Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis
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 tr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Osteoarthritis and Cartilage Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2665913123000055 |
| _version_ | 1811160845719175168 |
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| author | Carolien H. Teirlinck Arianne P. Verhagen Leontien M. van Ravesteyn Elja A.E. Reijneveld-van de Vendel Jos Runhaar Marienke van Middelkoop Manuela L. Ferreira Sita MA. Bierma-Zeinstra |
| author_facet | Carolien H. Teirlinck Arianne P. Verhagen Leontien M. van Ravesteyn Elja A.E. Reijneveld-van de Vendel Jos Runhaar Marienke van Middelkoop Manuela L. Ferreira Sita MA. Bierma-Zeinstra |
| author_sort | Carolien H. Teirlinck |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T06:04:28Z |
| format | Article |
| id | doaj.art-f821076e1cdd4d0f9d6bb8380be97822 |
| institution | Directory Open Access Journal |
| issn | 2665-9131 |
| language | English |
| last_indexed | 2024-04-10T06:04:28Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj.art-f821076e1cdd4d0f9d6bb8380be978222023-03-03T04:25:23ZengElsevierOsteoarthritis and Cartilage Open2665-91312023-03-0151100338Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysisCarolien H. Teirlinck0Arianne P. Verhagen1Leontien M. van Ravesteyn2Elja A.E. Reijneveld-van de Vendel3Jos Runhaar4Marienke van Middelkoop5Manuela L. Ferreira6Sita MA. Bierma-Zeinstra7Dept. General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands; Corresponding author. Carolien. H Teirlinck. Department of General Practice Na-19-02, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.Dept. General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands; Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, AustraliaDiscipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, AustraliaDept. General Practice, Erasmus MC University Medical Center Rotterdam, the NetherlandsDept. General Practice, Erasmus MC University Medical Center Rotterdam, the NetherlandsDept. General Practice, Erasmus MC University Medical Center Rotterdam, the NetherlandsSydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, AustraliaDept. General Practice, Erasmus MC University Medical Center Rotterdam, the NetherlandsObjective: 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.http://www.sciencedirect.com/science/article/pii/S2665913123000055Exercise therapyOsteoarthritis of the hipCumulative meta-analysisClinical relevance |
| spellingShingle | Carolien H. Teirlinck Arianne P. Verhagen Leontien M. van Ravesteyn Elja A.E. Reijneveld-van de Vendel Jos Runhaar Marienke van Middelkoop Manuela L. Ferreira Sita MA. Bierma-Zeinstra Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis Osteoarthritis and Cartilage Open Exercise therapy Osteoarthritis of the hip Cumulative meta-analysis Clinical relevance |
| title | Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis |
| title_full | Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis |
| title_fullStr | Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis |
| title_full_unstemmed | Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis |
| title_short | Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis |
| title_sort | effect of exercise therapy in patients with hip osteoarthritis a systematic review and cumulative meta analysis |
| topic | Exercise therapy Osteoarthritis of the hip Cumulative meta-analysis Clinical relevance |
| url | http://www.sciencedirect.com/science/article/pii/S2665913123000055 |
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