Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark (T.K.).
The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark, and Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (S.T.S.).
Ann Intern Med. 2024 May;177(5):573-582. doi: 10.7326/M23-3225. Epub 2024 Apr 9.
Exercise is recommended as first-line treatment for patients with hip osteoarthritis (OA). However, randomized controlled trials providing evidence for the optimal exercise type are lacking.
To investigate whether progressive resistance training (PRT) is superior to neuromuscular exercise (NEMEX) for improving functional performance in patients with hip OA.
Multicenter, cluster-randomized, controlled, parallel-group, assessor-blinded, superiority trial. (ClinicalTrials.gov: NCT04714047).
Hospitals and physiotherapy clinics.
160 participants with clinically diagnosed hip OA were enrolled from 18 January 2021 to 28 April 2023 and randomly assigned to PRT ( = 82) or NEMEX ( = 78).
Twelve weeks of PRT or NEMEX with 2 supervised 60-minute group sessions each week. The PRT intervention consisted of 5 high-intensity resistance training exercises targeting muscles at the hip and knee joints. The NEMEX intervention included 10 exercises and emphasized sensorimotor control and functional stability.
The primary outcome was change in the 30-second chair stand test (30s-CST). Key secondary outcomes were changes in scores on the pain and hip-related quality of life (QoL) subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS).
The mean changes from baseline to 12-week follow-up in the 30s-CST were 1.5 (95% CI, 0.9 to 2.1) chair stands with PRT and 1.5 (CI, 0.9 to 2.1) chair stands with NEMEX (difference, 0.0 [CI, -0.8 to 0.8] chair stands). For the HOOS pain subscale, mean changes were 8.6 (CI, 5.3 to 11.8) points with PRT and 9.3 (CI, 5.9 to 12.6) points with NEMEX (difference, -0.7 [CI, -5.3 to 4.0] points). For the HOOS QoL subscale, mean changes were 8.0 (CI, 4.3 to 11.7) points with PRT and 5.7 (CI, 1.9 to 9.5) points with NEMEX (difference, 2.3 [CI, -3.0 to 7.6] points).
Participants and physiotherapists were not blinded.
In patients with hip OA, PRT is not superior to NEMEX for improving functional performance, hip pain, or hip-related QoL.
Independent Research Fund Denmark.
运动被推荐为髋骨关节炎（OA）患者的一线治疗方法。然而，缺乏提供最佳运动类型证据的随机对照试验。
研究渐进式抗阻训练（PRT）是否优于神经肌肉训练（NEMEX），以改善髋 OA 患者的功能表现。
多中心、集群随机、对照、平行组、评估者盲法、优效性试验。（ClinicalTrials.gov：NCT04714047）。
医院和物理治疗诊所。
2021 年 1 月 18 日至 2023 年 4 月 28 日，从临床诊断为髋 OA 的 160 名患者中招募，并随机分配至 PRT（n=82）或 NEMEX（n=78）。
每周进行 12 周的 PRT 或 NEMEX，每周进行 2 次监督的 60 分钟小组课程。PRT 干预包括针对髋关节和膝关节肌肉的 5 项高强度阻力训练练习。NEMEX 干预包括 10 项练习，强调感觉运动控制和功能稳定性。
主要结局是 30 秒椅子站立测试（30s-CST）的变化。关键次要结局是髋关节残疾和骨关节炎结果评分（HOOS）中疼痛和髋部相关生活质量（QoL）子量表的评分变化。
PRT 组的 30s-CST 从基线到 12 周随访的平均变化为 1.5（95%CI，0.9 至 2.1）个座位，NEMEX 组为 1.5（CI，0.9 至 2.1）个座位（差异，0.0[CI，-0.8 至 0.8]个座位）。对于 HOOS 疼痛子量表，PRT 组的平均变化为 8.6（CI，5.3 至 11.8）分，NEMEX 组为 9.3（CI，5.9 至 12.6）分（差异，-0.7[CI，-5.3 至 4.0]分）。对于 HOOS QoL 子量表，PRT 组的平均变化为 8.0（CI，4.3 至 11.7）分，NEMEX 组为 5.7（CI，1.9 至 9.5）分（差异，2.3[CI，-3.0 至 7.6]分）。
参与者和物理治疗师没有被蒙蔽。
在髋骨关节炎患者中，PRT 并不优于 NEMEX 改善功能表现、髋部疼痛或髋部相关 QoL。
丹麦独立研究基金。
