title: Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: protocol for a three-armed randomized clinical trial.
abstract: BACKGROUND
  Hip osteoarthritis is a common and chronic condition resulting in pain, functional disability and reduced quality of life. In the early stages of the disease, a combination of non-pharmacological and pharmacological treatment is recommended. There is evidence from several trials that exercise therapy is effective. In addition, single trials suggest that patient education in the form of a hip school is a promising intervention and that manual therapy is superior to exercise.
  
  
  METHODS
  This is a randomized clinical trial. Patients with clinical and radiological hip osteoarthritis, 40-80 years of age, and without indication for hip surgery were randomized into 3 groups. The active intervention groups A and B received six weeks of hip school, taught by a physiotherapist, for a total of 5 sessions. In addition, group B received manual therapy consisting of joint manipulation and soft-tissue therapy twice a week for six weeks. Group C received a self-care information leaflet containing advice on "live as usual" and stretching exercises from the hip school. The primary time point for assessing relative effectiveness is at the end of the six weeks intervention period with follow-ups after three and 12 months.Primary outcome measure is pain measured on an eleven-point numeric rating scale. Secondary outcome measures are the hip dysfunction and osteoarthritis outcome score, patient's global perceived effect, patient specific functional scale, general quality of life and hip range of motion.
  
  
  CONCLUSIONS
  To our knowledge this is the first randomized clinical trial comparing a patient education program with or without the addition of manual therapy to a minimal intervention for patients with hip osteoarthritis.
  
  
  BACKGROUND
  ClinicalTrials NCT01039337.
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark. e.poulsen@nikkb.dk
authors.forename: Erik
authors.initials: E
authors.lastname: Poulsen
authors.forename: Henrik W
authors.initials: HW
authors.lastname: Christensen
authors.forename: Ewa M
authors.initials: EM
authors.lastname: Roos
authors.forename: Werner
authors.initials: W
authors.lastname: Vach
authors.forename: Søren
authors.initials: S
authors.lastname: Overgaard
authors.forename: Jan
authors.initials: J
authors.lastname: Hartvigsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D004185:Disability Evaluation; D007722:Health Knowledge, Attitudes, Practice; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D010174:Pamphlets; D010353:Patient Education as Topic; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome