Secondary Analysis of a Study on Exercise Therapy in Hip Osteoarthritis: Follow-Up Data on Pain and Physical Functioning
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Interventions
2.3.1. Exercise Therapy (E)
2.3.2. Placebo Ultrasound (P)
2.3.3. Control (C)
2.4. Measures
2.4.1. Primary Outcome
2.4.2. Secondary Outcomes
2.4.3. Confounders
2.5. Sample Size
2.6. Statistical Analysis
3. Results
3.1. Participant Flow
3.2. Participant Characteristics
3.3. Primary Objective: Long-Term Responsiveness (t0-t12) within Sequence Groups
3.4. Explorative Analysis: Comparisons of Sequence Groups
3.5. Adherence to Exercise
3.6. Treatment Satisfaction
3.7. Sensitivity Analysis
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total (n = 115) | E-C (n = 49) | C-E (n = 33) | P-E (n = 33) | p | |
---|---|---|---|---|---|
Age (years) (n = 115) | 0.59 | ||||
mean (SD) | 57 (9.6) | 57 (10.1) | 59 (9.4) | 56 (9.2) | |
Gender (n = 115) | 0.47 | ||||
female; n (%) | 39 (33.9) | 15 (30.6) | 10 (30.3) | 14 (42.4) | |
male | 76 (66.1) | 34 (69.4) | 23 (69.7) | 19 (57.6) | |
BMI (n = 115) | 0.42 | ||||
mean (SD) | 26.5 (3.4) | 26.7 (3.6) | 26.9 (3.4) | 25.9 (3.3) | |
Education (n = 111) | 0.25 | ||||
university; n (%) | 50 (45.0) | 23 (47.0) | 17 (56.7) | 10 (31.3) | |
higher vocational education | 58 (52.3) | 25 (51.0) | 12 (40.0) | 21 (65.6) | |
basic secondary school | 3 (2.7) | 1 (2.0) | 1 (3.3) | 1 (3.1) | |
SF-36, bodily pain (n = 115) | 0.52 | ||||
mean (SD) | 58.1 (18.0) | 60.3 (16.6) | 57.1 (19.0) | 55.9 (19.2) | |
WOMAC, pain (n = 115) | 0.52 | ||||
mean (SD) | 27.0 (16.2) | 25.0 (14.4) | 29.0 (18.3) | 27.8 (16.6) | |
WOMAC, physical functioning (n = 115) | 0.50 | ||||
mean (SD) | 26.0 (15.9) | 24.0 (15.6) | 27.4 (17.2) | 27.6 (15.3) | |
WOMAC, stiffness (n = 115) | 0.17 | ||||
mean (SD) | 33.7 (21.4) | 29.4 (18.5) | 36.4 (24.9) | 37.6 (21.3) |
E-C (n = 49) | C-E (n = 33) | P-E (n = 33) | ||||
---|---|---|---|---|---|---|
Mean (SD) | Change Score (ES; 95% CI) | Mean (SD) | Change Score (ES; 95% CI) | Mean (SD) | Change Score (ES; 95% CI) | |
SF-36 bodily pain | ||||||
t0 | 60.3 (16.6) | 57.3 (19.3) | 55.8 (19.2) | |||
t3 | 67.1 (18.8) | 6.80 * (0.36; (0.07; 0.65)) | 55.7 (19.1) | −1.63 (−0.10; (−0.44, 0.25)) | 57.5 (18.9) | 1.64 (0.08; (−0.26, 0.42)) |
t6 | 66.8 (21.2) | 6.35 * (0.31; (0.02, 0.61)) | 64.6 (20.0) | 7.25 (0.34; (−0.01, 0.70)) | 61.1 (17.2) | 5.37 (0.35; (−0.01, 0.71)) |
