Progressive Resistance Training or Neuromuscular Exercise for Hip Osteoarthritis : A Multicenter Cluster Randomized Controlled Trial.

Autor:	Kjeldsen T; Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark (T.K.)., Skou ST; The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark, and Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (S.T.S.)., Dalgas U; Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark (U.D.)., Tønning LU; Department of Orthopedic Surgery, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (L.U.T.)., Ingwersen KG; Department of Physio- and Occupational Therapy, Lillebaelt Hospital - Vejle, University Hospital of Southern Denmark, and Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark (K.G.I.)., Birch S; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Physiotherapy and Occupational Therapy, Gødstrup Regional Hospital, Herning, Denmark; and Department of Orthopedic Surgery, Gødstrup Regional Hospital, Herning, Denmark (S.B.)., Holm PM; The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; and Faculty of Health Sciences, University of Faroe Islands, Tórshavn, Faroe Islands (P.M.H.)., Frydendal T; Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Physio- and Occupational Therapy, Lillebaelt Hospital - Vejle, University Hospital of Southern Denmark, Odense, Denmark; and Department of Clinical Research, University of Southern Denmark, Odense, Denmark (T.F.)., Garval M; Elective Surgery Centre, Regional Hospital Silkeborg, Silkeborg, Denmark (M.G.)., Varnum C; Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, and Department of Orthopedic Surgery, Lillebaelt Hospital - Vejle, University Hospital of Southern Denmark, Odense, Denmark (C.V.)., Bibby BM; Department of Biostatistics, Institute of Public Health, Aarhus University, Aarhus, Denmark (B.M.B.)., Mechlenburg I; Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark (I.M.).
Jazyk:	angličtina
Zdroj:	Annals of internal medicine [Ann Intern Med] 2024 May; Vol. 177 (5), pp. 573-582. Date of Electronic Publication: 2024 Apr 09.
DOI:	10.7326/M23-3225
Abstrakt:	Background: Exercise is recommended as first-line treatment for patients with hip osteoarthritis (OA). However, randomized controlled trials providing evidence for the optimal exercise type are lacking. Objective: To investigate whether progressive resistance training (PRT) is superior to neuromuscular exercise (NEMEX) for improving functional performance in patients with hip OA. Design: Multicenter, cluster-randomized, controlled, parallel-group, assessor-blinded, superiority trial. (ClinicalTrials.gov: NCT04714047). Setting: Hospitals and physiotherapy clinics. Participants: 160 participants with clinically diagnosed hip OA were enrolled from 18 January 2021 to 28 April 2023 and randomly assigned to PRT ( n = 82) or NEMEX ( n = 78). Intervention: Twelve weeks of PRT or NEMEX with 2 supervised 60-minute group sessions 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. Measurements: The primary outcome was change in the 30-second chair stand test (30s-CST). Key secondary outcomes were changes in scores on the pain and hip-related quality of life (QoL) subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS). Results: 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). Limitation: Participants and physiotherapists were not blinded. Conclusion: In patients with hip OA, PRT is not superior to NEMEX for improving functional performance, hip pain, or hip-related QoL. Primary Funding Source: Independent Research Fund Denmark. Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-3225.
Databáze:	MEDLINE
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