title: In hip osteoarthritis, Nordic Walking is superior to strength training and home-based exercise for improving function.
abstract: This observer-blinded, randomized controlled trial compared the short- and long-term effects of 4 months of supervised strength training (ST) in a local fitness center, supervised Nordic Walking (NW) in a local park, and unsupervised home-based exercise (HBE, control) on functional performance in 60+-year-old persons (n = 152) with hip osteoarthritis (OA) not awaiting hip replacement. Functional performance [i.e., 30-s chair stand test (primary outcome), timed stair climbing, and 6-min walk test] and self-reported outcomes (i.e., physical function, pain, physical activity level, self-efficacy, and health-related quality of life) were measured at baseline and at 2, 4, and 12 months. Based on intention-to-treat-analyses improvements [mean (95% CI)] after intervention in number of chair stands were equal in all three groups at 4 months [ST: 0.9 (0.2-1.6), NW: 1.9 (0.8-3.0), HBE: 1.1 (0.1-2.0)] but greater in the NW group [1.4 (0.02-2.8)] than in the ST group at 12 months. Generally, improvements in functional performance were greater (P < 0.001-P < 0.03) after NW compared with HBE and ST at all follow-up time points. Furthermore, NW was superior (P < 0.01) to HBE for improving vigorous physical activity and to both ST and HBE for improving (P < 0.01) mental health. These data suggest that NW is the recommended exercise modality compared with ST and HBE.
authors.affiliation: Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|Musculoskeletal Rehabilitation Research Unit, Department of Physical & Occupational Therapy Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Bieler
authors.affiliation: The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: V
authors.initials: V
authors.lastname: Siersma
authors.affiliation: Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|Musculoskeletal Rehabilitation Research Unit, Department of Physical & Occupational Therapy Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.
authors.forename: S P
authors.initials: SP
authors.lastname: Magnusson
authors.affiliation: Musculoskeletal Rehabilitation Research Unit, Department of Physical & Occupational Therapy Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Kjaer
authors.affiliation: Department of Radiology Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.
authors.forename: H E
authors.initials: HE
authors.lastname: Christensen
authors.affiliation: Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Beyer
mesh_terms: D000368:Aged; D015444:Exercise; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000534:rehabilitation*; D010146:Pain; D000071066:Patient Reported Outcome Measures; D011788:Quality of Life; D055070:Resistance Training; D020377:Self Efficacy; D016037:Single-Blind Method; D016138:Walking
keywords: RCT design; aerobic training; exercise therapy; functional performance; hip; osteoarthritis; resistance training