Background and Purpose: The primary purpose of this study was to develop a clinical prediction rule (CPR) for identifying patients with knee pain and clinical evidence of knee osteoarthritis (OA) with favorable short-term response to hip mobilizations. The secondary purpose was to determine the predictive validity of individual clinical tests for identifying these same patients.Subjects and Methods: Sixty subjects with knee OA, aged 51 to 79 years, completed self-report questionnaires, a clinical examination of the hip and knee, and functional tests and were treated with 4 hip mobilizations. Follow-up testing was completed 2 days later. The reference criterion for determining a favorable response was either (1) a decrease of at least 30% on composite Numerical Pain Rating Scale score obtained during functional tests or (2) a Global Rating of Change Scale score of at least 3.Results: The CPR developed in this study comprised 5 variables: (1) hip or groin pain or paresthesia, (2) anterior thigh pain, (3) passive knee flexion less than 122 degrees, (4) passive hip medial (internal) rotation less than 17 degrees, and (5) pain with hip distraction. Based on the pretest probability of success (68%), the presence of one variable had a positive likelihood ratio of 5.1 and increased the probability of a successful response to 92% at 48-hour follow-up. If 2 variables were present, the positive likelihood ratio was 12.9 and the probability of success increased to 97%.Discussion and Conclusion: The results suggest that the CPR developed in this study could improve clinicians’ decision making and efficiency in examining and treating patients with knee OA.

Many older Veterans are physically debilitated, with a reduced quality of life (QOL.) Use of assistive devices during ambulation is indicative of fall risk. We describe two case studies following six-months of participation in Gerofit, a structured exercise program. Ms. M., a 75 y/o Veteran with chronic PTSD and joint pain could walk 237 yards in six-minutes using a cane. Mr. D., an 86 y/o Veteran, came to Gerofit using a Front Wheeled Walker and could walk 307 yards in 6-minutes. After six-months of Gerofit, neither Veteran used assistive devices during testing, and both reported higher QOL. Ms. M. now walks 514 yards in six minutes, while Mr. D. can walk 375 yards in six minutes. Both Veterans exhibit improved balance and endurance. They tell us: “Gerofit gave me my life back!” and “Gerofit gets me out of the house and off the couch.”