ORIGINAL PAPER
Assessing the impact of a long-term physiotherapy program on hip
function in patients with osteoarthritis: the role of patient-reported and assessor-observed outcome measures
1
Chair of Clinical Physiotherapy, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland Head of the Chair: Grażyna Brzuszkiewicz-Kuźmicka PT, PhD
2
1st Department of Clinical Radiology, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Head of the Department: Prof. Marek Gołębiowski MD, PhD
3
2nd Department of Clinical Radiology, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Head of the Department: Magdalena Januszewicz MD, PhD
4
Department of Rehabilitation, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland Head of the Department: Dariusz Białoszewski MD, PhD
Submission date: 2022-03-05
Final revision date: 2022-10-09
Acceptance date: 2022-11-08
Publication date: 2022-12-16
Medical Studies 2022;38(4):311-320
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Because there are few trials evaluating rehabilitation effects in people with hip osteoarthritis, it is important to increase the body of research and develop assessment methods improving the objectivity of evaluation.
Aim of the research:
To evaluate the effect of a long-term, land-based physiotherapy program on the hip-related function in patients with hip osteoarthritis, and to assess the relationship of self-reported and assessor-observed functional outcome measures.
Material and methods:
The trial was conducted prospectively over a 12-month period. The study cohort consisted of 37 people of both genders. The intervention included three rounds of 3-week physiotherapist-supervised treatment and two 5-month intervals of an unsupervised maintenance program in between. The functional assessment was performed 4 times using the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and a set of performance-based tests (PBTs): the 30-Second Chair Stand Test (30secCST), 40-Metre Fast-paced Walk Test (40mFPWT), and Stair Climb Test (SCT). The hip joint was evaluated twice structurally using the Scoring Hip Osteoarthritis with MRI (magnetic resonance imaging).
Results:
A significant improvement in hip-related function was observed in HOOS among MRI progressors, exclusively physical workers. Non-progressors, mostly sedentary workers, were characterized by improvement of PBTs. There was a correlation between HOOS and 40mFPWT and SCT at the baseline, 3-week, and 6-month follow-ups. The outcomes for 30secCST were not consistent. We observed a positive effect of rehabilitation on hip function in the studied population, although progressors and non-progressors achieved different outcomes. The relationship of PBTs and HOOS was marked, but not unequivocal.
Conclusions:
The improvement in self-reported measures may mask disease progression in MRI progressors.
Because there are few trials evaluating rehabilitation effects in people with hip osteoarthritis, it is important to increase the body of research and develop assessment methods improving the objectivity of evaluation.
Aim of the research:
To evaluate the effect of a long-term, land-based physiotherapy program on the hip-related function in patients with hip osteoarthritis, and to assess the relationship of self-reported and assessor-observed functional outcome measures.
Material and methods:
The trial was conducted prospectively over a 12-month period. The study cohort consisted of 37 people of both genders. The intervention included three rounds of 3-week physiotherapist-supervised treatment and two 5-month intervals of an unsupervised maintenance program in between. The functional assessment was performed 4 times using the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and a set of performance-based tests (PBTs): the 30-Second Chair Stand Test (30secCST), 40-Metre Fast-paced Walk Test (40mFPWT), and Stair Climb Test (SCT). The hip joint was evaluated twice structurally using the Scoring Hip Osteoarthritis with MRI (magnetic resonance imaging).
Results:
A significant improvement in hip-related function was observed in HOOS among MRI progressors, exclusively physical workers. Non-progressors, mostly sedentary workers, were characterized by improvement of PBTs. There was a correlation between HOOS and 40mFPWT and SCT at the baseline, 3-week, and 6-month follow-ups. The outcomes for 30secCST were not consistent. We observed a positive effect of rehabilitation on hip function in the studied population, although progressors and non-progressors achieved different outcomes. The relationship of PBTs and HOOS was marked, but not unequivocal.
Conclusions:
The improvement in self-reported measures may mask disease progression in MRI progressors.
REFERENCES (42)
1.
Suri P, Morgenroth DC, Hunter DJ. Epidemiology of osteoarthritis and associated comorbidities. PMR 2012; 4 (5 Suppl): S10-S19.
2.
Schofield D, Cunich M, Shrestha RN, Tanton R, Veerman L, Kelly S, Passey ME. The long-term economic impacts of arthritis through lost productive life years: results from an Australian microsimulation model. BMC Public Health 2018; 18: 654.
3.
Safiri S, Kolahi AA, Smith E, Hill C, Bettampadi D, Mansournia MA, Hoy D, Ashrafi-Asgarabad A, Sepidarkish M, Almasi-Hashiani A, Collins G, Kaufman J, Qorbani M, Moradi-Lakeh M, Woolf AD, Guillemin F, March L, Cross M. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis 2020; 79: 819-828.
