Exercise improves hip osteoarthritis function

By Lucy Piper, Senior medwireNews Reporter

Patients with hip osteoarthritis (OA) can achieve improvements in function and range of motion with the help of exercise therapy (ET), regardless of whether adjunctive manual therapy (MT) is also used, study findings suggest.

Additional MT was associated with increased patient satisfaction, but no other significant benefits.

Helen French (Royal College of Surgeons, Dublin, UK) and colleagues also found that patients not receiving ET or MT deteriorated over a 9-week waiting period.

"This deterioration in the control group over such a short timeframe was a surprising outcome," they say in the Archives of Physical Medicine and Rehabilitation.

It may have been due to the disappointment of not receiving the target intervention, or because the study included patients with severe as well as mild/moderate symptoms, the team explains.

In all, 131 patients with hip OA, aged an average of 62 years, participated in the study. They were randomly assigned to receive ET (n=45), ET plus MT (n=43), or to a waiting list for 9 weeks (n=43), after which they were re-randomized to either the ET or ET plus MT group.

ET consisted of six to eight individual 30-minute physiotherapy sessions over 8 weeks, which included flexibility and strengthening exercises. Those receiving additional MT attended longer 45-minute sessions, during which 15 minutes of manipulative techniques based on pain/stiffness relationships were administered in addition to ET.

At a 9-week follow up, the patients receiving ET and ET plus MT showed significantly greater improvements in physical function, as measured using the Western Ontario and McMaster Universities Index (WOMAC), compared with controls, with an average 7.76-point difference in scores between those receiving interventions and those not.

A significant difference in favor of intervention was also seen for hip range of motion, at 15.85 degrees, and patients who received ET and ET plus MT were more likely to show an improvement on the Patient Global Assessment.

However, there was no significant difference between the ET and ET plus MT groups in any of the outcomes, except for higher patient satisfaction with outcome among individuals receiving additional MT.

The researchers also note that although self-reported physical function improved as a result of both ET and ET plus MT interventions, there was no change in physical performance tests and neither intervention had a significant impact on psychologic status.

The researchers conclude that "more research is required to identify the optimal components of rehabilitation required to target the multifaceted elements of hip OA."

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