “Physiotherapeutic treatment in patients with hip dysplasia”. Journal of Education, Health and Sport. 2018; 8(9): 1622-1628.

[18] McClure P, Podeszwa DA. “Hip click in the neonate: should i be concerned?”. Pediatric Annals. 2016; 45(4): e122-e127. doi: https://doi.org/10.3928/00904481-20160310-02.

[19] Mortensen L, Schultz J, Elsner A, Jakobsen SS, Søballe K, Jacobsen JS,... Mechlenburg I. “Progressive resistance training in patients with hip dysplasia: A feasibility study”. Journal of Rehabilitation Medicine. 2018; 50(8): 751-758. doi: 10.2340/16501977-2371.

[20] Sakellariou VI, Christodoulou M, Sasalos G, Babis GC. (2014). Reconstruction of the acetabulum in developmental dysplasia of the hip in total hip replacement. Archives of Bone and Joint Surgery. 2014; 2(3): 130. doi: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225014/.

[21] Harris JD, Lewis BD, Park KJ. “Hip dysplasia”. Clinics in Sports Medicine. 2021; 40(2): 271-288. doi: https://doi.org/10.1016/j.csm.2020.11.004.

[23] Zonoobi D, Hareendranathan A, Mostofi E, Mabee M, Pasha S, Cobzas D, ... Jaremko JL. “Developmental hip dysplasia diagnosis at three-dimensional US: a multicenter study”. Radiology. 2018; 287(3): 1003-1015. doi: https://doi.org/10.1148/radiol.2018172592.

[24] McCarthy JJ, Scoles PV, MacEwen GD. “Developmental dysplasia of the hip (DDH)”. Current Orthopaedics. 2005; 19(3): 223-230. doi: https://doi.org/10.1016/j.cuor.2005.05.007.

[25] Noordin S, Umer M, Hafeez K, Nawaz H. “ Developmental dysplasia of the hip”. Orthopedic Reviews. 2010; 2(2). doi: https://doi.org/10.4081%2For.2010.e19.

[26] Schwend RM. “Developmental dysplasia of the hip”. In Global Orthopedics. Springer, Cham. 2020. https://link.springer.com/chapter/10.1007/978-3-030-13290-3_38

[27] Storer SK, Skaggs DL. “Developmental dysplasia of the hip”. American Family Physician. 2006; 74(8), 1310-1316. doi: https://www.aafp.org/pubs/afp/issues/2006/1015/p1310.html/1000.

[28] Loder RT, Skopelja EN. “The epidemiology and demographics of hip dysplasia”. International Scholarly Research Notices. 2011: 1-46. doi: https://doi.org/10.5402/2011/238607.

[29] Hartig-Andreasen C, Søballe K, Troelsen A. “The role of the acetabular labrum in hip dysplasia: a literature overview”. Acta Orthopaedical. 2013; 84(1): 60-64. doi: https://doi.org/10.3109/17453674.2013.765626.

[31] Pollet V, Percy V, Prior HJ. “Relative risk and incidence for developmental dysplasia of the hip”. The Journal of Pediatrics. 2017; 181: 202-207. doi: https://doi.org/10.1016/j.jpeds.2016.10.017.

[32] Thomas SRYW. “A review of long-term outcomes for late presenting developmental hip dysplasia”. The Bone & Joint Journal. 97(6): 729-733. doi: https://doi.org/10.1302/0301-620X.97B6.35395.

Volume 16, Issue 1January 2024Pages 37-47

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Volume 16, Issue 1
January 2024
Pages 37-47