Abstract
Brantingham JW, Parkin-Smith G, Cassa TK, Globe GA, Globe D, Pollard H, deLuca K,
Jensen M, Mayer S, Korporaal C. Full kinetic chain manual and manipulative therapy
plus exercise compared with targeted manual and manipulative therapy plus exercise
for symptomatic osteoarthritis of the hip: a randomized controlled trial.
Objective
To determine the short-term effectiveness of full kinematic chain manual and manipulative
therapy (MMT) plus exercise compared with targeted hip MMT plus exercise for symptomatic
mild to moderate hip osteoarthritis (OA).
Design
Parallel-group randomized trial with 3-month follow-up.
Setting
Two chiropractic outpatient teaching clinics.
Participants
Convenience sample of eligible participants (N=111) with symptomatic hip OA were consented
and randomly allocated to receive either the experimental or comparison treatment,
respectively.
Interventions
Participants in the experimental group received full kinematic chain MMT plus exercise
while those in the comparison group received targeted hip MMT plus exercise. Participants
in both groups received 9 treatments over a 5-week period.
Main Outcome Measures
Western Ontario and McMasters Osteoarthritis Index (WOMAC), Harris hip score (HHS),
and Overall Therapy Effectiveness, alongside estimation of clinically meaningful outcomes.
Results
Total dropout was 9% (n=10) with 7% of total data missing, replaced using a multiple
imputation method. No statistically significant differences were found between the
2 groups for any of the outcome measures (analysis of covariance, P=.45 and P=.79 for the WOMAC and HHS, respectively).
Conclusions
There were no statistically significant differences in the primary or secondary outcome
scores when comparing full kinematic chain MMT plus exercise with targeted hip MMT
plus exercise for mild to moderate symptomatic hip OA. Consequently, the nonsignificant
findings suggest that there would also be no clinically meaningful difference between
the 2 groups. The results of this study provides guidance to musculoskeletal practitioners
who regularly use MMT that the full kinematic chain approach does not appear to have
any benefit over targeted treatment.
Key Words
List of Abbreviations:
ANCOVA (analysis of covariance), CI (confidence interval), HHS (Harris hip score), MCID (minimally clinically important difference), MMT (manual and manipulative therapy), OA (osteoarthritis), OTE (Overall Therapy Effectiveness), WOMAC (Western Ontario and McMasters Osteoarthritis Index)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by a grant from UniHealth Foundation, a nonprofit philanthropic organization whose mission is to support and facilitate activities that significantly improve the health and well being of individuals and communities within its service area (grant no. 1447), and intramurally funded by Cleveland Chiropractic College, Los Angeles.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Clinical Trial Registration No.: NCT00523172.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
