Evidence map›Paper›PMID 42501795›Full record

SynthesisJournal of ISAKOS : joint disorders & orthopaedic sports medicine2026

Prehabilitation for femoroacetabular impingement syndrome: intervention development using the Medical Research Council Framework.

Anuj Punnoose, Leica Claydon Mueller, Vianca Shah, Alison B Rushton, Vikas Khanduja

Abstract readSystematic Review
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In one paragraph

Synthesis in Journal of ISAKOS : joint disorders & orthopaedic sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anuj PunnooseYoung Adult Hip Service & Department of Physiotherapy, Addenbrooke's - Cambridge University Hospital NHS Foundation Trust, Cambridge, UK; School of Allied Health and Social Care, Anglia Ruskin University, Cambridge, UK.
Leica Claydon MuellerSchool of Allied Health and Social Care, Anglia Ruskin University, Cambridge, UK.
Vianca ShahSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Alison B RushtonSchool of Physical Therapy, Faculty of Health Sciences, Western University, London, Canada.
Vikas KhandujaSchool of Clinical Medicine, University of Cambridge, Cambridge, UK; Young Adult Hip Service, Department of Trauma & Orthopaedics, Addenbrooke's - Cambridge University Hospital NHS Foundation Trust, Cambridge, UK. Electronic address: vk279@cam.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEffectiveness of pre-operative or pre-surgical rehabilitation also known as "prehabilitation" in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) is unknown. The aim of this study was to develop a novel prehabilitation intervention using structured processes as per the Medical Research Council (MRC) for this cohort.

methodsA multi-method intervention development process was undertaken using the MRC framework. Patient and public involvement (PPI) explored patient experiences of hip pain, barriers to exercise engagement, and preferences for intervention delivery. A systematic review and meta-analysis of prehabilitation in orthopedic surgery informed intervention dosage and delivery characteristics. An international expert consensus identified core domains to be targeted, and a focused literature review synthesized electromyographic evidence using maximum voluntary isometric contraction (MVIC) percentage to select and grade exercises based on muscle activation and symptom provocation risk.

resultsThe resulting PREHAB femoroacetabular impingement (FAI) program is an 8-week, two-phase intervention comprising progressive strengthening, range of motion, balance and proprioception, cardiovascular conditioning, and education components. Phase 1 (weeks 1-4) emphasizes low- to moderate-intensity exercises (16-40% MVIC) targeting hip abductors, extensors, adductors, and trunk muscles, while phase 2 (weeks 5-8) progresses to higher-intensity strengthening (>40% MVIC). Exercises that positioned the hip in impingement or had a high likelihood of symptom aggravation were excluded. The program is delivered using a combination of supervised and home-based sessions, supported by digital monitoring to promote adherence. The intervention was designed to optimize physical readiness for hip arthroscopy while minimizing symptom exacerbation during the pre-operative waiting period.

conclusionThis prehabilitation program was developed through multiple structured methods and is supported by PPI involvement, published evidence, and a consensus statement as per the MRC framework for development of an intervention. The developed program will be utilized in a feasibility study (PREHAB FAI) that will assess the feasibility, suitability, acceptability, and safety of this novel intervention in patients with FAIS undergoing arthroscopic surgery. LEVEL OF EVIDENCE: Not applicable.

Indexed as

Exercise TherapyFemoracetabular ImpingementPreoperative ExerciseArthroscopyHip JointHumansRange of Motion, ArticularTreatment OutcomeFAISFemoroacetabular impingement syndromeIntervention developmentPrehabilitation

Identifiers

PMID42501795

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.