Exercise and manual physiotherapy arthritis research trial for osteoarthritis of the hip: a multicenter randomized controlled trial.
To determine the effectiveness of exercise therapy (ET) compared with ET with adjunctive manual therapy (MT) for people with hip osteoarthritis (OA); and to identify if immediate commencement of treatment (ET or ET&MT) was more beneﬁcial than a 9-week waiting period for either intervention. An assessor-blind RCT with a 9-week and 18-week follow-up recruited 131 participants; ET n=45, ET&MT n=43, Waitlist controls n=43.
Participants in both the ET and ET&MT groups received up to 8 treatments over 8 weeks. Control group participants were rerandomised into either ET or ET&MT groups after 9 week follow-up. Their data were pooled with original treatment group data: ET n=66, and ET&MT n=65.
The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function (PF) subscale. Secondary outcomes included physical performance, pain severity, hip range of motion (ROM), anxiety/depression, quality of life, medication usage, patient-perceived change, and patient satisfaction.
There was no signiﬁcant difference in WOMAC PF between the ET (n= 66) and ET&MT (n=65) groups at 9 weeks or 18 weeks, or between other outcomes, except patient satisfaction with outcomes, which was higher in the ET&MT group. Improvements in WOMAC, hip ROM, and patient-perceived change occurred in both treatment groups compared with the control group.
Self-reported function, hip ROM, and patient-perceived improvement occurred after an 8-week program of ET for patients with OA of the hip. MT as an adjunct to exercise provided no further beneﬁt, except for higher patient satisfaction with outcome. > From: French et al., Arch Phys Med Rehabil 94 (2013) 302-314. All rights reserved to the American Congress of Rehabilitation Medicine.
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