Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: A randomized clinical trial

Hoeksma, Hugo L.; Dekker, Joost; Ronday, H.K.; Heering, Annet; Lubbe, Nico Van Der; Vel, Cees; Breedveld, Ferdinand C.; Ende, C.H.M. van den

doi:10.1002/art.20685

Cited by 243 publications

(257 citation statements)

References 18 publications

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“…Although causality cannot be inferred from cross-sectional data, it is possible that addressing hip ROM deficits that fall below the breakpoints would improve function, which is reminiscent of the substantial functional improvements associated with hip joint mobilizations demonstrated by Hoeskma et al (18) and Currier et al (47). Interestingly, although Hoeskma et al (48) did not identify patient subgroups for whom mobilizations would be most beneficial, the clinical criteria used to diagnose hip OA in their study included less than 115°and 15°for hip flexion and internal rotation, respectively (49).…”

Section: Discussionmentioning

confidence: 99%

Association of physical performance with muscle strength and hip range of motion in hip osteoarthritis

Pua

Wrigley

Collins

et al. 2009

Arthritis & Rheumatism

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Objective. To examine whether the associations of physical performance with isometric hip and knee extensors strength and passive hip flexion and internal rotation range of motion (ROM) are nonlinear in community-dwelling adults with hip osteoarthritis (OA). Methods. Participants were 100 adults (mean age 62 years) with radiographically confirmed hip OA. Physical performance measures included gait speed test and timed stair tests. Piecewise regression models of muscle strength and hip ROM on physical performance measures were used to identify possible breakpoints. Receiver operating characteristic (ROC) curve analysis was used to identify participants with functionally inadequate (<1.0 meters/second) gait speed and optimal cut points were identified. Results. Muscle strength and hip ROM were nonlinearly associated with stair measures but not with gait speed measures. The optimal breakpoints and ROC-derived cut points were 1.8 -2.5Nm/kg for knee extensors, 1.5-2.1Nm/kg for hip extensors, 25-26°for hip internal rotation ROM, and 109 -115°for hip flexion ROM. Muscle strength breakpoints increased monotonically with increasing movement demand. Conclusion. In individuals with hip OA, the associations between physical performance and measures of muscle strength and hip ROM are less straightforward than previously assumed. These breakpoints and ROC-derived cut points may be useful in identifying individuals for whom interventions that improve muscle strength or hip ROM would be most beneficial.

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Section: Discussionmentioning

confidence: 99%

Association of physical performance with muscle strength and hip range of motion in hip osteoarthritis

Pua

Wrigley

Collins

et al. 2009

Arthritis & Rheumatism

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“…14,29 Based on previous results, 9 it was recognized that physical performance measures could determine whether functional change had occurred following our physiotherapy program. A baseline examination was performed for all patients, and physical performance measures were repeated after the treatment period (at approximately 9 weeks).…”

Section: Responsivenessmentioning

confidence: 99%

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Wright¹,

Cook²,

Baxter³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

325

246

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For rehabilitation professionals engaged in the treatment of osteoarthritis (OA), it is standard practice to perform objective assessments of physical function (using both physical performance and self-report measures) to obtain a picture of patient status. These assessments also serve as a baseline value for estimating changes (treatment effects) over time. While reliability and validity of some commonly used physical performance measures have been investigated in an OA population, most require further research regarding clinical utility and responsiveness. 14 Physical performance measures have often been criticized, as detailed testing of their measurement properties has not been extensively reported. 14,22,33 Measures of responsiveness have commonly been reported as statistically significant change scores, which are useful in establishing the threshold of change needed beyond measurement error. 10 Investigation of minimal clinically important differences (MCIDs) of physical performance measures is warranted, as these have become commonly used outcome measures in the treatment of OA. 8,12,17,[35][36][37] At present, the responsiveness (in terms of MCID) of the timed up-and-go (TUG) test, 40-meter self-paced walk test (40-m SPWT), 30-second chair stand (30 CST), and 20-cm step test has not been investigated in T T STUDY DESIGN: Prospective cohort study. T T OBJECTIVES:To establish the major clinically important improvement (MCII) of the timed upand-go test (TUG), 40-meter self-paced walk test (40-m SPWT), 30-second chair stand (30 CST), and a 20-cm step test in patients with hip osteoarthritis (OA) undergoing physiotherapy treatment. As a secondary aim, a comparison of methods was employed to evaluate the effect of method on the reported MCII. T T BACKGROUND: Minimal clinically importantdifference scores are commonly used by rehabilitation professionals to determine patient response following treatment. A gold standard for calculating MCII has yet to be determined, which has resulted in problems of interpretation due to varied results. T T METHODS:As part of a randomized controlled trial, 65 patients were randomized into a physiotherapy treatment group for hip OA, in which they completed 4 physical performance measures at baseline and 9 weeks. Upon completion of physiotherapy, patients assessed their response to treatment on a 15-point global rating of change scale (GRCS). MCII was estimated using 3 variations of an anchor-based method, based on the patient's opinion. T T RESULTS:A comparison of 3 methods resulted in the following change scores being best associated with our definition of MCII: a reduction equal to or greater than 0.8, 1.4, and 1.2 seconds for the TUG; an increase equal to or greater than 0.2, 0.3, and 0.2 m/s for the 40-m SPWT; an increase equal to or greater than 2.0, 2.6, and 2.1 repetitions for the 30 CST; an increase equal to or greater than 5.0, 12.8, and 16.4 steps for the 20-cm step test. T T CONCLUSION:The variation in methods provided very different results. This illustrates the impor...

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“…Green et al 9 found that simple home exercises were beneficial in patients with osteoarthritis of the hip in improving range of motion and strength. Hoeksma et al 13 found that manual therapy, including manipulation and stretching techniques, had better outcomes than exercise therapy in improving pain, stiffness, range of motion, and function in patients with hip osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…He performed this mobilization for 5 minutes 3 times per day, maintaining the patient's left hip in 30° of flexion, 30° of abduction, and slight lateral rotation, the presumed resting position of the hip joint. 13 It was felt that this position would be safe and effective because it produces minimal congruency between the joint surfaces and the joint capsule, the ligaments are in the position of greatest laxity, and there is maximal potential for passive separation of the joint surfaces. 19 Arvidsson 3 reported that it is possible to separate the joint surfaces of the hip using manual distraction, especially in the joint's resting position.…”

Section: Plan Of Carementioning

confidence: 99%

Manual Therapy Intervention for a Patient With a Total Hip Arthroplasty Revision

Howard¹,

Levitsky²

2007

J Orthop Sports Phys Ther

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Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: A randomized clinical trial

Cited by 243 publications

References 18 publications

Association of physical performance with muscle strength and hip range of motion in hip osteoarthritis

Association of physical performance with muscle strength and hip range of motion in hip osteoarthritis

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Manual Therapy Intervention for a Patient With a Total Hip Arthroplasty Revision

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