Exercise for osteoarthritis of the hip

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Sciences
• Evidence-Based Practice

Background:

• Hip osteoarthritis (OA) is a significant public health concern, with exercise recommended by international guidelines for symptom management.
• This review is an update of previous analyses first published in 2009 and last updated in 2014, focusing on land-based exercise interventions.

Purpose of the Study:

• To evaluate the efficacy of land-based exercise in improving pain, physical function, and quality of life in individuals with hip OA.
• To assess the impact of exercise on participant-reported treatment success, study withdrawals, and adverse events.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) including adults with hip OA.
• Searches conducted across major databases (CENTRAL, MEDLINE, Embase) and trial registries up to February 2025.
• Comparisons included exercise versus attention control/placebo, exercise versus no treatment/usual care, and exercise plus co-intervention versus co-intervention alone.

Main Results:

• Compared to attention control/placebo, exercise showed low certainty evidence for little to no effect on pain but a slight improvement in physical function.
• Against no treatment/usual care, exercise demonstrated moderate certainty evidence for slight improvements in pain and physical function, though potentially not clinically meaningful.
• Exercise plus a co-intervention likely had little to no effect on pain, physical function, or quality of life, but probably reduced adverse events.

Conclusions:

• Land-based exercise provides modest benefits for pain and physical function in hip OA, particularly when compared to usual care.
• The evidence for exercise's effect on quality of life and participant-reported success is limited or uncertain across comparisons.
• While exercise generally appears safe, especially when combined with other therapies, the certainty of evidence for adverse events varies.