Exercise for osteoarthritis of the hip

Abstract

A B S T R A C T BackgroundCurrent international treatment guidelines recommending therapeutic exercise for people with symptomatic hip osteoarthritis (OA) report are based on limited evidence. ObjectivesTo determine whether land-based therapeutic exercise is beneficial for people with hip OA in terms of reduced joint pain and improved physical function and quality of life. Search methodsWe searched five databases from inception up to February 2013. Selection criteriaAll randomised controlled trials (RCTs) recruiting people with hip OA and comparing some form of land-based therapeutic exercise (as opposed to exercises conducted in water) with a non-exercise group. Data collection and analysisFour review authors independently selected studies for inclusion. We resolved disagreements through consensus. Two review authors independently extracted data, assessed risk of bias and the quality of the body of evidence for each outcome using the GRADE approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) and dichotomous outcomes (proportion of study withdrawals). Main resultsWe considered that seven of the 10 included RCTs had a low risk of bias. However, the results may be vulnerable to performance and detection bias as none of the RCTs were able to blind participants to treatment allocation and, while most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self reported. One of the 10 RCTs was only reported as a conference abstract and did not provide sufficient data for the evaluation of bias risk.High-quality evidence from nine trials (549 participants) indicated that exercise reduced pain (standardised mean difference (SMD) -0.38, 95% confidence interval (CI) -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately Exercise for osteoarthritis of the hip (Review) This summary of an update of a Cochrane review presents what we know from research about the effect of exercise for people with OA of the hip. After searching for all relevant studies up to February 2013, we included five new studies since the last version of the review, giving 10 studies (549 participants) with mostly mild-to-moderate symptomatic hip OA, alone or with knee OA. Except for one study where participants enrolled in a tai chi programme, all other participants underwent land-based exercise programmes consisting of traditional muscle strengthening, functional training and aerobic fitness programmes, either individually supervised or as part of a group, compared with people who did not exercise. Key results2 Exercise for osteoarthritis of the hip (Review)

Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis

“…10 This systematic review underwent Cochrane peer review, thus search results were considered to be of high quality. The selection criteria of the systematic review were modified to consider studies with participants primarily having hip osteoarthritis ('signal' joint; used to characterize patient's disease) and consider all outcomes according to the objectives of the Ottawa Panel guideline.…”

Nonoperative Options for Management of Articular Cartilage Disease

“…4 Although not as marked as the effect for knee OA, a significant improvement in both pain and physical function was noted. Pain was reduced by 8 points with exercise, and physical function was improved by 7 points.…”

A Current Trend in the Scenario of Management of Major Joint Disorder Arthritis With Yoga.

“…6(5), 1040-1045 1041 result in muscle or tendon shortening, articular capsule contraction and weakened ligaments. [12] Conversely, regular activity may decrease pain and preserve stability. [13,14] While there was once concern that exercise might increase inflammation and exacerbate pain, regular physical activity is now recommended as part of comprehensive treatment of arthritis [15 -18].…”