title: Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis.
abstract: OBJECTIVE
  The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis.
  
  
  METHODS
  The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p < 0.5), and clinical importance (⩾15% improvement).
  
  
  RESULTS
  Four high-quality studies were included, which demonstrated that variations of strength training, stretching, and flexibility exercises are generally effective for improving the management of hip osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+).
  
  
  CONCLUSIONS
  The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion.
authors.affiliation: School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada Lucie.Brosseau@uottawa.ca.
authors.forename: Lucie
authors.initials: L
authors.lastname: Brosseau
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.affiliation: Department of Public Health Sciences, Queens University, Canada.
authors.forename: Arlanna G
authors.initials: AG
authors.lastname: Pugh
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Christine Am
authors.initials: CA
authors.lastname: Smith
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Prinon
authors.initials: P
authors.lastname: Rahman
authors.affiliation: Department of Physical Education and Sport, University of Granada, Granada, Spain.
authors.forename: Inmaculada C
authors.initials: IC
authors.lastname: Àlvarez Gallardo
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Toupin-April
authors.affiliation: School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Laurianne
authors.initials: L
authors.lastname: Loew
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Gino
authors.initials: G
authors.lastname: De Angelis
authors.affiliation: School of Public Health, Option Epidemiology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cavallo
authors.affiliation: Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jade
authors.initials: J
authors.lastname: Taki
authors.affiliation: School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Marcotte
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, Australia.
authors.forename: Marlene
authors.initials: M
authors.lastname: Fransen
authors.affiliation: Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Canada.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hernandez-Molina
authors.affiliation: School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.affiliation: Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Regnaux
authors.affiliation: Department of Medicine and Rehabilitation, Institute of Rheumatology, Cochin Hospital, Paris, France.
authors.forename: Marie-Martine
authors.initials: MM
authors.lastname: Lefevre-Colau
authors.affiliation: The Arthritis Society, Ontario Division, Ontario, Canada.
authors.forename: Sydney
authors.initials: S
authors.lastname: Brooks
authors.affiliation: Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada.
authors.forename: Lucie
authors.initials: L
authors.lastname: Laferriere
authors.affiliation: School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: McLean
authors.affiliation: Consumer expert.
authors.forename: Guy
authors.initials: G
authors.lastname: Longchamp
mesh_terms: D002170:Canada; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D006801:Humans; D015207:Osteoarthritis, Hip / Q000534:rehabilitation*
keywords: Therapeutic exercise; evidence-based clinical practice guideline; management; osteoarthritis; recommendations; rehabilitation; rheumatology; systematic review