Background Osteoarthritis (OA) is the most common joint disorder in the world and is recognized as a substantial source of disability. For people with OA of the knee, exercise in combination with weight loss is a proven, effective, conservative treatment option, yet evidence is lacking for people with hip OA.
Objective The aim of this study was to obtain preliminary evidence of the effect of a program of exercise in combination with weight loss on physical function in people who have hip OA and are overweight or obese.
Design This investigation was a prospective cohort study.
Methods Thirty-five people who were 25 years or older, had clinical and radiological evidence of hip OA, and were overweight or obese (body mass index of >25 kg/m2) were included. They participated in an 8-month program of exercise in combination with weight loss. A body mass index of 40 kg/m2 was used as the upper limit. The primary outcome was self-reported physical function, as measured with a subscale of the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcome measures included pain and walking tests as quantitative measures of function.
Results Participation in the combination program resulted in a 32.6% improvement in self-reported physical function after 8 months, a finding that could be considered clinically relevant. Significant improvements also were seen in pain and on walking tests.
Limitations The lack of a control group was a limitation of this study.
Conclusions This appears to be the first study investigating the effect of exercise and weight loss as a combination treatment in people with hip OA. The results provide preliminary evidence that this combination treatment is effective in people with hip OA.
Ms Paans, Dr Akker-Scheek, and Dr Stevens provided concept/idea/research design and project management. Ms Paans, Dr Akker-Scheek, Dr van der Meer, Dr Bulstra, and Dr Stevens provided writing. Ms Paans, Ms Dilling, and Ms Bos provided data collection. Ms Paans provided data analysis. Ms Dilling provided study participants. Ms Dilling and Ms Bos provided facilities/equipment. Dr Akker-Scheek, Dr van der Meer, and Dr Bulstra provided consultation (including review of manuscript before submission). The authors are grateful to all physical therapists of the Allied Health Care Center for Rheumatology and Rehabilitation, Hilberdink, and the participants who joined the study. They thank Roy Stewart for his advice about statistical analysis and help.
The study was approved by the Medical Ethics Committee of the University Medical Center Groningen.
The study was funded by the Health Care Efficiency Fund, University Medical Center Groningen, Groningen, the Netherlands.
This trial was registered with the Nederlands Trial Register. Trial registration number: NTR1053.
- Received November 17, 2011.
- Accepted September 24, 2012.
- © 2013 American Physical Therapy Association