Email updates

Keep up to date with the latest news and content from BMC Musculoskeletal Disorders and BioMed Central.

Open Access Highly Accessed Study protocol

Exercise and manual physiotherapy arthritis research trial (EMPART): a multicentre randomised controlled trial

Helen P French1*, Tara Cusack2, Aisling Brennan3, Breon White4, Clare Gilsenan5, Martina Fitzpatrick6, Paul O'Connell5, David Kane3, Oliver FitzGerald6 and Geraldine M McCarthy4

Author Affiliations

1 School of Physiotherapy, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland

2 School of Physiotherapy and Performance Science, University College Dublin, Belfield, Dublin 4, Ireland

3 Adelaide, Meath Hospital Dublin (incorporating the National Children's Hospital), Tallaght, Dublin 24, Ireland

4 Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland

5 Beaumont Hospital, Dublin 9, Ireland

6 St Vincent's University Hospital, Elm Park, Dublin 4, Ireland

For all author emails, please log on.

BMC Musculoskeletal Disorders 2009, 10:9  doi:10.1186/1471-2474-10-9

Published: 19 January 2009

Abstract

Background

Osteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy.

Methods and design

An assessor-blind multicentre RCT will be undertaken to compare the effect of a combination of manual therapy and exercise therapy, exercise therapy only, and a waiting-list control on physical function in hip OA. One hundred and fifty people with a diagnosis of hip OA will be recruited and randomly allocated to one of 3 groups: exercise therapy, exercise therapy with manual therapy and a waiting-list control. Subjects in the intervention groups will attend physiotherapy for 6–8 sessions over 8 weeks. Those in the control group will remain on the waiting list until after this time and will then be re-randomised to one of the two intervention groups. Outcome measures will include physical function (WOMAC), pain severity (numerical rating scale), patient perceived change (7-point Likert scale), quality of life (SF-36), mood (hospital anxiety and depression scale), patient satisfaction, physical activity (IPAQ) and physical measures of range of motion, 50-foot walk and repeated sit-to stand tests.

Discussion

This RCT will compare the effectiveness of the addition of manual therapy to exercise therapy to exercise therapy only and a waiting-list control in hip OA. A high quality methodology will be used in keeping with CONSORT guidelines. The results will contribute to the evidence base regarding the clinical efficacy for physiotherapy interventions in hip OA.

Trial Registration

Number: NCT00709566