A Pilot Randomized Controlled Trial for Aerobic and Strengthening Exercises on Physical Function and Pain for Hip Osteoarthritis

Abstract

Background Hip osteoarthritis (OA) limits lower extremity physical function. Exercise therapy may improve physical function and reduce pain in patients with hip OA. Objective To evaluate the feasibility of a randomized controlled trial (RCT) to measure the effect of a structured hip‐specific resistance and aerobic exercise program on physical function and self‐reported pain in adults with hip OA. Design Pilot RCT. Setting Academic medical center. Participants Thirty one adults with radiographic hip OA. Interventions Participants were randomly allocated in a 2:1 ratio to a 3‐month structured exercise intervention (n = 21) or a 3‐month waitlist control (n = 10). Main Outcome Measures The 6‐minute walk test was the primary outcome measure. Self‐reported physical function was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and pain visual analog scale (VAS). Measures of feasibility were assessed as secondary outcomes. Results From baseline to 3 months, the median change from baseline in distance covered during the 6‐minute walk test in the intervention group (49 m) was double that of the control group (22 m), but the difference was not statistically significant (P = .13). Likewise, the WOMAC physical function subscale score median changes in the intervention group (5 points) were double that of the controls (2 points), although the difference was not statistically significant (P = .06). Median change in pain scores was slightly reduced in each group but not significantly different between groups (P = .53). Conclusion Although no statistically significant between‐group differences were found in this pilot RCT, improvements were seen in measures of physical function compared to controls. A larger RCT of this structured exercise program may be warranted.

The quality of intervention reporting in trials of therapeutic exercise for hip osteoarthritis: a secondary analysis of a systematic review

“…The search yielded fourteen RCTs with a total of 707 participants enrolled in an intervention of therapeutic exercise for HOA [30][31][32][33][34][35][36][37][38][39][40][41][42][43]. These studies are described in detail in the original systematic review [20].…”

Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis

“…Three studies from the 12 included studies in the Cochrane reviews were excluded for following reasons: no data available separately for hip OA patients, only an abstract was provided, exercise was not physical therapy but Tai Chi. In total nine studies of the Cochrane reviews could be included in our present study [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ], together with the nine references of the literature search [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] ], so in total 18 studies were included.

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“… Waiting list (n ​= ​5). After treatment: Function: HOOS Pain: HOOS Thompson 2020 [ 33 ] Radiological hip OA and pain and loss of function Exercise (n ​= ​21). Groups sessions, strengthening/flexibility/endurance exercises (12 weeks, 3x per week, 60 ​min) Waiting list (n ​= ​10).…”

Osteoarthritis year in review 2020: rehabilitation and outcomes

“…Of the 18 SRs one evaluated hand OA 14 , four hip and knee OA 15e18 , 10 knee OA 19e28 and three mixed OA 29e31 . Of the 38 RCTs three evaluated hand OA 32e34 , two hip OA 35,36 , 31 knee OA 37e68 , and one foot 69 OA. Table I summarizes the SRs and RCTs by intervention type and joint.…”

“…The 38 identified RCTs investigated various individual (aerobic 35,51,57 , (aquatic 42,43 , neuromuscular 39,47 , resistancebased, 38,44,45 ) and combined 37,41,46 exercise-therapies/physical activities, technologies (telerehab 48,50 , video games 40 ) and behaviour change approaches 49 to improve adherence to exercise and PA, modalities (cryotherapy 54,68 , electrical current therapy 53 , ESWT 62 , interferential current 61 , laser 32 , pneumatic compression 58 , transcutaneous electrical nerve stimulation 60 and therapeutic ultrasound 59 ), manual (acupressure 65 , mobilization with movement 66,67 , neurodynamic mobilizations 34 ), needling 36,52 , taping 33,63,64 , or combined 55,56,69 therapies.…”