Comparison of Manual Therapy and Exercise Therapy in Osteoarthritis of the Hip: A Randomized Clinical Trial

 

Objective. To determine the effectiveness of a manual therapy program compared with an exercise therapy program in
patients with osteoarthritis (OA) of the hip.
Methods. A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for
physical therapy of a large hospital. The manual therapy program focused on specific manipulations and mobilization of
the hip joint. The exercise therapy program focused on active exercises to improve muscle function and joint motion. The
treatment period was 5 weeks (9 sessions). The primary outcome was general perceived improvement after treatment.
Secondary outcomes included pain, hip function, walking speed, range of motion, and quality of life.
Results. Of 109 patients included in the study, 56 were allocated to manual therapy and 53 to exercise therapy. No major
differences were found on baseline characteristics between groups. Success rates (primary outcome) after 5 weeks were
81% in the manual therapy group and 50% in the exercise group (odds ratio 1.92, 95% confidence interval 1.30, 2.60).
Furthermore, patients in the manual therapy group had significantly better outcomes on pain, stiffness, hip function, and
range of motion. Effects of manual therapy on the improvement of pain, hip function, and range of motion endured after
29 weeks.
Conclusion. The effect of the manual therapy program on hip function is superior to the exercise therapy program in
patients with OA of the hip.
KEY WORDS. Osteoarthritis; Hip; Rehabilitation; Musculoskeletal manipulations; Exercise therapy.

 

Comparison of Manual Therapy and Exercise Therapy in Osteoarthritis of the Hip: A Randomized Clinical Trial

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