Table 32Osteoarthritis hip pain: manual therapy

Author, Year, Followup, Pain Duration, Study QualityInterventionPopulationFunction and Pain OutcomesOther Outcomes

Abbott, 2013

9.75 months

Duration of diagnosis: 2.6 years

Fair

A. Manual therapy (n=54/24 hip ): 7 manual therapy sessions in 9 weeks with 2 additional booster sessions

B. Exercise (n=51/22 hip ), 7 exercise sessions in 9 weeks with 2 additional booster sessions

C. Usual care (n=51/23 hip )

A vs. B vs. C (total population, includes knee )

Age: 67 vs. 67 vs. 66 years

Female: 49% vs. 52% vs. 58%

Percent knee : 56% vs. 57% vs. 55%

Percent hip : 44% vs. 43% vs. 45%

Percent both hip and knee OA: 22% vs. 20% vs. 26%

Baseline WOMAC (0-240): 114.8 vs. 95.5 vs. 93.8

A vs. B (hip only)

9.75 months

WOMAC, mean change from baseline: −22.9 vs. −12.4, p=

A vs. C (hip only)

9.75 months

WOMAC, mean change from baseline: −22.9 vs. 6.6, p=

None

Hoeksma, 2004

3 and 6 months

Duration of symptoms:

Fair

A. Manual therapy (n=56): Sessions consisted of stretching followed by traction manipulation in each limited position (high velocity thrust technique).

B. Exercise therapy (n=53): Sessions implemented exercises for muscle functions, muscle length, joint mobility, pain relief, and walking ability and were tailored to the specific needs of the patient. Instructions for home exercises were given.

Both groups received 2 sessions per week for 5 weeks (9 sessions in total).

Age: 72 vs. 71 years

Females: 68% vs. 72%

Symptom duration of 1 month to 5 years: 76% vs. 81%

Severe on radiography: 45% vs. 38%

Baseline (0-100): 54 vs. 53

Baseline pain at rest (0-100): 22.5 vs. 23.0

Baseline pain walking (0-100): 34.0 vs. 28.8

A vs. B

3 months

: 68.4 vs. 56.0, adjusted difference 11.1, 95% 4.0 to 18.6

Pain at rest : 19.1 vs. 26.9, adjusted difference −7.2, 95% −13.8 to −0.5

Pain walking : 16.4 vs. 23.7, adjusted difference −12.1, 95% −22.9 to −2.5

6 months

: 70.2 vs. 59.7, adjusted difference 9.7, 95% 1.5 to 17.9

Pain at rest : 14.0 vs. 21.6, adjusted difference −7.0, 95% −20.3 to 5.9

Pain walking : 17.0 vs. 24.3, adjusted difference −12.7, 95% −24.0 to −1.9

A vs. B

3 months

SF-36 physical function (0-100): 45.3 vs. 46.6, adjusted difference −2.1, 95% −11.7 to 7.7

SF-36 role physical function: 25.4 vs. 29.8, adjusted difference −23.5 to 10.2

SF-36 bodily pain: 47.4 vs. 46.1, adjusted difference −3.2, 95% −13.1 to 6.8

6 months

SF-36 physical function: 50.4 vs. 45.3, adjusted difference 3.1, 95% −4.1 to 10.5

SF-36 role physical function: 36.7 vs. 32.4, adjusted difference 2.2, 95% −16.8 to 21.1

SF-36 bodily pain: 51.4 vs. 49.9, adjusted difference −1.5, 95% −11.1 to 7.7

= confidence interval; = Harris Hip Score; = not reported; = osteoarthritis; SF-36 = Short Form 36 Questionnaire; = visual analog scale; WOMAC =Western Ontario and McMaster Universities Arthritis Index

a

Unless otherwise noted, followup time is calculated from the end of the treatment period

From: Results

Cover of Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update
Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update [Internet].
Comparative Effectiveness Review, No. 227.
Skelly AC, Chou R, Dettori JR, et al.

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