Hip mobilization + movement may yield immediate pain and function improvement in hip OA

Study Type: Therapy
OE Level of Evidence: 2
Journal Level of Evidence: N/A
Synopsis
40 patients with osteoarthritis of the hip were randomized to receive mobilization with movement manual therapy or placebo therapy for the purpose of determining the immediate benefits of mobilization with movement in terms of improvement in hip pain, the internal rotation range of motion, and function. Results demonstrated that Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Not Reported
Conflicts: None disclosed
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Why was this study needed now?
Radiographically diagnosed osteoarthritis of the hip is currently one of the most common chronic conditions in the elderly population. It is often characterized by hip pain, mobility impairments, and limitation in activities of daily living. Manual therapy is commonly prescribed as the first line of conservative treatment for patients with hip OA. However, not all patients are responsive to standardized physical therapy, thus forming an increasing need for the development of varied forms of manual treatment. Mobilization with movement therapy includes the combination of accessory glide forces and active or passive movements, and it is suggested to aid patients with chronic hip OA by improving function and range of motion, and decreasing pain. As the effects of mobilization with movement have not been thoroughly investigated when performed in isolation (as opposed to in combination with other manual therapies), the current study was warranted.
What was the principal research question?
Did a single session of mobilization with movement provide a significant and immediate improvement in hip pain, flexion, internal rotation range of motion, and functional activity for patients with hip osteoarthritis?
Population: 40 patients aged over 65 years with clinical and radiographical diagnosis of osteoarthritis of the hip were included in this trial.
Intervention: Mobilization with Movement (MWM) group: Two forms of mobilization with movement were performed: (1) hip flexion mobilization with movement, which involved flexion to the maximum pain-free range (3 sets of 10 repetitions) and (2) hip internal rotation mobilization with movement, which involved passive internal rotation with the hip as close as possible to 90 degrees flexion (n=20, 20 completed follow-up; mean age= 78.3+/-6.1, 6M/14F).
Comparison: Placebo group: A simulated mobilization with movement technique was performed, involving similar patient positioning but no passive hip flexion or internal rotation. Positioning of patients was held for 10 seconds and repeated 3 times (n=20, 20 completed follow-up; mean age= 77.5+/-6.9, 8M/12F).
Outcomes: The primary outcome of interest was hip pain intensity at rest measured with a numeric rating pain scale (NRPS). Secondary outcomes of interest included hip flexion and internal rotation range of motion (ROM, measured with a goniometer), the time up-and-go test, the 30-second Chair Stand (CS) test, and the 40-meter Self Placed Walk (SPW) test.
Methods: RCT: double-blinded, placebo controlled
Time: Outcomes of interest were evaluated at baseline and immediately (within five minutes) after a singular session of allocated intervention.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.