Background: Groin pain is a common pathology among athletes, presenting pain and a reduced range of motion
(ROM) as clinical characteristics. Passive physical therapy (PPT) and exercise therapy (ET) interventions are chosen
firstly before surgery. The aim of this systematic review and meta-analysis was: (i) to qualitative review the effects of
each non-surgical intervention; (ii) to quantitative compare the effects of PPTs plus ET intervention to ET in isolation in
pain intensity, and hip ROM in athletes with groin pain.
Methods: A systematic review and meta-analysis was conducted. Pubmed, PEDro, Web of science, Scopus and
Cochrane library were searched. Randomized controlled trials comparing PPT plus ET to ET interventions were
included. The methodological quality and risk of bias of the included studies, were assessed with the PEDro scale and
the Cochrane risk-of-bias tool. To assess the certainty of evidence the GRADEpro GDT was used. Meta-analyses were
conducted using RevMan 5.4 using mean difference analysis to assess the variables pain intensity and hip ROM.
Results: A total of 175 studies was identified from the consulted databases. Five studies were included for systematicreview,
from which three studies were meta-analyzed. The methodological quality of the included studies ranged
from poor to high. ET compared to PPT plus ET provided statistically significant improvements in pain intensity in the
short-term (MD = 2.45; 95% CI 1.11, 3.79; I2 :65%). No statistically significant differences between interventions were
obtained for hip ROM in the short-term.
Conclusions: The qualitative review showed that PPTs plus ET and ET seem to have positive effects on pain intensity
and hip ROM. The quantitative analysis found very low certainty of evidence proposing a positive effect in pain
intensity for ET interventions based on hip muscles stretching, compared to PPT combined with ET, in the short-term.
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