439 Exercise effective for osteoarthritis of hip

October 27, 2014

written by Brian R McAvoy

Clinical question
Is land-based, therapeutic exercise beneficial for people with osteoarthritis (OA) in terms of reduced joint pain, improved physical function and quality of life?

Bottom line
Land-based exercise was beneficial in terms of reduced pain (NNT* 6) and improved physical function (NNT 6) at the completion of a supervised exercise programme, and these benefits were sustained for at least a further 3 to 6 months. There was insufficient evidence available to determine the effect of exercise on quality of life among people with hip OA. The level of pain was generally mild to moderate at baseline (mean score 29 on a scale 0 to100, 0 being no pain). Although the reduction in pain in favour of exercise was small (mean score 21), a mean relative change of 28% (confidence intervals 14% to 38%) could be considered clinically important for a low-risk intervention such as exercise. Similarly, for physical function, mean relative change was 24% (confidence intervals 3% to 42%). Exercise did not increase study drop-out rate.
*NNT = number needed to treat to benefit 1 individual.

Caveat
Only 5 of the 10 RCTs exclusively recruited people with symptomatic hip OA .There was no significant difference in pain or physical function outcomes compared with 5 studies recruiting participants with hip or knee OA. The evidence underpinning quality of life was low, overall, due to the limited number (3) of small studies evaluating this outcome.

Context
OA is one of the most common forms of arthritis, and it affects men and women equally. Land-based exercise programmes consist of traditional muscle strengthening, functional training and aerobic fitness programmes, either individually supervised or as part of a group.

Cochrane Systematic Review
Fransen M et al. Exercise for osteoarthritis of the hip. Cochrane Reviews, 2014, Issue 4. Art. No.: CD007912.DOI: 10.1002/14651858. CD007912.pub2. This review contains 10 studies involving 549 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.