t12 | 67.1 (19.2) | 6.86 * (0.39; (0.10, 0.68)) | 60.3 (22.0) | 3.03 (0.15; (−0.20, 0.49)) | 60.1 (20.1) | 4.21 (0.21; (−0.14, 0.55)) |
WOMAC pain | ||||||
t0 | 25.0 (14.4) | 29.0 (18.3) | 27.8 (16.4) | |||
t3 | 16.9 (15.0) | −8.16 * (0.57; (0.27, 0.87)) | 29.2 (19.8) | 0.12 (−0.01; (−0.34, 0.33)) | 22.4 (14.2) | −5.39 * (0.37; (0.02, 0.73)) |
t6 | 17.3 (15.6) | −8.17 *(0.50; (0.19, 0.80)) | 22.3 (17.7) | −6.73 * (0.37; (0.02, 0.73)) | 17.9 (13.1) | −10.37 * (0.65; (0.27, 1.03)) |
t12 | 16.9 (13.4) | −8.08 * (0.56; (0.25, 0.86)) | 21.9 (15.7) | −7.09 * (0.37; (0.02, 0.72)) | 22.3 (15.7) | −5.52 (0.33; (0.02, 0.68)) |
WOMAC function | ||||||
t0 | 24.0 (15.6) | 27.4 (17.2) | 27.6 (15.1) | |||
t3 | 15.6 (14.1) | −8.44 * (0.63; (0.32, 0.93)) | 25.6 (15.9) | −1.86 (0.14; (−0.20, 0.48)) | 21.0 (13.0) | −6.58 * (0.49; (0.12, 0.84)) |
t6 | 15.9 (15.7) | −8.38 * (0.50; (0.20, 0.81)) | 19.4 (13.9) | −8.06 * (0.52; (0.16, 0.88)) | 20.4 (12.3) | −7.32 * (0.54; (0.17, 0.91)) |
t12 | 14.9 (13.8) | −9.03 * (0.59; (0.28, 0.89)) | 20.6 (14.0) | −6.86 * (0.47; (0.11, 0.83)) | 22.6 (15.4) | −4.98 (0.32; (−0.03, 0.67)) |
WOMAC stiffness | ||||||
t0 | 29.4 (18.5) | 36.4 (24.9) | 37.6 (21.3) | |||
t3 | 20.4 (18.2) | −8.98 * (0.43; (0.13, 0.72)) | 27.1 (20.5) | −9.24 * (0.49; (0.13, 0.86)) | 27.7 (16.3) | −9.85 * (0.49; (0.13, 0.84)) |
t6 | 22.4 (17.8) | −7.23 * (0.33; (0.03, 0.62)) | 25.0 (17.4) | −11.36 * (0.65; (0.27,1.02)) | 26.9 (15.4) | −11.25 * (0.53; (0.16, 0.90)) |
t12 | 24.1 (17.9) | −5.31 (0.26; (−0.03, 0.54)) | 23.0 (16.0) | −13.33 * (0.55; (0.18, 0.91)) | 28.5 (18.1) | −9.09 * (0.49; (0.12, 0.84)) |
Exercise Intervention Period For P-E, C-E (ES, 95% CI) | Follow-Up (ES, 95% CI) | |
---|---|---|
C-E (n = 33) | t3–t6 | t3–t12 |
SF-36 bodily pain | 0.50 (0.13, 0.86) | 0.22 (−0.13, 0.57) |
WOMAC pain | 0.38 (0.03, 0.74) | 0.38 (0.03, 0.74) |
WOMAC function | 0.40 (0.05, 0.76) | 0.34 (0.01, 0.69) |
WOMAC stiffness | 0.13 (−0.21, 0.46) | 0.25 (−0.09, 0.59) |
P-E (n = 33) | t3–t6 | t3–t12 |
SF-36 bodily pain | 0.27 (−0.08, 0.62) | 0.12 (−0.22, 0.46) |
WOMAC pain | 0.37 (0.01, 0.73) | 0.01 (−0.33, 0.35) |
WOMAC function | 0.10 (−0.24, 0.44) | −0.15 (−0.50, 0.19) |
WOMAC stiffness | 0.09 (−0.26, 0.42) | −0.05 (−0.39, 0.28) |
p | E-C (n = 49) | C-E (n = 33) | P-E (n = 33) | Difference C-E and E-C ** | p | Difference P-E and E-C ** | p | |
---|---|---|---|---|---|---|---|---|
SF-36 bodily pain | ||||||||
pre (mean, SD) | 60.3 (16.6) | 55.7 (19.1) | 57.5 (18.9) | |||||
