13/04/2024
Yaaasss, exercise helping Hip Qsteoarthritis...
Just published 🔥
Progressive Resistance Training or Neuromuscular Exercise for Hip Osteoarthritis : A Multicenter Cluster Randomized Controlled Trial
🏋️ High-quality evidence has shown that exercise is effective in reducing pain and improving physical function in hip OA (https://pubmed.ncbi.nlm.nih.gov/24756895/, https://pubmed.ncbi.nlm.nih.gov/36817089/), and clinical guidelines recommend exercise as first-line treatment (https://pubmed.ncbi.nlm.nih.gov/33560326/). However, randomized controlled trials providing evidence for the optimal exercise content and dosage are lacking (https://pubmed.ncbi.nlm.nih.gov/24756895/, https://pubmed.ncbi.nlm.nih.gov/36817089/).
🤷 Consequently, it is currently not possible to recommend one type of exercise over another (https://pubmed.ncbi.nlm.nih.gov/31908163/, https://pubmed.ncbi.nlm.nih.gov/33481454/).
📘 In a brand-new study published in Annals of Internal Medicine, Kjeldsen and colleagues (https://pubmed.ncbi.nlm.nih.gov/38588540/) compared the effects of a progressive resistance training or neuromuscular exercise (a core component of the GLA:D® program, https://pubmed.ncbi.nlm.nih.gov/33561542/, s. picture) at improving functional performance, measured by the 30-second chair stand test (30s-CST) and secondary outcomes like patient-reported pain and hip-related QoL in 160 participants with clinically diagnosed hip OA.
🏋️ 12 weeks of PRT or NEMEX with 2 supervised 60-minute group sessions were performed each week. The PRT intervention consisted of 5 high-intensity resistance training exercises targeting muscles at the hip and knee joints. The NEMEX intervention included 10 exercises and emphasized sensorimotor control and functional stability. (s. picture, only difficulty level 4 is shown for the neuromuscular exercises. Levels 1 to 3 can be found in a supplement to the article by Ageberg and colleague, https://pubmed.ncbi.nlm.nih.gov/20565735/).
📊 The mean changes from baseline to 12-week follow-up in the 30s-CST were 1.5 (95% CI, 0.9 to 2.1) chair stands with PRT and 1.5 (CI, 0.9 to 2.1) chair stands with NEMEX (difference, 0.0 [CI, −0.8 to 0.8] chair stands).
📊 For the HOOS pain subscale, mean changes were 8.6 (CI, 5.3 to 11.8) points with PRT and 9.3 (CI, 5.9 to 12.6) points with NEMEX (difference, −0.7 [CI, −5.3 to 4.0] points). For the HOOS QoL subscale, mean changes were 8.0 (CI, 4.3 to 11.7) points with PRT and 5.7 (CI, 1.9 to 9.5) points with NEMEX (difference, 2.3 [CI, −3.0 to 7.6] points).
💡 In patients with hip OA and contrary to the authors hypothesis, PRT is not superior to NEMEX for improving functional performance, hip pain, or hip-related QoL.
▶︎ The slightly larger improvement in muscle strength and power after PRT may provide a reason for choosing PRT for patients who present with muscle weakness or are at risk for developing sarcopenia (https://pubmed.ncbi.nlm.nih.gov/33921356/). Conversely, NEMEX can be a more practical and preferable choice for some patients and clinicians, and it might provide superior results for physical function in sports and recreational activities, requires minimal and inexpensive equipment, and can easily be performed at home.
▶︎ Future trials should identify responders to exercise in hip OA and investigate the underlying mechanisms, which are largely unknown (https://pubmed.ncbi.nlm.nih.gov/37640513/).
