Long-Term Effect of Exercise Therapy and Patient Education on Impairments and Activity Limitations in People With Hip Osteoarthritis: Secondary Outcome Analysis of a Randomized Clinical Trial

Background The effect of exercise on specific impairments and activity limitations in patients with hip osteoarthritis (OA) is limited. Objectives To evaluate long-term results of exercise therapy and patient education on range of motion (ROM), muscle strength, physical fitness, walking capacity and pain during walking in patients with hip OA. Design Randomized clinical trial Setting University Hospital Patients One hundred and nine patients with clinical and radiographic hip OA, included at a university hospital, were randomly allocated to exercise therapy and patient education (exercise group) or patient education only (control group). Interventions All patients participated in a patient education program consisting of three group meetings led by two physical therapists. Two other physical therapists were responsible for providing the exercise therapy program, consisting of 2-3 weekly sessions of strengthening, functional and stretching exercises over 12-weeks. Both interventions were conducted at a sports medicine clinic. Outcome measures Outcome measures included ROM, isokinetic muscle strength, predicted maximal oxygen consumption determined by the Astrand bike test, the six minute walk test (6MWT) for distance and pain during the 6MWT. Follow-ups were conducted four, ten and 29 months after inclusion by five physical therapists blinded to group allocation. Results No significant group differences were found for ROM, muscle strength, predicted maximal oxygen consumption, or 6MWT for distance over the follow-up period, but the exercise group had less pain during the 6MWT compared to the control group at 10 months [mean difference (95 % confidence interval) -8.5 mm (-16.1, -0.9)] and 29 months [-9.3 mm (-18.1, -0.6)]. Limitations Reduced statistical power and 53 % compliance rate with the exercise program. Conclusions The previously reported effect of exercise on self-reported function was not reflected by beneficial results in ROM, muscle strength, physical fitness and walking capacity, but exercise in addition to patient education resulted in less pain during walking in the long-term.