4.
Pivec R, Johnson AJ, Mears SC, Mont MA. Hip arthroplasty. Lancet 2012; 380: 1768-1777.
5.
Bichsel D, Liechti FD, Schlapbach JM, Wertli MM. Cross-sectional analysis of recommendations for the treatment of hip and knee osteoarthritis in clinical guidelines. Arch Phys Med Rehabil 2022; 103: 559-569.
6.
Smith T, Collier TS, Smith B, Mansfield M. Who seeks physiotherapy or exercise treatment for hip and knee osteoarthritis? A cross-sectional analysis of the English Longitudinal Study of Ageing. Int J Rheum Dis 2019; 22: 897-904.
7.
Abbott JH, Wilson R, Pinto D, Chapple CM, Wright AA. Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomised controlled trial. Osteoarthritis Cartilage 2019; 27: 424-434.
8.
Chen WH, Tsai WC, Wang HT, Wang CH, Tseng YT. Can early rehabilitation after osteoarthritis reduce knee and hip arthroplasty risk? A national representative cohort study. Medicine 2019; 98: e15723.
9.
Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H, Duruoz T, Esbensen BA, Gün- ther KP, Hurkmans E, Juhl CB, Kennedy N, Kiltz U, Knittle K, Nurmohamed M, Pais S, Severijns G, Swinnen TW, Pitsillidou IA, Warburton L, Yankov Z, Vliet Vlieland TPM. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018; 77: 1251-1260.
10.
Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey WF, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello C, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimo- ri M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner AS, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol 2020; 72: 220-233.
11.
Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Ab- bott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019; 27: 1578-1589.
12.
Roux CH. Hip osteoarthritis guidelines: differences, applicability and application? Joint Bone Spine 2020; 87: 111-114.
13.
Verhagen AP, Ferreira M, Reijneveld-van de Vendel EAE, Teirlinck CH, Runhaar J, van Middelkoop M, Hermsen L, de Groot IB, Bierma-Zeinstra SMA. Do we need another trial on exercise in patients with knee osteoarthritis? No new trials on exercise in knee OA. Osteoarthritis Cartilage 2019; 27: 1266-1269.
14.
Daste C, Kirren Q, Akoum J, Lefèvre-Colau MM, Rannou F, Nguyen C. Physical activity for osteoarthritis: efficiency and review of recommandations. Joint Bone Spine 2021; 88: 105207.
15.
Maly MR, Marriott KA, Chopp-Hurley JN. Osteoarthritis year in review 2019: rehabilitation and outcomes. Osteoarthritis Cartilage 2020; 28: 249-266.
16.
Whittaker JL, Truong LK, Dhiman K, Beck C. Osteoarthritis year in review 2020: rehabilitation and outcomes. Osteoarthritis Cartilage 2021; 29: 190-207.
17.
Brosseau L, Wells GA, Pugh AG, Smith CA, Rahman P, Alvarez Gallardo IC, Toupin-April K, Loew L, De Ange- lis G, Cavallo S, Taki J, Marcotte R, Fransen M, Hernandez-Molina G, Kenny GP, Regnaux JP, Lefevre-Colau MM, Brooks S, Laferriere L, McLean L, Longchamp G. Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis. Clin Rehabil 2016; 30: 935-946.
18.
Lane NE, Hochberg MC, Nevitt MC, Simon LS, Nel- son AE, Doherty M, Henrotin Y, Flechsenhar K. OARSI Clinical Trials Recommendations: design and conduct of clinical trials for hip osteoarthritis. Osteoarthritis Cartilage 2015; 23: 761-771.
19.
Fitzgerald GK, Hinman RS, Zeni J Jr, Risberg MA, Snyder-Mackler L, Bennell KL. OARSI Clinical Trials Recommendations: design and conduct of clinical trials of rehabilitation interventions for osteoarthritis. Osteoarthritis Cartilage 2015; 23: 803-814.
20.
Lee S, Nardo L, Kumar D, Wyatt CR, Souza RB, Lynch J, McCulloch CE, Majumdar S, Lane NE, Link TM. Scoring hip osteoarthritis with MRI (SHOMRI): a whole joint osteoarthritis evaluation system. J Magn Reson Imaging 2015; 41: 1549-1557.
21.
Lewińska A, Palczewski P, Piłat K, Cieszanowski A, Ron- gies W. The use of scoring hip osteoarthritis with MRI as an assessment tool for physiotherapeutic treatment in patients with osteoarthritis of the hip. J Clin Med 2022; 11: 17.
22.
Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16: 494-502.
23.
Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Fel- dman D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991; 34: 505-514.
24.
Thompson PD, Arena R, Riebe D, Pescatello LS. ACSM’s new preparticipation health screening recommendations from ACSM’s guidelines for exercise testing and prescription, ninth edition. Curr Sports Med Rep 2013; 12: 215-217.
