Hip Osteoarthritis: Effects of Exercise Programs on Pain and Disability
| Status: | Completed |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 1/9/2019 |
| Start Date: | May 23, 2007 |
| End Date: | November 11, 2010 |
Hip Osteoarthritis: Effects of Structured Exercise Programs on Pain and Long-term Disability
Osteoarthritis is the most common form of arthritis in the United States. It is estimated
that 20 million Americans have arthritis, and the annual societal cost is $95 billion.
Several exercise studies have shown modest improvements in disability, physical performance,
and pain in subjects with knee osteoarthritis. While similar results have been suggested in
hip osteoarthritis, well-designed randomized clinical trials have not been conducted.
Exercise programs appear beneficial but without adherence, the beneficial effects of exercise
for knee and hip osteoarthritis decline over time. A well-designed, evidence-based,
arthritis-specific study controlling for exercise duration, frequency and adherence is
needed. The objective of this study is to determine the effects of structured exercise
programs on self-reported pain and disability in adults with hip osteoarthritis. This
prospective, randomized study with a wait-list control is designed to develop preliminary
data to support an R01 funding request for a large, randomized clinical trial. All exercise
interventions and outcome assessments will take place at OHSU in the Orthopaedics and
Rehabilitation Clinics, Rehabilitation Services physical therapy gym, and the General
Clinical Research Center. Subjects will be selected to include individuals representative of
the larger population with documented hip osteoarthritis. This three-month study will
evaluate the effects of an aerobic and resistance exercise program on pain and disability in
individuals with hip osteoarthritis. Outcome assessment will follow the Outcome Measures in
Rheumatology (OMERACT) recommendations for a core set of outcome measures for clinical trials
in arthritis and assess pain, physical function, patient global assessment, and joint
imaging. Data analysis will focus on comparing pre- and post-intervention endpoints using
conventional statistical analyses such as repeated-measure analysis of variance for repeated
continuous measures (e.g. walking distance), and non-parametric methods such as Chi-square or
frequency analysis for proportions (e.g. visual pain scores).
that 20 million Americans have arthritis, and the annual societal cost is $95 billion.
Several exercise studies have shown modest improvements in disability, physical performance,
and pain in subjects with knee osteoarthritis. While similar results have been suggested in
hip osteoarthritis, well-designed randomized clinical trials have not been conducted.
Exercise programs appear beneficial but without adherence, the beneficial effects of exercise
for knee and hip osteoarthritis decline over time. A well-designed, evidence-based,
arthritis-specific study controlling for exercise duration, frequency and adherence is
needed. The objective of this study is to determine the effects of structured exercise
programs on self-reported pain and disability in adults with hip osteoarthritis. This
prospective, randomized study with a wait-list control is designed to develop preliminary
data to support an R01 funding request for a large, randomized clinical trial. All exercise
interventions and outcome assessments will take place at OHSU in the Orthopaedics and
Rehabilitation Clinics, Rehabilitation Services physical therapy gym, and the General
Clinical Research Center. Subjects will be selected to include individuals representative of
the larger population with documented hip osteoarthritis. This three-month study will
evaluate the effects of an aerobic and resistance exercise program on pain and disability in
individuals with hip osteoarthritis. Outcome assessment will follow the Outcome Measures in
Rheumatology (OMERACT) recommendations for a core set of outcome measures for clinical trials
in arthritis and assess pain, physical function, patient global assessment, and joint
imaging. Data analysis will focus on comparing pre- and post-intervention endpoints using
conventional statistical analyses such as repeated-measure analysis of variance for repeated
continuous measures (e.g. walking distance), and non-parametric methods such as Chi-square or
frequency analysis for proportions (e.g. visual pain scores).
Inclusion Criteria:
- Age 21 years or more
- Pain at least once a week in one or both hips
- Difficulty with at least one of the following secondary to hip pain: walking 1/4 mile,
climbing stairs, getting in and out of a car, rising from a chair, lifting and
carrying groceries, getting out or bed, getting out of the bathtub, or performing
shopping, cleaning or self-care activities
- Radiographic evidence of femoral and/or acetabular osteophytes on radiograph -OR-
radiographic evidence of axial joint space narrowing and active hip flexion degrees
- Primary care physician's written consent to participate in the exercise-based
protocol. If te subject does not have a primary care physician, the subject will
complete a screening questionnaire for coronary artery disease. If the subject screens
as "high risk", te subject will be excluded from the study
Exclusion Criteria:
- A medical condition that precludes safe participation in an exercise program including
active cardiac disease, angina, class III heart failure, myocardial infarction in the
past year
- Screening as "high risk" for coronary artery disease
- Inflammatory arthritis (e.g. psoriatic or rheumatoid)
- Collecting workers' compensation
- Involved in litigation regarding pain and/or disability
- Unable to walk six minutes without cane or assistive device
- Participating in a conflicting research study
- Significant, symptomatic knee or ankle osteoarthritis
- Other lower extremity pathology including peripheral vascular disease that would
preclude participation in an exercise program
- Pregnancy
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