Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series

Abstract

Objectives:

Describe short- and long-term outcomes observed in individuals with hip osteoarthritis (OA) treated with a pre-selected, standardized set of best-evidence manual therapy and therapeutic exercise interventions.

Methods:

Fifteen consecutive subjects (9 males, 6 females; mean age: 52±7·5 years) with unilateral hip OA received an identical protocol of manual therapy and therapeutic exercise interventions. Subjects attended 10 treatment sessions over an 8-week period for manual therapy interventions and performed the therapeutic exercise as a home program.

Results:

Baseline to 8-week follow-up outcomes were as follows: Harris Hip Scale (HHS) scores improved from 60·3(±10·4) to 80·7(±10·5), Numerical Pain Rating Scale (NPRS) scores improved from 4·3(±1·9) to 2·0(±1·9), hip flexion range of motion (ROM) improved from 99 degrees (±10·6) to 127 degrees (±6·3) and hip internal rotation ROM improved from 19 degrees (±9·1) to 31 degrees (±11·5). Improvements in HHS, NPRS, and hip ROM measures reached statistical significance (P<0·05) at 8-weeks and remained significant at the 29-week follow-up. Mean changes in NPRS and HHS scores exceeded the minimal clinically important difference (MCID) at 8-weeks and for the HHS scores alone at 29 weeks. The 8 and 29 week mean Global Rating of Change scores were 5·1(±1·4) and 2·1(±4·2), respectively.

Improved outcomes observed following a pre-selected, standardized treatment protocol were similar to those observed in previous studies involving impairment-based manual therapy and therapeutic exercise for hip OA. Future studies might directly compare the two approaches.

Discussion:

Keywords:

• Hip
• Osteoarthritis
• Physical therapy
• Manual therapy
• Therapeutic exercise
• Orthopedic manual physical therapy
• Hip OA
• Exercise