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NASM Research Update Effect of Exercise and Weight Loss in People Who Have Hip Osteoarthritis and Are Overweight or Obese: A Prospective Cohort Study Nienke Paans, Inge van den Akker-Scheek, Roelien C. Dilling, Martine Bos, Klaas van der Meer, Sjoerd K. Bulstra, Martin Stevens. Physical Therapy. 2013 Feb;93(2):137-46.


Introduction • Osteoarthritis (OA) is the most common form of arthritis and joint dysfunction in the world. • Exercise in combination with weight loss strategies is a proven, effective, and conservative treatment for individuals with knee OA. • However, evidence is lacking for people with hip OA.


Objective • The purpose of this prospective cohort study is to: – Obtain preliminary evidence of the effect of an exercise program in combination with weight loss strategies on the physical function and capabilities of overweight and obese individuals with hip OA.


Cohort • Cohort: – 35 people, 25 years or older – Clinical and radiological evidence of hip OA – Overweight or obese (BMI >25) – BMI of >40 was the upper limit – Individuals with multiple chronic conditions were excluded – Individuals seeking a hip replacement were excluded


Intervention • Intervention: – 8-month program of exercise + weight loss program – Exercise program (overseen by physical therapists) – 10-15 minute warm-up – 30-minuteus moderate-to-intense aerobic exercise – 15-minute mobility and strength exercises

– Weight loss program (overseen by dieticians) – Consult eating habits using social cognitive theory

• Outcomes: – Self-reported with a subscale of the Western Ontario and McMaster Universities Osteoarthritis Index – Measure pain and walking tests as a quantitative measure of function


Results • Participation in the exercise + weight loss program resulted: – 32.6% improvement in self-reported physical function – Considered clinically relevant

– Significant improvement in pain and walking tests


Limitations • Limitation of Cohort Study: – Lack of control group


Conclusions • While previous studies investigated the effects of exercise and weight loss on knee OA, this appears to be the first prospective cohort study examining a combination program for hip OA. • The results provide preliminary evidence that an exercise and weight loss treatment program is effective for overweight and obese people with hip OA.


Future Research • Future Research: – A randomized controlled setting is needed – Research beyond 8-months is needed


Implications for the Fitness Professional

• Once a client has been given clearance by physician, fitness professionals can implement safe exercise + weight loss programs for overweight and obese adults with hip OA. • Fitness professionals should: – Offer exercise programs to improve fitness, body composition and functional mobility – Always err on the side of caution and slowly progress a client’s exercise program – Offer sound nutritional and weight loss advice while staying within scope of practice


Weight Loss Study