New research suggests people with knee osteoarthritis should add hip-strengthening exercises to their current exercise program to improve walking ability and potentially reduce pain.
Knee osteoarthritis (Knee OA) is a common form of arthritis affecting 1 in 4 people over 55 and is characterised by degenerative changes or “wear and tear” to the bone, cartilage, synovium and menisci in the knee. The disease commonly results in pain, stiffness and often has an impact on the ability to perform activities of daily life.
With a growing and aging population, effective management of Knee OA is becoming more and more important in clinical practice.
Currently, physical exercise is recommended by most international guidelines as an important component in the conservative management of Knee OA for improving pain, function and quality of life.
While exercise has been found beneficial for managing Knee OA, specifically which type of exercise should be included to best manage Knee OA remains largely unknown.
A recent study by Hislop and colleges (2019) reviewed existing evidence to determine the effect of adding hip-strengthening exercises to a commonly prescribed quadriceps exercise program on pain, function and quality of life. They also looked to determine which type of hip exercise resistance, functional neuromuscular or multimodal had the greatest impact on the same parameters.
In this systematic review and meta-analysis they pooled data from eight randomised controlled trials with a total of 340 patients and reported some clinically significant findings for the treatment of Knee OA.
The study reported that the combination of hip and quadricep strengthening exercises resulted in a statistically significant improvement in walking ability but not in reducing pain, function or quality of life when compared to quadricep exercises alone.
Furthermore, the data showed that the use of hip resistance exercise (particularly involving weights or elastic bands) was the more effective than functional neuromuscular hip exercises for improving pain and functioning, while multimodal hip exercise had no effect.
The author of the study theorises that “strengthening the hip muscles, particularly the hip abductors, might improve pelvic drop and trunk control, lightening the load on the knee”.
The findings of this study suggest the need for health professionals to consider the regional consequences of Knee OA rather than just the affected site when managing the condition.
Hislop, A., Collins, N., Tucker, K., Deasy, M., & Semciw, A. (2019). Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis. British Journal Of Sports Medicine, bjsports-2018-099683. doi: 10.1136/bjsports-2018-099683