title: Long-Term Effect of Exercise Therapy and Patient Education on Impairments and Activity Limitations in People With Hip Osteoarthritis: Secondary Outcome Analysis of a Randomized Clinical Trial.
abstract: BACKGROUND
  The effect of exercise on specific impairments and activity limitations in people with hip osteoarthritis (OA) is limited.
  
  
  OBJECTIVE
  The study objective was to evaluate the long-term effect of exercise therapy and patient education on range of motion (ROM), muscle strength, physical fitness, walking capacity, and pain during walking in people with hip OA.
  
  
  METHODS
  This was a secondary outcome analysis of a randomized clinical trial.
  
  
  METHODS
  The setting was a university hospital.
  
  
  METHODS
  One hundred nine people with clinically and radiographically evident hip OA were randomly allocated to receive both exercise therapy and patient education (exercise group) or patient education only (control group).
  
  
  METHODS
  All participants attended a patient education program consisting of 3 group meetings led by 2 physical therapists. Two other physical therapists were responsible for providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening, functional, and stretching exercises over 12 weeks. Both interventions were conducted at a sports medicine clinic.
  
  
  METHODS
  Outcome measures included ROM, isokinetic muscle strength, predicted maximal oxygen consumption determined with the Astrand bicycle ergometer test, and distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware of group allocations.
  
  
  RESULTS
  No significant group differences were found for ROM, muscle strength, predicted maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but the exercise group had less pain during the 6MWT than the control group at 10 months (mean difference=-8.5 mm; 95% confidence interval=-16.1, -0.9) and 29 months (mean difference=-9.3 mm; 95% confidence interval=-18.1, -0.6).
  
  
  CONCLUSIONS
  Limitations of the study were reduced statistical power and 53% rate of adherence to the exercise therapy program.
  
  
  CONCLUSIONS
  The previously described effect of exercise on self-reported function was not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking capacity, but exercise in addition to patient education resulted in less pain during walking in the long term.
authors.affiliation: I. Svege, PT, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopaedics, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway. ida.svege@ous-hf.no.
authors.forename: Ida
authors.initials: I
authors.lastname: Svege
authors.affiliation: L. Fernandes, PT, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopaedics, Oslo University Hospital, and Department of Orthopaedic Surgery and Traumatology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Linda
authors.initials: L
authors.lastname: Fernandes
authors.affiliation: L. Nordsletten, MD, PhD, Department of Orthopaedics, Oslo University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Nordsletten
authors.affiliation: I. Holm, PT, PhD, Department of Orthopaedics, Oslo University Hospital, and Institute of Health and Society, Faculty of Medicine, University of Oslo.
authors.forename: Inger
authors.initials: I
authors.lastname: Holm
authors.affiliation: M.A. Risberg, PT, MA, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopaedics, Oslo University Hospital.
authors.forename: May Arna
authors.initials: MA
authors.lastname: Risberg
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D059352:Musculoskeletal Pain / Q000209:etiology; D015207:Osteoarthritis, Hip / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D010101:Oxygen Consumption; D010349:Patient Compliance; D010353:Patient Education as Topic; D010807:Physical Endurance / Q000502:physiology; D016059:Range of Motion, Articular; D013997:Time Factors; D000070857:Walk Test; D016138:Walking / Q000502:physiology