title: Effectiveness of exercise therapy added to general practitioner care in patients with hip osteoarthritis: a pragmatic randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of exercise therapy added to general practitioner (GP) care compared with GP care alone, in patients with hip osteoarthritis (OA) during 12 months follow-up.
  
  
  METHODS
  We performed a multi-center parallel pragmatic randomized controlled trial in 120 general practices in the Netherlands. 203 patients, aged ≥45 years, with a new episode of hip complaints, complying with the ACR criteria for hip OA were randomized to the intervention group (n = 101; GP care with additional exercise therapy) or the control group (n = 102; GP care only). GP care was given by patient's own GP. The intervention group received, in addition, a maximum of 12 exercise therapy sessions in the first 3 months and hereafter three booster sessions. Blinding was not possible. Primary outcomes were hip pain and hip-related function measured with the HOOS questionnaire (score 0-100).
  
  
  RESULTS
  The overall estimates on hip pain and function during the 12-month follow-up showed no between-group difference (intention-to-treat). At 3-months follow-up there was a statistically significant between-group difference for HOOS pain -3.7 (95% CI: -7.3; -0.2), effect size -0.23 and HOOS function -5.3 (95% CI: -8.9; -1.6), effect size -0.31. No adverse events were reported.
  
  
  CONCLUSIONS
  No differences were found during 12-months follow-up on pain and function. At 3-months follow-up, pain and function scores differed in favor of patients allocated to the additional exercise therapy compared with GP care alone.
  
  
  BACKGROUND
  The Netherlands Trial Registry NTR1462.
authors.affiliation: Erasmus MC University Medical Center, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: c.teirlinck@erasmusmc.nl.
authors.forename: C H
authors.initials: CH
authors.lastname: Teirlinck
authors.affiliation: Erasmus MC University Medical Center, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: P A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.affiliation: VU University Medical Center, Department of Rehabilitation Medicine, EMGO+ Institute for Health and Care Research, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Dekker
authors.affiliation: Erasmus MC University Medical Center, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Bohnen
authors.affiliation: Erasmus MC University Medical Center, Department of Orthopedics, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: J A N
authors.initials: JA
authors.lastname: Verhaar
authors.affiliation: Erasmus University Rotterdam, Department of Health Policy and Management, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Koopmanschap
authors.affiliation: Erasmus MC University Medical Center, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: P P
authors.initials: PP
authors.lastname: van Es
authors.affiliation: Erasmus MC University Medical Center, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: B W
authors.initials: BW
authors.lastname: Koes
authors.affiliation: Erasmus MC University Medical Center, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: S M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015207:Osteoarthritis, Hip / Q000628:therapy*; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Disability; Exercise therapy; HOOS; Hip osteoarthritis; Pain; Physiotherapy