Exercise in patients with hip osteoarthritis - effects on muscle and functional performance: A randomized trial

• Published in: Physiotherapy theory and practice Vol. 38; no. 12; pp. 1946 - 1957
• Main Authors: Bieler, Theresa, Kristensen, Asker Lau Røn, Nyberg, Mette, Magnusson, S. Peter, Kjaer, Michael, Beyer, Nina
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.12.2022; Taylor & Francis Ltd
• Subjects: Arthritis; Changes; Disability; Exercise; Exercise therapy; Functional performance; Health care management; hip osteoarthritis; Home based; Humans; Induced; Magnetic resonance imaging; muscle adaptations; Muscle strength; Muscle Strength - physiology; Osteoarthritis; Osteoarthritis, Hip - therapy; Physical ability; Power; Quadriceps; Quadriceps Muscle; randomized controlled trial; Resistance; Resistance Training - methods; Strength; Strength training; Walking; Walking - physiology; functional performance; hip osteoarthritis; Exercise therapy; muscle adaptations; randomized controlled trial
• ISSN: 0959-3985; 1532-5040
• DOI: 10.1080/09593985.2021.1923096

It is believed that clinical management of osteoarthritis should address muscle weakness to improve physical function and prevent disability and frailty This sub-study investigated the effects of supervised progressive resistance training (RT), supervised Nordic Walking (NW), and unsupervised home-based exercise (HBE) on muscle and functional performance; and associations between these exercise-induced changes in persons with hip osteoarthritis. Forty-two patients with hip osteoarthritis were recruited from a larger RCT (NCT01387867). All the groups (RT, n = 15; NW, n = 12; HBE, n = 15) exercised 1 h 3 times/week for 4 months. Quadriceps cross-sectional area (QCSA, MRI-determined); quadriceps strength (QMVC); leg extensor power (LEP); functional performance (chair stands (30sCS); stair climbs (TSC); and 6-minute walk (6MWT)) were assessed at baseline and 4 months. Per protocol analyses (one-way ANOVA and Bonferroni test) showed significant between-group differences for improvements in QCSA in the most symptomatic leg favoring RT versus NW (2.3 cm 2 , 95% CI [0.6, 3.9]) and HBE (2.3 cm 2 [0.8, 3.9]); and 30sCS (1.8 repetitions [0.2-3.3]), and 6MWT (35.1 m [3.5-66.7]) favoring NW versus HBE. Associations existed between exercise-induced changes in QCSA and QMVC (r = 0.366, p = .019) for the most symptomatic leg and between changes in 6MWT and QMVC (r = 0.320, p = .04) and LEP (r = 0.381, p = .01), respectively, for the least symptomatic leg. Resistance training appeared effective for improving muscle mass, but less effective for improving muscle strength, power, and functional performance. Only exercise-induced changes in muscle strength and power of the least symptomatic leg, not the most symptomatic leg, were related to changes in functional performance.