Lucie Brosseau1, George A Wells2, Arlanna G Pugh3, Christine Am Smith2, Prinon Rahman4, Inmaculada C Àlvarez Gallardo5, Karine Toupin-April6, Laurianne Loew7, Gino De Angelis2, Sabrina Cavallo8, Jade Taki9, Rachel Marcotte10, Marlene Fransen11, Gabriela Hernandez-Molina12, Glen P Kenny10, Jean-Philippe Regnaux13, Marie-Martine Lefevre-Colau14, Sydney Brooks15, Lucie Laferriere16, Linda McLean7, Guy Longchamp17. 1. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada Lucie.Brosseau@uottawa.ca. 2. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. 3. Department of Public Health Sciences, Queens University, Canada. 4. Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. 5. Department of Physical Education and Sport, University of Granada, Granada, Spain. 6. Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. 7. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada. 8. School of Public Health, Option Epidemiology, University of Montreal, Montreal, Quebec, Canada. 9. Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. 10. School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. 11. Faculty of Health Sciences, University of Sydney, Sydney, Australia. 12. Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Canada. 13. Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France. 14. Department of Medicine and Rehabilitation, Institute of Rheumatology, Cochin Hospital, Paris, France. 15. The Arthritis Society, Ontario Division, Ontario, Canada. 16. Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada. 17. Consumer expert.
Abstract
OBJECTIVES: The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. METHODS: The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p < 0.5), and clinical importance (⩾15% improvement). RESULTS: Four high-quality studies were included, which demonstrated that variations of strength training, stretching, and flexibility exercises are generally effective for improving the management of hip osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). CONCLUSION: The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion.
OBJECTIVES: The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. METHODS: The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritispatients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p < 0.5), and clinical importance (⩾15% improvement). RESULTS: Four high-quality studies were included, which demonstrated that variations of strength training, stretching, and flexibility exercises are generally effective for improving the management of hip osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). CONCLUSION: The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion.
Authors: Michael A Clynes; Camille Parsons; Mark H Edwards; Jonathan H Tobias; Kevin Deere; Cyrus Cooper; Elaine M Dennison Journal: Rheumatol Int Date: 2019-04-29 Impact factor: 2.631
Authors: Adam Ivan Semciw; Tania Pizzari; Stephanie Woodley; Anita Zacharias; Michael Kingsley; Rod A Green Journal: Trials Date: 2018-09-20 Impact factor: 2.279