Exercise therapy for the management of osteoarthritis of the hip joint: a systematic review (original) (raw)

Effects of medical exercise therapy in patients with hip osteoarthritis: A randomized controlled trial with six months follow-up. A pilot study

Journal of Bodywork and Movement Therapies, 2017

Background & Aims: There is no consensus regarding what type of exercises, combination of exercises or exercise dosage is most effective in patients with longterm hip arthrosis. The goal of this study was to evaluate the effects of two different exercise programs related to dose-response relationships. Method: Prospective randomized controlled clinical trial with 6 months follow where 33 participants were randomly assigned to either high repetitive, high dosage medical exercise therapy (MET) (n=16) or low dosage exercise therapy (ET) (n=17). Primary outcomes are pain using a visual analogue scale (VAS) and function using a functional assessment questionnaire (WOMAC). Results: Patients were equal at baseline. Two patients (6 %) dropped out during the treatment period. There were no difference between groups after end of treatment nor at 6 months follow up. However, there were significant differences within each exercise group at end of treatment. Conclusion: In this pilot study, we were not able to show any difference between MET and ET. More research is needed with a larger patient population and a more extensive exercise period similar to other studies that are published regarding dose-response effects.

Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: A systematic review of randomized clinical trials

Arthritis & Rheumatism, 1999

Methods. A computerized literature search of Medline, Embase, and Cinahl was carried out. Randomized clinical trials on exercise therapy for OA of the hip or knee were selected if treatment had been randomly allocated and if pain, self-reported disability, observed disability, or patient's global assessment of effect had been used as outcome measures. The validity of trials was systematically assessed by independent reviewers. Effect sizes and power estimates were calculated. A best evidence synthesis was conducted, weighting the studies with respect to their validity and power.

Effectiveness of exercise in patients with osteoarthritis of hip or knee: nine months' follow up

Annals of the Rheumatic Diseases, 2001

Objective-To determine whether the effects of an exercise programme in patients with osteoarthritis of hip or knee are sustained at six and nine months' follow up. Methods-A randomised, single blind, clinical trial was conducted in a primary care setting. Patients with osteoarthritis of hip or knee (ACR criteria) were selected. Two intervention groups were compared. Both groups received treatment from their general practitioner, including patient education and drug treatment if necessary. The experimental group also received exercise treatment from a physiotherapist in primary care. The treatment period was 12 weeks, with an ensuing 24 week follow up. The main outcome measures were pain, drug use (non-steroidal anti-inflammatory drugs), and observed disability. Results-201 patients were randomly allocated to the exercise or control group, and 183 patients completed the trial. At 24 weeks exercise treatment was associated with a small to moderate eVect on pain during the past week (diVerence in change between the two groups −11.5 (95% CI −19.7 to −3.3). At 36 weeks no diVerences were found between the groups. Conclusions-Beneficial eVects of exercise decline over time and finally disappear.

Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review

2013

This systematic review aimed at investigating the role of therapeutic exercise and/or manual therapy in the treatment of hip osteoarthritis (OA). Two independent reviewers (AR, CV) searched PubMed, Cinahl, Cochrane Library, PEDro and Scopus databases and a third one (SP) was consulted in case of disagreement. The research criteria were publication period (from May 2007 to April 2012) and publication language (English or Italian). Ten randomized controlled trials matched inclusion criteria, eight of which concerning therapeutic exercise and two manual therapy. Few good quality studies were found. At mid-and long-term follow-up land-based exercises showed insufficient evidence of effectiveness with respect to pain and quality of life, but positive results were found for physical function. Water exercises significantly reduced fall risk when combined with functional exercises. Programs containing progressive and gradual exposure of difficult activities, education and exercises promoted better outcomes, higher adherence to home program and increased amount of physical activity, especially walking. Manual therapy seemed to reduce pain and decrease disability at short-term. Less use of nonsteroidal anti-inflammatory drugs was statistically significant at long-term follow-up in patients treated with manual therapy. The relationship between clinical results and radiological grade of OA was not investigated. Encouraging results were found in recent literature for manual therapy and functional training. Further research is needed to elucidate this issue through high-quality trials, especially addressing the aspects that have not been thoroughly explored yet, for instance type, amount and scheduling of conservative treatment.

Development of a Therapeutic Exercise Program for Patients With Osteoarthritis of the Hip

Physical Therapy, 2010

No detailed exercise programs specifically for patients with hip osteoarthritis (OA) have been described in the literature. This lack of data creates a gap between the recommendation that people with OA should exercise and the type and dose of exercises that they should perform. The purpose of this case report is to describe and demonstrate the use of a therapeutic exercise program for a patient with hip OA.

Exercise and Manual Physiotherapy Arthritis Research Trial (EMPART) for Osteoarthritis of the Hip: A Multicenter Randomized Controlled Trial

Archives of Physical Medicine and Rehabilitation, 2013

Background: Osteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy.

Osteoarthritis: 119. The Effectiveness of Exercise Therapy with and without Manual Therapy for Hip Osteoarthritis: A Multicentre Randomised Controlled Trial

Rheumatology, 2011

The definition of vitamin D sufficiency according to our reference laboratory is a 25(OH)D level of >75 nmol/L. Vitamin D status was checked in a total of 85 patients (53 female; 32 male). The mean age was 54.8 years (range: 19-86 years). A total of 90.6% patients showed inadequate levels of 25(OH)D (87.5% of males and 92.5% of females). 64.7% of patients had a 25(OH)D level < 50 nmol/L. 23.5% of the total had a 25(OH)D level < 30 nmol/L. Conclusions: The vast majority of rheumatology outpatients complaining of polyarthralgia, polymyalgia or fatigue either as a primary diagnosis or secondary to their main rheumatological diagnosis had inadequate vitamin D levels. It should be noted that most of these results were obtained in early autumn when it might be expected that vitamin D levels would be at their peak. Almost a quarter of these patients had very low vitamin D levels (<30 nmol/L).