Hislop, A. (1,2); Collins, N. (2); Tucker, K. (2); Deasy, M. (2); Semciw, A. (2,3)
(1) The Prince Charles Hospital Physiotherapy Department; (2) The University of Queensland; (3) La Trobe University
Introduction: To determine, in people with knee osteoarthritis (KOA): i) the effectiveness of adding hip strengthening exercises to quadriceps exercises; and ii) the type of hip strengthening exercise that has the greatest evidence for improving pain, function and quality of life.
Methods: A systematic review with meta-analysis of outcomes was conducted from randomised clinical trials. Medline, Embase, Cochrane, Cinahl and SportDiscus databases were searched from inception to January 2018. Studies investigating the effect of adding hip exercises to quadriceps exercises in people with KOA on pain, function and/or quality of life were included. Three sub-groups of hip exercises were included: resistance, functional neuromuscular or multi-modal exercise.
Results: Eight studies were included. Pooled data provide evidence that combined hip and quadriceps exercise is significantly more effective than quadriceps exercise alone in improving walking function (standardised mean difference -1.06, 95% confidence interval -2.01 to -0.12), but not for outcomes of pain (-0.09, -0.96 to 0.79), patient-reported function (-0.74, -1.56 to 0.08) or stair function (-0.7, -1.67 to 0.26). Subgroup analyses reveal that hip resistance exercises are more effective than functional neuromuscular exercises for improving pain (P<0.0001) and patient-reported function (P<0.0001). Multi-modal exercise is no more effective than quadriceps strengthening alone for pain (0.13, -0.31 to 0.56), patient-reported function (-0.15, -0.58 to 0.29) or stair function (0.13, -0.3 to 0.57).
Conclusion: The addition of hip strengthening to quadriceps strengthening improves walking in people with KOA. The addition of resisted hip exercises to quadriceps results in greater improvements in patient-reported pain and function.
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For more information about this abstract, please contact:
Andrew Hislop, The Prince Charles Hospital Physiotherapy Department and the University of Queensland
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