Efficacy of a multimodal physiotherapy treatment program for hip osteoarthritis: a randomised placebo-controlled trial protocol.
BACKGROUND
Hip osteoarthritis (OA) is a common condition leading to pain, disability and reduced quality of life. There is currently limited evidence to support the use of conservative, non-pharmacological treatments for hip OA. Exercise and manual therapy have both shown promise and are typically used together by physiotherapists to manage painful hip OA. The aim of this randomised controlled trial is to compare the efficacy of a physiotherapy treatment program with placebo treatment in reducing pain and improving physical function.


METHODS
The trial will be conducted at the University of Melbourne Centre for Health, Exercise and Sports Medicine. 128 participants with hip pain greater or equal to 40/100 on visual analogue scale (VAS) and evidence of OA on x-ray will be recruited. Treatment will be provided by eight community physiotherapists in the Melbourne metropolitan region. The active physiotherapy treatment will comprise a semi-structured program of manual therapy and exercise plus education and advice. The placebo treatment will consist of sham ultrasound and the application of non-therapeutic gel. The participants and the study assessor will be blinded to the treatment allocation. Primary outcomes will be pain measured by VAS and physical function recorded on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) immediately after the 12 week intervention. Participants will also be followed up at 36 weeks post baseline.


CONCLUSIONS
The trial design has important strengths of reproducibility and reflecting contemporary physiotherapy practice. The findings from this randomised trial will provide evidence for the efficacy of a physiotherapy program for painful hip OA.
Centre for Health, Exercise & Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia. k.bennell@unimelb.edu.au
Kim L
KL
Bennell
Thorlene
T
Egerton
Yong-Hao
YH
Pua
J Haxby
JH
Abbott
Kevin
K
Sims
Ben
B
Metcalf
Fiona
F
McManus
Tim V
TV
Wrigley
Andrew
A
Forbes
Anthony
A
Harris
Rachelle
R
Buchbinder
D003131:Combined Modality Therapy / Q000379:methods* / Q000639:trends; D004185:Disability Evaluation; D006621:Hip Joint / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D026741:Physical Therapy Modalities / Q000592:standards / Q000639:trends; D010919:Placebos; D011859:Radiography; D012107:Research Design / Q000592:standards; D016896:Treatment Outcome
D010919:Placebos