25.
Klassbo M, Larsson E, Mannevik E. Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol 2003; 32: 46-51.
26.
Dobson F, Hinman RS, Roos EM, Abbott JH, Stratford P, Davis AM, Buchbinder R, Snyder-Mackler L, Henrotin Y, Thumboo J, Hansen P, Bennell KL. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013; 21: 1042-1052.
27.
Holm I, Pripp AH, Risberg MA. The Active with OsteoArthritis (AktivA) Physiotherapy Implementation Model: a patient education, supervised exercise and self-management program for patients with mild to moderate osteoarthritis of the knee or hip joint. A national register study with a two-year follow-up. J Clin Med 2020; 9: E3112.
28.
Kumar D, Wyatt C, Chiba K, Lee S, Nardo L, Link TM, Majumdar S, Souza RB. Anatomic correlates of reduced hip extension during walking in individuals with mild-moderate radiographic hip osteoarthritis. J Orthop Res 2015; 33: 527-534.
29.
Kumar D, Wyatt C, Lee S, Okazaki N, Chiba K, Link TM, Souza RB, Majumdar S. Sagittal plane walking patterns are related to MRI changes over 18-months in people with and without mild-moderate hip osteoarthritis. J Orthop Res 2018; 36: 1472-1477.
30.
Liao TC, Samaan MA, Popovic T, Neumann J, Zhang AL, Link TM, Majumdar S, Souza RB. Abnormal joint loading during gait in persons with hip osteoarthritis is associated with symptoms and cartilage lesions. J Orthop Sports Phys Ther 2019; 49: 917-924.
31.
Nadeau S, McFadyen BJ, Malouin F. Frontal and sagittal plane analyses of the stair climbing task in healthy adults aged over 40 years: what are the challenges compared to level walking? Clin Biomech 2003; 18: 950-959.
32.
Popovic T, Samaan MA, Link TM, Majumdar S, Souza RB. Patients with symptomatic hip osteoarthritis have altered kinematics during stair ambulation. PMR 2021; 13: 128-136.
33.
Burgess LC, Taylor P, Wainwright TW, Swain ID. Strength and endurance deficits in adults with moderate-to-severe hip osteoarthritis, compared to healthy, older adults. Disabil Rehabil 2022; 44: 5563-5570.
34.
Lyman S, Lee YY, McLawhorn AS, Islam W, MacLean CH. What are the minimal and substantial improvements in the HOOS and KOOS and JR versions after total joint replacement? Clin Orthop Relat Res 2018; 476: 2432-2441.
35.
Davis AM, King LK, Stanaitis I, Hawker GA. Fundamentals of osteoarthritis: outcome evaluation with patient-reported measures and functional tests. Osteoarthritis Cartilage 2022; 30: 775-785.
36.
Wright AA, Cook CE, Baxter GD, Dockerty JD, Abbott JH. A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis. J Orthop Sports Phys Ther 2011; 41: 319-327.
37.
Coleman G, Dobson F, Hinman RS, Bennell K, White DK. Measures of physical performance. Arthritis Care Res 2020; 72 Suppl 10: 452-485.
38.
Bossmann T, Kirchberger I, Glaessel A, Stucki G, Cieza A. Validation of the comprehensive ICF core set for osteoarthritis: the perspective of physical therapists. Physiotherapy 2011; 97: 3-16.
39.
Dobson F, Hinman RS, Hall M, Marshall CJ, Sayer T, Anderson C, Newcomb N, Stratford PW, Bennell KL. Reliability and measurement error of the Osteoarthritis Research Society International (OARSI) recommended performance-based tests of physical function in people with hip and knee osteoarthritis. Osteoarthritis Cartilage 2017; 25: 1792-1796.
40.
Tolk JJ, Janssen RPA, Prinsen C, van der Steen MMC, Bierma Zeinstra SMA, Reijman M. Measurement properties of the OARSI core set of performance-based measures for hip osteoarthritis: a prospective cohort study on reliability, construct validity and responsiveness in 90 hip osteo-arthritis patients. Acta Orthop 2019; 90: 15-20.
41.
Scott EJ, Willey MC, Mercado A, Davison J, Wilken JM. Assessment of disability related to hip dysplasia using objective measures of physical performance. Orthop J Sports Med 2020; 8: 2325967120903290.
42.
Sheean AJ, Schmitz MR, Ward CL, Barrow AE, Tennent DJ, Roach CJ, Burns TC, Wilken JM. Assessment of disability related to femoroacetabular impingement syndrome by use of the Patient-Reported Outcome Measure Information System (PROMIS) and objective measures of physical performance. Am J Sports Med 2017; 45: 2476-2482.
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