None listed
Conditions
Brief summary
Hip osteoarthritis is major public health problem with significant personal, social and economic burden. Exercise is central to self-management., but little is known what type of exercise is best. Our primary aim is to evaluate whether people with hip osteoarthritis respond differently to two types of exercise interventions i) lower-limb muscle strengthening and ii) lower limb muscle strengthening with aerobic physical activity. People with hip osteoarthritis will be randomly allocated into one of two different 9-month home exercise programs. Over the first 12 weeks participant will attend 9 in clinic physiotherapist appointments. The physiotherapist will prescribe a home exercise program following the exercise protocol assigned to the participant. Primary outcomes are overall hip pain and physical function measured at 12 weeks. The findings of this study will help determine which of the two exercise program are best for people with hip osteoarthritis and will guide clinicians in providing appropriate evidence-based advice for patients.
Interventions
This randomised controlled trial will compare two exercise interventions for management of hip osteoarthritis.
Both interventions will include 9 individual physiotherapist consultations online via videoconference (first consultation up to 1 hour and up to 30 minutes thereafter) and a home exercise program over the same 12 week period. Physiotherapy consultations are expected to occur at weeks 1,2,3,4,5,6,8,10 and 12. The purpose of the physiotherapy consultations are to deliver, monitor and pro
This randomised controlled trial will compare two exercise interventions for management of hip osteoarthritis. Both interventions will include 9 individual physiotherapist consultations online via videoconference (first consultation up to 1 hour and up to 30 minutes thereafter) and a home exercise program over the same 12 week period. Physiotherapy consultations are expected to occur at weeks 1,2,3,4,5,6,8,10 and 12. The purpose of the physiotherapy consultations are to deliver, monitor and progress participants through the interventions described below. The two interventions are: i) lower-limb muscle strengthening exercises ii) lower-limb muscle strengthening (exactly as in intervention described above) and aerobic physical activity i) The lower-limb muscle strengthening exercise program will included up to 6 exercises including a hip extensor exercise, a hip flexor exercise, a hip adductor exercise, a hip abductor exercise and 1-2 functional exercises (i.e. squat). The intensity for the strengthening exercise will aim to be “very hard” (i.e. 7 out of 10) on the modified Borg Rating of Perceived Exertion CR-10 scale for muscle strengthening. Strengthening exercises will take approximately 20 minutes to complete and participants will be asked to complete these 3 times per week at home. ii) In addition to the strengthening program exactly as described above, participants will receive an aerobic physical activity program. Physiotherapists will facilitate participants to build up to engage in 150 minutes of moderate intensity aerobic physical activity per week. Physiotherapist will guide participants to self-manage their aerobic physical activity at an intensity equivalent to at least “somewhat hard” (i.e. 13 out of 20) on the Borg Rating of Perceived exercise and corresponding heart rate on their wearable activity monitor. Types of aerobic physical activity will be negotiated between the physiotherapist and participant, and may include any type of activity, acceptable to, and feasible for the participant. Participants will be encouraged to incorporate aerobic physical activity into their daily lives and guided to gradually increase their aerobic physical activity at moderate intensity by at least 10 minutes block per week over the 3-month supervised intervention period until 150 minutes of at least moderate intensity exercise per week, in bouts of at least 10 minutes. Participants will be provided with all the related exercise equipment including: elastic bands, ankle-cuff weights, exercise mat and a wearable activity monitor. The initial 3 months will be followed by a continuation of the exercise intervention independently for a further 6 months.
Sponsors
The University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be eligible for the study if they meet the following inclusion criteria: i. Meet the National Institute for Health and Care Excellence clinical criteria for OA; a) aged 45 years or older; b) activity-related hip joint pain; c) morning hip stiffness for less than or equal to 30 minutes; ii. Report history of hip pain for longer than 3 months; iii. Report hip pain on most days of the past month; iv. Report an average overall pain score of at least 4 on an 11-point numeric rating scale over the previous week; v. Pass the American College of Sports Medicine Exercise Pre-participation Health Screening Questionnaire; or if anyone who fails this pre-exercise questionnaire, general practitioner clearance must be obtained to participate in this study (see Phoenix Exercise Clearance GP letter) vi. access to a device with internet connection
Exclusion criteria
i. Unable or unwilling to comply with study protocol; ii. Inability to speak English; iii. On waiting list or planning back/lower limb surgery in the next 12 months; iv. Previous hip replacement in the affected hip; v. Any hip surgery in the past 6 months; vi. Currently taking corticosteroids or have done so in the past 3 months; vii. Any hip injections in the past 3 months or planned hip injections in next 9 months; viii. Participating in strengthening exercises at least three times per week and/or engaging in 150 minutes of moderate aerobic physical activity per week within past 6 months; ix. Self-reported inflammatory arthritis; x. Any neurological condition affecting lower limb and ability to exercise safely; xi. Any unstable or uncontrolled cardiovascular condition; xii. Pregnancy or planned pregnancy.
Outcome results
None listed