Updated 03 November 2016

Exercise therapy helps severe hip osteoarthritis

Exercise therapy can help patients with osteoarthritis of the hip, according to a recent study in San Diego at the World Congress on Osteoarthritis.

While exercise is the cornerstone of treatment for mild to moderate osteoarthritis, few researchers have explored its potential in patients in severe disease, said Dr Allan A. Villadsen from the University of Southern Denmark.

"We were able to establish that it's possible to exercise with osteoarthritis patients this has a positive impact on their performance," he said.

For the trial, Dr Villadsen and his colleagues randomised 84 patients who were scheduled for total hip replacement into two groups: eight weeks of neuromuscular exercise.  or care as usual (verbal and written preoperative instructions). Therapists supervised the exercise twice a week, with each session lasting one hour.

The research team tested the effectiveness of the program by having the patients walk for 20 meters at maximum speed, stand up from a chair five times in a row, and perform multi-joint leg extensions with a leg-extension press and perform single-joint knee extensions on a seated knee extension machine.

At the end of the eight weeks, they found significant between-group differences favouring the exercise group in the 20-meter walk (2.2 seconds, p=0.009), chair stands (1.7 seconds, p=0.022) and leg extension for the non operated leg (0.17 Watts/kg, p=0.049).

More patients should exercise

Dr Sharon L. Kolasinski, a University of Pennsylvania rheumatologist who wasn't involved in the research, said the results show that more patients should try exercise. "It's often thought that nothing can be done for these patients," she said.

But Dr Villadsen said doctors must be careful about prescribing exercise in this population because many patients are in great pain. "The disc joint is pretty worn, so you have to be careful that the patients don't have more pain," he said. "If they do, you have to regress the level of exercise."

On the other hand, if patients can do the prescribed exercises too easily, the therapist can increase the level of difficulty, he said. The researchers also collected data on self-reported physical functioning and on pain but have not yet analysed the numbers, Dr Villadsen said.

The study was funded by the Health Region of Southern Denmark and by several non-profit foundations. 

Read more:

10 exercise myths busted 

Exercise and arthritis  

Alternative remedies for joint pain


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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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