Article

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.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS