Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis. Issue 1 (March 2023)

• Record Type: Journal Article
• Authors: Teirlinck, Carolien H.; Verhagen, Arianne P.; van Ravesteyn, Leontien M.; Reijneveld-van de Vendel, Elja A.E.; Runhaar, Jos; van Middelkoop, Marienke; Ferreira, Manuela L.; Bierma-Zeinstra, Sita MA.
• Is Part Of: Osteoarthritis and cartilage open. Volume 5:Issue 1(2023)
• Publication Date: 2023-03
• Subjects: Exercise therapy -- Osteoarthritis of the hip -- Cumulative meta-analysis -- Clinical relevance; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; 616.7223005
• DOI: 10.1016/j.ocarto.2023.100338
• Languages: English
• ISSNs: 2665-9131

Abstract

Abstract: Objective: To evaluate the existing evidence on the effect of exercise therapy in patients with hip osteoarthritis (OA) compared to no treatment and explore whether a further trial will change the current evidence. Design: Systematic review and cumulative meta-analysis using randomized controlled trials (RCT) to determine the effect on pain and function post-treatment, and at 6–9 months after treatment. Standardized mean difference (SMD) ​≤ ​−0.37 was considered clinically worthwhile. Extended funnel plots were used to simulate the impact of a new trial on the pooled effect size of pain and function. Results: 18 RCTs were included. Post-treatment we found a beneficial effect of exercise therapy on pain (SMD -0.38, 95% Confidence Interval (CI): 0.55 to −0.22) and function (SMD -0.31, 95% CI -0.49 to −0.11). A beneficial effect of exercise therapy on pain (SMD -0.23, 95% CI: 0.41 to −0.05) and function (SMD -0.29, 95% CI: 0.45 to −0.12) was found 6–9 months after treatment. Most effect estimates were small, and it is unclear whether these are clinically meaningful. Extended funnel plots and a simulation of a new trial showed that only a new trial with a larger effect than the current pooled effect or a trial including 74, 843 participants would change the pooled effect estimate from an unclear to a clearly clinically worthwhile effect. Conclusions: We found a beneficial effect of exercise therapy on pain and function in hip OA. It is unlikely a new trial added to current evidence will change the conclusion.