title: A pragmatic randomized controlled study of the effectiveness and cost consequences of exercise therapy in hip osteoarthritis.
abstract: OBJECTIVE
  To evaluate the short- and long-term effectiveness of exercise training in relation to pain, function and direct costs to health care systems attributable to hip osteoarthritis.
  
  
  METHODS
  Prospective, two-year randomized controlled trial.
  
  
  METHODS
  An outpatient primary health care setting.
  
  
  METHODS
  One hundred and twenty men and women aged from 55 to 80, with radiologically diagnosed hip osteoarthritis with associated clinical symptoms.
  
  
  METHODS
  The combined exercise and general practitioner (GP) care group received 12 supervised (once per week) exercise sessions at the baseline and four additional booster sessions one year later. Both groups received standard GP care.
  
  
  METHODS
  The WOMAC Osteoarthritis Index, physical functioning score of RAND-36 (SF-36), the use and health care system costs of doctor visits and physiotherapy associated with hip osteoarthritis, number of total hip replacements, the use of analgesic and non-steroidal anti-inflammatory drugs (NSAIDs), performance-based outcome scores and body mass index (BMI).
  
  
  RESULTS
  There were no differences between the groups with respect to WOMAC hip pain, physical functioning score of RAND-36, performance-based outcome scores or BMI. The effect of the exercise intervention on WOMAC function was statistically significant at 6 months (mean = -7.5; 95% confidence interval (CI) -13.9 to -1.0; P = 0.02) and 18 months (mean = -7.9; 95% CI -15.3 to -0.4; P = 0.04). There were no statistically significant differences in the total health care system costs between the groups.
  
  
  CONCLUSIONS
  The mostly home-based exercise training programme provided in this study did not result in reduced hip pain over the two-year follow-up period.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Mikkeli Central Hospital, Mikkeli.
authors.forename: Riikka
authors.initials: R
authors.lastname: Juhakoski
authors.forename: Seppo
authors.initials: S
authors.lastname: Tenhonen
authors.forename: Antti
authors.initials: A
authors.lastname: Malmivaara
authors.forename: Vesa
authors.initials: V
authors.lastname: Kiviniemi
authors.forename: Tapio
authors.initials: T
authors.lastname: Anttonen
authors.forename: Jari P A
authors.initials: JP
authors.lastname: Arokoski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000191:economics / Q000379:methods*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000191:economics / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000191:economics / Q000209:etiology / Q000534:rehabilitation*; D011446:Prospective Studies