Conservative Treatment for Hip Osteoarthritis (COHART)
Conservative Treatment for Hip Osteoarthritis: Effect of Manual Treatment and Hip School on Pain, Disability and Quality of Life - a Single-blinded Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Hip osteoarthritis (hip OA) is the second most common arthritis of the larger joints and may result in pain and disability and lead to reduced quality of life (QoL). The prevalence of hip OA, in the adult population, > 35 years, is estimated to 4-11% in the western society. In specific countries hip OA affects up to 25% in adults > 60 years. With a growing elder population, these prevalence rates will increase and the demand for cost-effective and safe interventions will increase as well.
International guidelines, 2008, on the management of hip and knee OA recommend a combination of non-pharmacological and pharmacological treatment. For years the majority of interventional research for hip and knee OA has focused on surgery and drugs. Surgery is an option, when pain and disability have reached severe levels, and an increasing group of patients are today looking for other treatment options than drug treatment (pharmacological). In the last 4-6 years, new randomized controlled trials (RCT) have shown promising results with non-pharmacological treatment, such as exercise, patient education, manual therapy and acupuncture.
The purpose of this RCT is to investigate the effect of combining manual treatment and a patient education programme and compare it to a minimal intervention in form of a home stretching programme. It will further investigate the specific effect of manual treatment.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
DK
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Odense, DK, Denmark, 5000 C
- Department of Ortopaedic Surgery and Traumatology, Odense University Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- patients referred from general practitioner, chiropractor or orthopaedic surgeon
- unilateral hip pain of minimum 3 months' duration
- radiology criteria for hip OA: joint space width (JSW) < 2.0 mm or a side difference in JSW of > 10%
- adequate mastering of the Danish language to complete instructions and questionnaires
Exclusion Criteria:
- inflammatory joint disease
- previous hip or knee alloplastic
- secondary arthritis due to hip fracture or infection
- bilateral hip pain
- hip dysplasia with a CE angle > 25 degrees and an AA angle > 10 degrees
- low back pain which dominates over the hip pain
- malignant disease
- patients with paresis or paralysis after neuromuscular, cerebrovascular or polyneuropathic disease
- hip pain resulting from labral tear, bursitis and/or snapping hip syndrome
- polyarthritis
- received manual treatment for the hip within the last year
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Hip school
This group will receive hip school during the intervention period of 6 weeks.
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The hip school consists of one initial personal interview, three group sessions, and one follow-up personal interview.
The hip school is a patient education programme which involves anatomy/physiology, epidemiology, disease progression and pain, advice on self-help and exercises.
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Active Comparator: Hip School and Manual Treatment
This group receives both hip school and manual treatment during the 6 weeks.
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Hip school as above.
Patients receive manual treatment twice a week for 6 weeks.
Manual treatment consists of joint manipulation and muscle energy techniques to the articular and soft-tissue structures of the hip.
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|
Active Comparator: Minimal control intervention
An information leaflet including exercises.
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As control group, an information leaflet is used with instructions to live as usual during the 6 weeks intervention period.
The exercise sheet of the hip school is given to the patients with no further instruction.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Pain: Numerical pain scale
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Hip Disability and Osteoarthritis Outcome Score
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
|
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General improvement experienced by patient - "Global Assessment"
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
|
|
Quality of life: EQ-5D
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
|
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Passive hip range of motion
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
|
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Hip surgery up to one year after baseline
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
|
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Use of pain medication
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
|
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Patient Specific Hip Disability
Time Frame: Baseline, 6 weeks, 3 months, 1 year
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Baseline, 6 weeks, 3 months, 1 year
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Erik Poulsen, DC, MSc, Nordic Institute of Chiropractic and Clinical Biomechanics
Publications and helpful links
General Publications
- Poulsen E, Hartvigsen J, Christensen HW, Roos EM, Vach W, Overgaard S. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis Cartilage. 2013 Oct;21(10):1494-503. doi: 10.1016/j.joca.2013.06.009. Epub 2013 Jun 21.
- Poulsen E, Christensen HW, Roos EM, Vach W, Overgaard S, Hartvigsen J. Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: protocol for a three-armed randomized clinical trial. BMC Musculoskelet Disord. 2011 May 4;12:88. doi: 10.1186/1471-2474-12-88.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- COHART
- CVK S-20080027
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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