The Importance of Dose in Land-based Supervised Exercise in Hip Osteoarthritis

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SCIENCE
The Importance of Dose in Land-based Supervised Exercise in Hip Osteoarthritis
Key Take-Away: 

There is substantial data to support the short-term beneficial effects of exercise on pain and function for knee osteoarthritis (OA). However, the importance of dose in land-based supervised exercises for hip OA has not been explored yet. The present study focused on the applicability of land-based supervised exercise interventions with varying compliance in people with hip osteoarthritis generating acceptable results in pain reduction and improvement in physical function.

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. There is lack of treatments that has proven to cure or slow the progression of disease. 

ABSTRACT: 
Background: 

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. There is lack of treatments that has proven to cure or slow the progression of disease.

Clinical guidelines have recommended land based exercises to be a part of an effective overall management strategy for people with hip OA. The study aimed to compare the effects of land-based exercise programmes with high vs. low or uncertain compliance with dose recommendations among people with hip OA.

Methods: 

A systematic review with meta-analyses of supervised exercise programmes in people with symptomatic hip OA was conducted. Dose of the exercise interventions was evaluated according to the American College of Sports Medicine's (ACSM) recommendations for developing and maintaining cardio-respiratory fitness, muscular strength and flexibility in healthy adults.

Compliance ratios with the recommendations were calculated. Standardized Mean Differences (SMDs) were calculated in meta-analyses for the outcomes pain and self-reported physical function. Outcome effects were compared between the sub-groups of studies with interventions with "high" vs. "uncertain" compliance with the ACSM recommendations.

Results: 

Twelve studies including 1202 participants were included in this analysis. Seven studies were categorized with "high" and five with "uncertain" compliance with the ACSM recommendations.

While ten studies had an overall low risk of bias. Comparing exercise with no exercise, the pooled SMD for pain was -0.42 (95% CI-0.58, -0.26) in the high compliance group, favoring exercise. In the uncertain compliance group, the pooled SMD was 0.04 (95% CI -0.24, 0.31). For physical function, the SMD was -0.41 (95% CI -0.58, -0.24) in the high compliance group and -0.23 (95% CI -0.52, 0.06) in the uncertain compliance group.

Conclusion: 

The results showed that land-based supervised exercise interventions with high compliance to the ACSM recommendations result in significantly larger improvements in pain and non-significantly larger improvement in self-reported physical function compared with land-based supervised exercise interventions with uncertain compliance.

 

Source:

Osteoarthritis Cartilage. 2017 Jun 22

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28648741

The original title of the article:

The importance of dose in land-based supervised exercise for people with hip osteoarthritis. A systematic review and meta-analysis

Authors:

Moseng T et al

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