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Cited by 476Hip disorders and treatmentsOsteoarthritis Treatment and MechanismsMusculoskeletal pain and rehabilitation

The DOI matches its Crossref record; 71 of the 72 references it cites were found in a registry or an index.

Exercise for osteoarthritis of the hip

Open access
Fransen, Marlene, McConnell, Sara, Hernandez-Molina, Gabriela, Reichenbach, Stephan·2014·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd007912.pub2PMC PMC10898220
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Abstract

BACKGROUND: Current international treatment guidelines recommending therapeutic exercise for people with symptomatic hip osteoarthritis (OA) report are based on limited evidence. OBJECTIVES: To determine whether land-based therapeutic exercise is beneficial for people with hip OA in terms of reduced joint pain and improved physical function and quality of life. SEARCH METHODS: We searched five databases from inception up to February 2013. SELECTION CRITERIA: All randomised controlled trials (RCTs) recruiting people with hip OA and comparing some form of land-based therapeutic exercise (as opposed to exercises conducted in water) with a non-exercise group. DATA COLLECTION AND ANALYSIS: Four review authors independently selected studies for inclusion. We resolved disagreements through consensus. Two review authors independently extracted data, assessed risk of bias and the quality of the body of evidence for each outcome using the GRADE approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) and dichotomous outcomes (proportion of study withdrawals). MAIN RESULTS: We considered that seven of the 10 included RCTs had a low risk of bias. However, the results may be vulnerable to performance and detection bias as none of the RCTs were able to blind participants to treatment allocation and, while most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self reported. One of the 10 RCTs was only reported as a conference abstract and did not provide sufficient data for the evaluation of bias risk.High-quality evidence from nine trials (549 participants) indicated that exercise reduced pain (standardised mean difference (SMD) -0.38, 95% confidence interval (CI) -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately after treatment. Pain and physical function were estimated to be 29 points on a 0- to 100-point scale (0 was no pain or loss of physical function) in the control group; exercise reduced pain by an equivalent of 8 points (95% CI 4 to 11 points; number needed to treat for an additional beneficial outcome (NNTB) 6) and improved physical function by an equivalent of 7 points (95% CI 1 to 12 points; NNTB 6). Only three small studies (183 participants) evaluated quality of life, with overall low quality evidence, with no benefit of exercise demonstrated (SMD -0.07, 95% CI -0.23 to 0.36). Quality of life was estimated to be 50 points on a norm-based mean (standard deviation (SD)) score of 50 (10) in the general population in the control group; exercise improved quality of life by 0 points. Moderate-quality evidence from seven trials (715 participants) indicated an increased likelihood of withdrawal from the exercise allocation (event rate 6%) compared with the control group (event rate 3%), but this difference was not significant (risk difference 1%; 95% CI -1% to 4%). Of the five studies reporting adverse events, each study reported only one or two events and all were related to increased pain attributed to the exercise programme.The reduction in pain was sustained at least three to six months after ceasing monitored treatment (five RCTs, 391 participants): pain (SMD -0.38, 95% CI -0.58 to -0.18). Pain was estimated to be 29 points on a 0- to 100-point scale (0 was no pain) in the control group, the improvement in pain translated to a sustained reduction in pain intensity of 8 points (95% CI 4 to 12 points) compared with the control group (0 to 100 scale). The improvement in physical function was also sustained (five RCTs, 367 participants): physical function (SMD -0.37, 95% CI -0.57 to -0.16). Physical function was estimated to be 24 points on a 0- to 100-point scale (0 was no loss of physical function) in the control group, the improvement translated to a mean of 7 points (95% CI 4 to 13) compared with the control group.Only five of the 10 RCTs exclusively recruited people with symptomatic hip OA (419 participants). There was no significant difference in pain or physical function outcomes compared with five studies recruiting participants with hip or knee OA (130 participants). AUTHORS' CONCLUSIONS: Pooling the results of these 10 RCTs demonstrated that land-based therapeutic exercise programmes can reduce pain and improve physical function among people with symptomatic hip OA.

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Research works printed but not linked: 6

  1. Steenstrup, 2012, Evaluation of a specific protocol of ambulatory physiotherapy for hip osteoarthritis, Kinesitherapie, 12, 67
  2. Cohen, 1977, Statistical Power Analysis for the Behavioural Sciences
  3. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2012
  4. Schünemann HJ Oxman AD Higgins JPT Vist GE Glasziou P Guyatt GH Chapter 11: Presenting results and 'Summary of findings' tables. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011 Available from www.cochrane-handbook.org
  5. Sterne JAC, Egger M, Moher D. Chapter 10: Addressing reporting biases. Cochrane Handbook for Systematic Reviews of Interventions. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011 Available from www.cochrane-handbook.org
  6. Fransen, 2009, Exercise for osteoarthritis of the hip, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD007912 · DOI

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Metadata

Authors
Fransen, M., McConnell, S., Hernandez-Molina, G., & Reichenbach, S.
Affiliations
  • The University of Sydney (AU)
  • St Joseph's Health Centre (CA)
  • Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Immunology and Rheumatology; Vasco de Quiroga 15. Colonia Sección XVI. Mexico city Mexico 14000
  • University Hospital of Bern (CH)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2014-04-22
Volume
2014
Issue
4
Pages
CD007912-CD007912
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd007912.pub2
PMC
PMC10898220
OpenAlex
W1616537603
Cited by
476
References
72
Citations by year
2026: 7 · 2025: 20 · 2024: 21 · 2023: 36 · 2022: 35 · 2021: 40 · 2020: 51 · 2019: 35 · 2018: 37 · 2017: 34 · 2016: 33 · 2015: 30 · 2014: 22
FWCI
7.39
Type
journal article
Language
en
Update notices
new_version (2026-07-23)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion)
  • BORIS (University Library Bern) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Hip disorders and treatments
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Keywords
hip osteoarthritis, exercise therapy, land-based exercise, joint pain, physical function, quality of life, aquatic exercise, medication adherence, risk of bias, GRADE quality of evidence, number needed to treat, number needed to harm, number needed to benefit
MeSH terms
Exercise Therapy, Hip Joint, Humans, Pain Measurement, Osteoarthritis, Hip, Randomized Controlled Trials as Topic, Arthralgia

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