Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis

Beumer, Lucy, Wong, Jennie, Warden, Stuart J., Kemp, Joanne L., Foster, Paul and Crossley, Kay M. (2016) Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis. British Journal of Sports Medicine, 50 8: 458-463. doi:10.1136/bjsports-2015-095255


Author Beumer, Lucy
Wong, Jennie
Warden, Stuart J.
Kemp, Joanne L.
Foster, Paul
Crossley, Kay M.
Title Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 1473-0480
0306-3674
Publication date 2016-04
Year available 2015
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/bjsports-2015-095255
Open Access Status Not Open Access
Volume 50
Issue 8
Start page 458
End page 463
Total pages 6
Place of publication London, United Kingdom
Publisher BMJ Publishing Group
Collection year 2016
Language eng
Formatted abstract
Aim To explore the effects of exercise (water-based or land-based) and/or manual therapies on pain in adults with clinically and/or radiographically diagnosed hip osteoarthritis (OA).
Methods A systematic review and meta-analysis was performed, with patient reported pain assessed using a visual analogue scale (VAS) or the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscale. Data were grouped by follow-up time (0–3 months=short term; 4–12 months=medium term and; >12 months=long term), and standardised mean differences (SMD) with 95% CIs were used to establish intervention effect sizes. Study quality was assessed using modified PEDro scores.
Results 19 trials were included. Four studies showed short-term benefits favouring water-based exercise over minimal control using the WOMAC pain subscale (SMD −0.53, 95% CI −0.96 to −0.10). Six studies supported a short-term benefit of land-based exercise compared to minimal control on VAS assessed pain (SMD −0.49, 95% CI −0.70 to −0.29). There were no medium (SMD −0.23, 95% CI −0.48 to 0.03) or long (SMD −0.22, 95% CI −0.51 to 0.06) term benefits of exercise therapy, or benefit of combining exercise therapy with manual therapy (SMD −0.38, 95% CI −0.88 to 0.13) when compared to minimal control.
Conclusions Best available evidence indicates that exercise therapy (whether land-based or water-based) is more effective than minimal control in managing pain associated with hip OA in the short term. Larger high-quality RCTs are needed to establish the effectiveness of exercise and manual therapies in the medium and long term.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published online 26 November 2015

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2016 Collection
School of Health and Rehabilitation Sciences Publications
 
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