Evaluation of the Clinical Parameters and Kinesiophobia in Femoroacetabular Impingement Syndrome

The scale is a questionnaire consisting of 17 questions applicable to musculoskeletal disorders, encompassing parameters related to work-associated activities, injury/reinjury, and fear-avoidance. The scale employs a 4-point Likert rating, where 1= Strongly Disagree and 4= Strongly Agree. After reversing the scoring of items 4, 8, 12, and 16, a total score is derived. The scale yields a total score ranging from 17 to 68. A high score on the scale indicates a high level of kinesiophobia.

The Visual Analog Scale (VAS) will be used for subjective measurement. The scale is created with a 10 cm line, with 'No Pain' written at one end and 'Unbearable Pain' at the other. The patient is asked to mark their pain intensity on this line. The portion from the 0 point to where the patient marks provides the score

For objective pain measurement, an Algometer (Baseline®) will be utilized. The Algometer is a calibrated pressure device with a 1 cm round plastic-tipped end, measured in kg/cm2. It is used to measure pain associated with pressure thresholds.While applying pressure to the body with this plastic disc, the indicator needle progresses clockwise in kg. The measurement concludes when the participant feels pain, and the maximum tolerance point, obtainable in kg, is recorded.

Harris Hip Score has been developed to measure disability in various hip problems. The questionnaire includes parameters that assess pain, function, absence of deformity, and joint range of motion. The pain domain queries the area of pain, pain intensity, activities affected by pain, and the need for medication. The function domain assesses daily activities and walking. The deformity domain includes hip movements and measurements of limb length. The joint range of motion evaluates hip mobility. The questionnaire consists of 10 items and is scored out of a maximum of 100. A higher score indicates less dysfunction.

The Sit-to-Stand test is employed for various purposes, including the measurement of postural control, fall risk, lower extremity strength, balance, and disability. It is suggested that the Sit-to-Stand test may serve as an indicator of lower extremity strength. The test requires a chair with a height of approximately 44 cm and back support, along with a stopwatch. When seated, the patient's feet should touch the ground, and their hands are placed crossed on their shoulders. Two practice trials are allowed before the test. The patient is instructed to stand up and sit down as quickly as possible. When standing, the hips and knees should be in full extension, and when sitting, the hips should make full contact with the chair. The number of times the patient can transition from sitting to an erect position within 30 seconds is recorded.Sitting and standing less than 10 times in 30 seconds indicates lower extremity weakness.

Two scales will be used for the assessment. Each participant's total body weight in kilograms will be recorded by having them step onto one of the scales. The scales will be used sequentially and alternately for each participant. After learning the weight of the participants, they will be placed 2 meters away from the wall with a 10 cm gap between their feet, and they will be asked to look straight ahead with one foot on each scale in an erect position. Three trials will be conducted, and the participants will be taken off the scale between trials. The average of the three measurements for each scale will be calculated, and the percentage of weight-bearing asymmetry will be determined using the following formula :

Weight-Bearing Asymmetry Percentage = [(Load on the unaffected foot - Load on the affected foot) / Total body weight] × 100

The patient's hip joint range of motion will be measured using a mobile application (Clinometer, plaincode app development and tech blog, Stephanskirchen, Germany). Wheyte et al. found that the application has excellent reliability in assessing hip extension and rotation values. The measurement will be repeated three times, and the average will be considered. For hip extension, the patient will progress from a seated position to the Modified Thomas Test position, while for internal and external rotation, the measurement will be taken with the patient in a seated position, legs hanging at 90 degrees flexion, and fixed above the knee. Measurements will be taken from the neutral position towards the direction of rotation.