Prescription: therapeutic exercise for hip osteoarthritis

Therapeutic exercise = “medicine” for many chronic illnesses

Therapeutic exercise is a key component in the conservative treatment of hip osteoarthritis. A paper published in the Scandinavian Journal of Medicine & Science in Sportsprovides the up-to-date evidence-based basis for prescribing therapeutic exercise for hip osteoarthritis and more than twenty other chronic diseases.   “Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases” was written by B.K. Pederson and B. Saltin and published in September 2015.

In the section focused on osteoarthritis, the authors observe “Patients with osteoarthritis have a low physical activity level (Semanik et al., 2012), low muscle strength, and impaired muscle function (Roos et al., 2011; Segal and Glass, 2011)” and go on to discuss the impact of physical exercise.  “There is strong evidence that physical exercise, both aerobic and resistance training, has an effect on self-reported pain and general level of functioning in individuals with osteoarthritis in the knee and hip joints (Zhang et al., 2010). The effect of resistance training on osteoarthritis in the knee and hip joints is comparable to peroral non-steroidal anti-inflammatory drugs and acupuncture, and the effect of aerobic training on knee osteoarthritis is comparable to intra-articular corticosteroid injections. There is evidence of a positive effect on pain and function with various types of physical training in patients with osteoarthritis (Zhang et al., 2010; Fransen et al., 2015).”

On hip osteoarthritis specifically, they draw on a meta-analysis from 2008: “Another meta-analysis from 2008 of nine studies comprising 1234 patients allowing a study of the effect of physical training on hip osteoarthritis found that it had a general positive effect (Hernandez-Molina et al., 2008)…Current knowledge suggests that all exercise (not just strength training) has an effect on symptoms as long as it is being done.”

The section on osteoarthritis concludes, “As mentioned above, there are an extensive number of studies showing that physical exercise improves general functioning in daily life and results in less pain…Physical training programs for osteoarthritis patients as a group should be individualized and supervised initially and focus on either improving aerobic capacity, quadriceps muscle strength, or performance. Over time, the supervised training can be adjusted to self-training with little or no follow-up by a professional. The training does not have to focus the affected joint(s).”

Read the full study here: Exercise as medicine – evidence for prescribing exercise as therapy for 26 different chronic diseases.

Professor Bente Klarlund Pedersen is a well-known, popular expert on sports physiology at the University of Copenhagen (UCPH), and a best-selling author and chief physician at Rigshospitalet. She is passionate about the importance of exercise in daily living, and gave a 2012 TEDX Copenhagen talk on the subject.