post | 67.1 (18.8) | 64.6 (20.0) | 61.1 (17.2) | |||||
ANCOVA | 0.489 | 65.8 * (2.7) | 65.7 * (2.25) | 61.8 * (2.8) | 0.11 (−7.17; 6.96) | 0.977 | −3.98 (−11.10; 3.13) | 0.270 |
WOMAC pain | ||||||||
pre (mean, SD) | 25.0 (14.4) | 29.2 (19.8) | 22.4 (14.2) | |||||
post | 16.9 (15.0) | 22.3 (17.7) | 17.9 (13.1) | |||||
ANCOVA | 0.488 | 17.2 * (1.8) | 20.5 * (2.2) | 19.2 * (2.25) | 3.35 (−2.34; 9.05) | 0.246 | 2.07 (−3.65; 7.79) | 0.475 |
WOMAC function | ||||||||
pre (mean, SD) | 24.0 (15.6) | 25.6 (15.9) | 21.1 (13.0) | |||||
post | 15.5 (14.1) | 19.4 (13.9) | 20.4 (12.3) | |||||
ANCOVA | 0.033 | 15.4 * (1.5) | 18.3 * (1.85) | 21.8 * (1.89) | 2.97 (−1.78; 7.73) | 0.218 | 6.41 (1.61; 11.22) | 0.009 |
WOMAC stiffness | ||||||||
pre (mean, SD) | 29.4 (18.5) | 27.1 (20.5) | 27.7 (16.3) | |||||
post | 20.4 (18.2) | 25.0 (17.5) | 26.9 (15.4) | |||||
ANCOVA | 0.084 | 19.9 * (2.2) | 25.6 (2.6) | 27.0 (2.7) | 5.63 (−2.43; 13.69) | 0.225 | 7.05 (−1.08; 15.17) | 0.103 |
E-C (n = 49) t0–t3 | C-E (n = 33) t3–t6 | P-E (n = 33) t3–t6 | ||||
---|---|---|---|---|---|---|
Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | |
Group Sessions (GS) | 93.7 (7.9) | 100 (8.3) | 80.0 (21.1) | 90.0 (25.8) | 78.1 (23.9) | 83.3 (21.6) |
Home Sessions (HS) | 97.6 (5.0) | 100 (2.1) | 76.6 (26.4) | 87.5 (27.1) | 69.4 (33.2) | 83.3 (58.3) |
Total (GS + HS) | 96.3 (4.4) | 97.2 (8.33) | 77.9 (22.5) | 85.3 (20.6) | 72.3 (28.7) | 85.3 (45.7) |
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Roesel, I.; Steinhilber, B.; Martus, P.; Janssen, P.; Krauss, I. Secondary Analysis of a Study on Exercise Therapy in Hip Osteoarthritis: Follow-Up Data on Pain and Physical Functioning. Int. J. Environ. Res. Public Health 2021, 18, 8366. https://doi.org/10.3390/ijerph18168366
Roesel I, Steinhilber B, Martus P, Janssen P, Krauss I. Secondary Analysis of a Study on Exercise Therapy in Hip Osteoarthritis: Follow-Up Data on Pain and Physical Functioning. International Journal of Environmental Research and Public Health. 2021; 18(16):8366. https://doi.org/10.3390/ijerph18168366
Chicago/Turabian StyleRoesel, Inka, Benjamin Steinhilber, Peter Martus, Pia Janssen, and Inga Krauss. 2021. "Secondary Analysis of a Study on Exercise Therapy in Hip Osteoarthritis: Follow-Up Data on Pain and Physical Functioning" International Journal of Environmental Research and Public Health 18, no. 16: 8366. https://doi.org/10.3390/ijerph18168366