Hip Muscle Strengthening for Knee Osteoarthritis: A Systematic Review of Literature

Abstract

Background and Purpose: Osteoarthritis (OA) of the knee joint results in chronic pain and functional decline among older adults. Hip muscle weakness has been observed in persons with knee OA and is claimed to increase the medial compartment loading on the knee joint. Although individual studies are available, no review has yet integrated the literature on the benefits of hip muscle strengthening for persons with knee OA. This review aims to systematically summarize the current evidence on the effectiveness of hip muscle strengthening on knee pain, lower extremity function, and biomechanical measures of the knee in persons with knee OA. Methods: An extensive electronic literature search was conducted in the databases PubMed, Scopus, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Physiotherapy Evidence Database (PEDro) to identify the published trials in the English language from January 1990 to August 2017. Randomized controlled trials that studied the effectiveness of hip muscle strengthening in persons with knee OA on knee pain, physical function, and biomechanical measures of the knee were considered for inclusion. The key word combinations were knee osteoarthritis, degenerative arthritis, arthralgia, muscle strengthening, and resistance training using the Boolean operators AND, OR. Two reviewers independently performed the study selection, and a third reviewer intervened when the consensus was not attained. Quality assessment of the included studies was carried out using the PEDro scale. Results and Discussion: The search produced 774 results, from which 81 full-text articles were studied. Five randomized controlled trials of good methodological quality, including 331 participants, were included in the review. The effectiveness of hip muscle strengthening was assessed in isolation, combination, and comparison with other lower extremity exercise. Overall, the studies reported clear benefits of hip muscle strengthening on knee pain, physical function, and hip muscle strength. However, hip muscle strengthening was ineffective in improving the biomechanical measures such as dynamic alignment and knee adduction (also known as valgus) moment. Conclusion: The current review identified strong, high-quality evidence to recommend hip muscle strengthening in the conservative management of persons with knee OA. Further research is needed to establish the underlying mechanisms for the clinical benefits.

Analysis of Clinical Efficacy of Clearing Heat and Dispelling Paralysis Soup in the Treatment of Osteoarthritis of the Knee Joint and Its Effect on Patients’ Motor Function

“…Pain is the main symptomatic manifestation of osteoarthritis of the knee, and effective control of joint pain in patients is crucial to improve their survival quality. It has been pointed out in a study that herbal treatment can better control joint pain [ 21 – 23 ]. In this study, the VAS, JOA, and AIMS2-SF scores of patients were analyzed, and the results showed that the VAS scores of the experimental group were lower than those of the control group after treatment, and the JOA and AIMS2-SF scores were higher than those of the control group ( P < 0.05), suggesting that the combined treatment with clearing heat and dispelling paralysis soup could better control the joint pain of patients and improve their survival quality.…”

Impaired muscle capacity of the hip and knee in individuals with isolated patellofemoral osteoarthritis: a cross-sectional study

“…Strong and high-quality evidence recommends strengthening the muscles of the hip and knee in the conservative treatment of people with knee OA. 68 – 70 In PFOA, there is a lack of randomized clinical trials on the effects of a program to strengthen the muscles of the lower limb. However, the results of a pilot feasibility study suggest that hip strengthening and a core stabilization program may be beneficial in improving symptoms, function, and physical performance in people with PFOA.…”

The Effect of Exercise Intervention on Disability and Kinesiophobia in a Retired Athlete With Old Patella Fracture: A Case Report

“…Simultaneously, a review study showed that muscle strength training around the hip joint can effectively improve the lower limb function and biomechanical measures of the knee in patients with chronic knee pain. A systematic review identified strong and high-quality evidence to recommend hip muscle strengthening in the conservative management of patients with knee OA (Raghava et al, 2020 ). The exercise program of this study also paid special attention to the ideal training of the muscles around the hip joint.…”