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Osteoarthritis Cartilage. 2010 Oct;18(10):1237-43. doi: 10.1016/j.joca.2010.05.015. Epub 2010 Jul 13.

Efficacy of patient education and supervised exercise vs patient education alone in patients with hip osteoarthritis: a single blind randomized clinical trial.

Author information

1
Norwegian Research Center for Active Rehabilitation (NAR), Department of Orthopedics, Oslo University Hospital, Oslo, Norway. linda.fernandes@medisin.uio.no

Abstract

OBJECTIVE:

To compare the efficacy of patient education and supervised exercise with that of patient education alone for the management of pain in patients with hip osteoarthritis (OA).

DESIGN:

Single blind randomized clinical trial.

SETTING:

Recruitment of patients from hospitals, primary health care and advertisement, Oslo, Norway.

PARTICIPANTS:

109 patients with radiographic and symptomatic hip OA with mild to moderate symptoms.

INTERVENTIONS:

Patient education (PE). Patient education and supervised exercise (PE+SE).

PRIMARY OUTCOME MEASURE:

The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC pain).

RESULTS:

No significant between group differences were found for WOMAC pain over the 16-month follow-up. Significant improvements were found for the secondary outcome WOMAC physical function (P=0.011) in the group receiving PE+SE compared to the group receiving PE only. No significant differences were found for WOMAC stiffness, the SF-36 subscales or the activity scale. The effect sizes (95% confidence interval) for WOMAC pain were -0.26 (0.11, -0.64), -0.35 (0.07, -0.77), and -0.30 (0.15, -0.75), and for WOMAC physical function -0.29 (0.09, -0.67), -0.48 (-0.06, -0.91), and -0.47 (-0.02, -0.93) at 4, 10 and 16 months, respectively, in favor of the group receiving both PE and SE. All patients attended the three-session PE program, and 75% performed ≥16 sessions of the 12-week SE program.

CONCLUSION:

The study could not demonstrate a significant difference in pain reduction over time between PE+SE vs PE alone. Adding SE to PE may improve physical function, but the magnitude of possible benefit is unknown as the 95% confidence intervals around the mean difference were wide.

TRIAL REGISTRATION:

Clinical Trials NCT00319423.

PMID:
20633669
DOI:
10.1016/j.joca.2010.05.015
[Indexed for MEDLINE]
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