Exercise for Osteoarthritis of the Hip

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness of appropriate interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.¹ Each article in this PTJ series summarizes a Cochrane review or other scientific evidence on a single topic and presents clinical scenarios based on real patients or programs to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on an adult patient with osteoarthritis of the hip. Can exercise help this patient?

Osteoarthritis (OA) is the most common form of arthritis and is characterized by a progressive degeneration of the joint, affecting most frequently the hands, knees, and hips. Radiographic signs of OA include joint space narrowing, subchondral bone sclerosis, and osteophyte formation. The loss of cartilage is often associated with synovium inflammation,² thickening of the capsule, and muscle weakness.^3,4 Osteoarthritis is a leading cause of disability, especially in the elderly population, with pain and functional limitation being the main associated symptoms.⁵

Management strategies for OA of the hip include a combination of nonpharmacological and pharmacological modalities. Education, exercise, and weight loss are considered to be core treatments by international guidelines^6–10 and should be considered as the first management option, before medications. When medication is needed, the treatment starts with paracetamol or nonsteroidal anti-inflammatory …