Efficacy of patient education and supervised exercise vs patient education alone in patients with hip osteoarthritis: a single blind randomized clinical trial.
OBJECTIVE
To compare the efficacy of patient education and supervised exercise with that of patient education alone for the management of pain in patients with hip osteoarthritis (OA).


METHODS
Single blind randomized clinical trial.


METHODS
Recruitment of patients from hospitals, primary health care and advertisement, Oslo, Norway.


METHODS
109 patients with radiographic and symptomatic hip OA with mild to moderate symptoms.


METHODS
Patient education (PE). Patient education and supervised exercise (PE+SE).


METHODS
The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC pain).


RESULTS
No significant between group differences were found for WOMAC pain over the 16-month follow-up. Significant improvements were found for the secondary outcome WOMAC physical function (P=0.011) in the group receiving PE+SE compared to the group receiving PE only. No significant differences were found for WOMAC stiffness, the SF-36 subscales or the activity scale. The effect sizes (95% confidence interval) for WOMAC pain were -0.26 (0.11, -0.64), -0.35 (0.07, -0.77), and -0.30 (0.15, -0.75), and for WOMAC physical function -0.29 (0.09, -0.67), -0.48 (-0.06, -0.91), and -0.47 (-0.02, -0.93) at 4, 10 and 16 months, respectively, in favor of the group receiving both PE and SE. All patients attended the three-session PE program, and 75% performed ≥16 sessions of the 12-week SE program.


CONCLUSIONS
The study could not demonstrate a significant difference in pain reduction over time between PE+SE vs PE alone. Adding SE to PE may improve physical function, but the magnitude of possible benefit is unknown as the 95% confidence intervals around the mean difference were wide.


BACKGROUND
Clinical Trials NCT00319423.
Fernandes
L
L
Norwegian Research Center for Active Rehabilitation (NAR), Department of Orthopedics, Oslo University Hospital, Oslo, Norway. linda.fernandes@medisin.uio.no
Storheim
K
K
Sandvik
L
L
Nordsletten
L
L
Risberg
M A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D010146:Pain / Q000209:etiology / Q000534:rehabilitation; D010147:Pain Measurement / Q000379:methods; D010353:Patient Education as Topic; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome