Progressive resistance training and neuromuscular exercise show similar outcomes in hip osteoarthritis patients: Study

A recent study published in the Annals of Internal Medicine provided new insights into the management of hip osteoarthritis (OA) by revealing that progressive resistance training (PRT) and neuromuscular exercise (NEMEX) offer similar benefits. This research is crucial as exercise is commonly recommended as the first-line treatment for patients suffering from hip OA, but the evidence for the optimal type of exercise has been sparse.

The study set out to determine whether PRT is superior to NEMEX in improving functional performance in patients with hip OA. This multicenter, cluster-randomized, controlled, parallel-group, assessor-blinded superiority trial spread out  this extensive investigation that involved various hospitals and physiotherapy clinics. A total of 160 participants who were all clinically diagnosed with hip OA were enrolled in the study from January 18, 2021 to April 28, 2023. These participants were randomly assigned to either the PRT group (82 participants) or the NEMEX group (78 participants).

Over 12 weeks, both groups engaged in two supervised 60-minute group sessions each week. The PRT program consisted of five high-intensity resistance training exercises that target muscles at the hip and knee joints. Also, the NEMEX program included ten exercises which focused on sensorimotor control and functional stability.

The primary outcome measure was the change in the 30-second chair stand test (30s-CST) which assessed functional performance. The secondary outcomes included changes in pain and hip-related quality of life (QoL) as measured by the Hip Disability and Osteoarthritis Outcome Score (HOOS).

The study found that both exercise regimens resulted in similar improvements in the 30s-CST with both groups showing a mean increase of 1.5 chair stands from baseline to the 12-week follow-up. The difference between the two groups was negligible which indicated no significant advantage for PRT over NEMEX. In terms of pain relief, the participants in the PRT group reported an average improvement of 8.6 points on the HOOS pain subscale while the individuals in the NEMEX group saw an average improvement of 9.3 points. Again, the difference was minimal and not statistically significant.

Quality of life improvements followed a similar pattern and the PRT group showed an average increase of 8.0 points on the HOOS QoL subscale when compared to a 5.7-point increase in the NEMEX group with a not significant difference. Overall, the study found that in patients with hip OA, progressive resistance training is not superior to neuromuscular exercise in improving functional performance, reducing hip pain or improving hip-related quality of life. 

Reference:

Kjeldsen, T., Skou, S. T., Dalgas, U., Tønning, L. U., Ingwersen, K. G., Birch, S., Holm, P. M., Frydendal, T., Garval, M., Varnum, C., Bibby, B. M., & Mechlenburg, I. (2024). Progressive Resistance Training or Neuromuscular Exercise for Hip Osteoarthritis. In Annals of Internal Medicine (Vol. 177, Issue 5, pp. 573–582). American College of Physicians. https://doi.org/10.7326/m23-3225