Hip Osteoarthritis
Conditions
Keywords
Exercise, Hip osteoarthritis, Randomized controlled trial
Brief summary
According to Danish and international guidelines the recommended first-line of management for people with osteoarthritis consist of exercise, education, analgesic medication, and, if necessary, weight reduction. It is well documented that exercise has a positive effect on pain and physical function in patients with knee OA, but the effect of exercise on hip OA is sparsely investigated. Aim of the study: To investigate the effects of 1) strength training, and 2) Nordic Walking, and 3) unsupervised home based exercise on muscle function, endurance, pain level, physical activity, and health related quality of life in patients with osteoarthritis of the hip. The effects of exercise on muscle mass and the mechanisms behind the osteoarthritis, i.e., disease activity, inflammation, and cartilage degradation, are investigated in a subgroup (n=45) of the participants. Study hypotheses: Strength training will have a greater effect on physical function and muscle strength than Nordic Walking and home based exercise; 2) Nordic Walking will have a greater effect on endurance than strength training and unsupervised home based exercise; 3) Strength training and Nordic Walking will have a greater effect on pain level and health related quality of life than unsupervised home based exercise.
Interventions
PROCEDUREStrength training
Supervised strength training in groups 2 x 1 hour weekly and un-supervised strength training 1 hour weekly for 4 months
PROCEDURENordic Walking
Supervised Nordic Walking in groups 2 x 1 hour weekly and un-supervised Nordic Walking 1 hour weekly for 4 months
PROCEDUREUnsupervised home based exercise
Unsupervised home based exercise as recommended by the Danish Arthritis Association 1 hour 3 x weekly for 4 months
Sponsors
Bispebjerg Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1)Home-dwelling 60+ year old persons with primary, symptomatic hip OA who meet the clinical criteria of hip OA according to American College of Rheumatology (ACR), and who are not on a waiting list for hip joint replacement.
Exclusion criteria
1. symptomatic OA in the knee or the big toe, 2. joint replacement of the knee or the hip, 3. other types of arthritis, e.g., rheumatoid arthritis, 4. previous hip fracture, 5. limitation in physical function to the extent that using public transportation is impossible, 6. co-morbidity that prevents exercising, 7. physiotherapy related to hip problems within the last 3 months, 8. steroid injections in the hip joint within the last 3 months, 9. performing exercise/sports 2+ times weekly, and 10. inability to cooperate.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change from Baseline to 2, 4 and 12 months in number of chair stands in 30 sec at 2, 4 and 12 months | Baseline, 2, 4 and 12 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline to 2, 4 and 12 months in 6 minute walking distance (m), stair climbing time (s), 15 s marching on the spot (number of knee lifts), Timed-Up-and-Go (s) at 2, 4 and 12 months | Baseline, 2, 4, and 12 months | — |
| Change from Baseline to 4 months in biomarkers of disease activity, inflammation, and cartilage degradation, in a subgroup (15 participants from each group) | Baseline and 4 months | Blood samples: COMP (cartilage oligomeric matrix protein) and CRP (C-reactive protein)and Urine sample: CTX II (C-terminal telopeptide of collagen II) |
| Change in task specific self-efficacy from baseline to 2, 4 and 12 months | Baseline, 2, 4 and 12 months | Self-efficacy in relation to stair climbing performance. |
| Change in patient global assessment from baseline to 2, 4 and 12 months. | Baseline to 2, 4 and 12 months | — |
| Change from Baseline in self-reported physical activity at 2, 4 and 12 months | Baseline, 2, 4, and 12 months | PASE (Physical Activity Scale for the Elderly) and a question from Copenhagen City Heart Study |
| Change from Baseline in health related quality of life at 2, 4 and 12 months | Baseline, 2, 4, and 12 months | SF-36 |
| Change from Baseline to 2, 4 and 12 months in isometric muscle strength (N) of the thigh and hip muscles at 2, 4 and 12 months | Baseline, 2, 4, and 12 months | — |
| Change from Baseline to 2, 4 and 12 months in lower limb extensor muscle power (Watt/kg BW) at 2, 4 and 12 months | Baseline, 2, 4, and 12 months | — |
| Change from Baseline in self-reported pain level at 2, 4 and 12 months | Baseline, 2, 4, and 12 months | HOOS (Hip dysfunction and Osteoarthritis Outcome Score) and VAS (Visual Analogue scale) |
| Change from Baseline to 4 months in the anatomical cross sectional area (cm2) of the quadriceps femoris muscle measured with MRI. The measurements are performed in a subgroup (15 participants from each group) | Baseline and 4 months | MRI (magnetic resonance imaging)- The anatomical cross sectional area is measured at mid-thigh level, i.e. 20 cm proximal to the tibia plateau. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in perceived competence from baseline to 4 and 12 months | Baseline, 4 and 12 months | Perceived Competence Scale |
| Change in illness perception from baseline to 12 months | Baseline and 12 months | Brief Illness Perception Questionnaire |
| Change in arthritis-specific self-efficacy from baseline to 4 and 12 months | Baseline, 4 and 12 months | Arthritis-specific Self-efficacy Scale |
Countries
Denmark
Outcome results
None listed