Appendix 3 (24-week follow-up results)

(T3) Status after 8 weeks: Participants who (T3) Status after 8 weeks: Participants who
continued exercising for additional 16 weeks stopped exercising after the 8-week exercise
after the 8-week exercise period (n = 27) period (n = 12)

(mean ± SD) (mean ± SD)

PP-T3 HAGOS-PAIN, 68.8 ± 14.8 PP-T3 HAGOS-PAIN, 52.7 ± 26.8

Between group difference 16.1 ± 6.4, P = 0.02†

PP-T3 – PP-T2 within group change, PP-T3 – PP-T2 within group change,
6.1 ± 8.6, P = 0.001‡ 3.1 ± 9.2, P = 0.26‡

Adherence to training week 8-24: Reasons for stopping exercising:

Exercise frequency per week - Not expected change (n = 5)
0 – 1 (n = 11) - Symptoms (n = 3)
1 – 2 (n = 6) - Pregnancy (n = 2)
2 – 3 (n = 1) - Planed hip arthroscopy (n = 1)
3 – 4 (n = 3) - No symptoms (n = 1)

(T4) 24 weeks follow-up: (T4) 24 weeks follow-up:

Results after additional 16 weeks of exercise Results after 16 weeks of no structured
(n = 21), lost to follow up (n = 6) exercise (n = 3), Lost to follow-up (n = 9)

Median (IQR) Median (IQR)

PP-T4 HAGOS-PAIN, 75 (52.5, 85) PP-T4 HAGOS-PAIN, 37.5 (30, 57.5)

No between group analysis

because of low sample size

PP-T4 – PP-T2 within group change, PP-T4 – PP-T2 within group change,
7.5 (-2.5, 15), P = 0.01§ 15 (12.5,17.5)

Overview figure of patient´s progress after 8-week exercising.

Abbreviations: PP: per-protocol dividing of the patients who continue to exercise and those who
stop, T2: ´start-up of exercise intervention´ 8 weeks from baseline, T3: ´end of exercise
intervention´ after 8 weeks (primary endpoint), T4: follow-up after 24-weeks, IQR: interquartile
range.
†
Independent t test, ‡ Paired t test, § Wilcoxon Signed-Rank Test
 Appendix 3 (24-week follow-up results)

Twenty-seven (69%) of the patients continued exercising for an additional 16 weeks after the 8-
week period. Patients who continued exercising reported less pain (16.1 ± 6.4 HAGOS-PAIN
points, P = 0.02) after the prior 8-week training (T3) compared to patients that stopped.

After a total of 24 weeks from T2 (8 weeks + additional 16 weeks), a significant but not clinically
relevant median reduction in the HAGOS-PAIN score (within-group median change) of 7.5 points
(IQR: -2.5, 15), P = 0.01, was observed from T2 to T4 in patients (n = 21) continuing exercising.
This change is comparable with the overall mean change of 5.2 HAGOS-PAIN points (95% CI: -
0.3, 10.6), (P = 0.06) observed at the primary endpoint (T3), suggesting that a continuation of
exercising does not add a change in hip-related pain. However, only three patients continued
exercising with a frequency of 3 times/week as prescribed in the additional training period, making
it inconclusive whether exercising beyond 8 weeks will change hip-related pain in patients with
acetabular retroversion.
Interestingly, those three patients who did not continue exercise but answered the questionnaire at
T4 also showed a median reduction in the HAGOS-PAIN score of 15 points (IQR: 12.5, 17.5). This
may be due to a non-responder phenomenon as these participants demonstrated severe pain levels
throughout the whole study period. Alternatively, the observation may be due to a statistical chance.