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Interestingly, higher maximal muscle strength is associated with less pain, better physical function and improved QoL in people with FAIS. Furthermore, preliminary evidence suggests that a proportion of patients with FAIS respond positively to strength exercise as first-line treatment. Nonetheless, there is little evidence supporting a specific exercise intervention offered as a first-line treatment. We will conduct a randomised controlled trial investigating the clinical effectiveness and cost-effectiveness of a 6-month strength exercise intervention compared with usual care as first-line treatment in patients with FAIS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>This is a multicentre randomised controlled trial that will be conducted at hospitals and physiotherapy clinics across Denmark and Australia. A total of 120 patients with FAIS will be randomised (1:1) to 6 months of supervised strength exercise or usual care. The primary outcome is the change in hip-related QoL measured using the International Hip and Outcome Tool 33 (iHOT-33) from baseline to the end of intervention. A health economic evaluation will be conducted from a societal and healthcare perspective based on the data collection over a 12-month period starting at baseline. The analysis will calculate incremental cost-effectiveness ratios using quality-adjusted life-years and iHOT-33 scores while estimating costs using microcosting and cost questionnaires. Secondary outcomes include objectively measured physical function at baseline and after 6 months and patient-reported outcomes measured at baseline, 3-month, 6-month and 12-month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The trial has been approved by the Committee on Health Research Ethics in the Central Denmark Region (journal no 1-10-72-45-23) and La Trobe University Human Ethics Committee (HEC24042) and is registered at the Central Denmark Region List of Research Projects (journal no 1-16-02-115-23). Informed consent will be obtained from each participant before randomisation. Results will be published in international peer-reviewed scientific journals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05927935\">NCT05927935<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078726","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T04:51:13Z","timestamp":1719031873000},"page":"e078726","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["First-line treatment for femoroacetabular impingement syndrome and hip-related quality of life: study protocol for a multicentre randomised controlled trial comparing a 6-month supervised strength exercise intervention to usual care (the Better Hip Trial)"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05927935","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05927935","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8675-9653","authenticated-orcid":false,"given":"Frederik Nicolai","family":"Foldager","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0802-9660","authenticated-orcid":false,"given":"Signe","family":"Kierkegaard-Br\u00f8chner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9234-1923","authenticated-orcid":false,"given":"Joanne L","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7589-8471","authenticated-orcid":false,"given":"Maurits W","family":"van Tulder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bent","family":"Lund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bjarne","family":"Mygind-Klavsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4742-4076","authenticated-orcid":false,"given":"Bo Martin","family":"Bibby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4132-2789","authenticated-orcid":false,"given":"Ulrik","family":"Dalgas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5432-8691","authenticated-orcid":false,"given":"Inger","family":"Mechlenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"2024062121500924000_14.6.e078726.1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/0363546520970914","article-title":"Incidence of Femoroacetabular Impingement and surgical management trends over time","volume":"49","author":"Hale","year":"2021","journal-title":"Am J Sports Med"},{"key":"2024062121500924000_14.6.e078726.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096743"},{"key":"2024062121500924000_14.6.e078726.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201643"},{"key":"2024062121500924000_14.6.e078726.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.07.004"},{"key":"2024062121500924000_14.6.e078726.5","doi-asserted-by":"crossref","unstructured":"Ganz R , Parvizi J , Beck M , et al . 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