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TOPLINE:

Adding aerobic physical activity to resistance exercise did not improve pain or function in patients with hip osteoarthritis (OA) after 3 months compared with resistance exercise alone. Exercise regimens with and without aerobic physical activity showed similar improvements, suggesting no added benefit of aerobic activity.

METHODOLOGY:

• In a randomized trial conducted in Melbourne, Australia (2019-2022), researchers aimed to evaluate whether adding aerobic physical activity to resistance exercise improves hip pain and function over 3 months compared with resistance exercise alone.
• They included 196 participants with symptomatic hip OA with activity-related hip pain, no morning hip stiffness or stiffness ≤ 30 min, and a history of hip pain for > 3 months.
• Participants were randomly assigned to two groups: One received aerobic physical activity and resistance exercise (n = 97; mean age, 61.8 years; 70% women), and the other received resistance exercise-only (n = 99; mean age, 62.9 years; 67% women). Both groups received nine physiotherapist consultations over 3 months.
• A personalized progressive lower limb exercise program was developed to be performed three times a week at home. A moderate-intensity aerobic physical activity of at least 150 min/wk was added to the resistance exercise in the aerobic physical activity and resistance exercise group.
• Co-primary outcomes were 3-month changes in hip pain severity and physical function, assessed online using the numerical rating scale and the Western Ontario and McMaster Universities Osteoarthritis Index, respectively. Secondary outcomes assessed online or in person were the changes in hip pain and function and other parameters at 3 and 9 months.

TAKEAWAY:

• No significant difference was found in hip pain severity or function between the aerobic physical activity and resistance exercise group and the resistance exercise-only group at 3 months. Both exercise regimens showed similar mean improvements in pain (2.4 vs 2.2) and function (7.0 vs 8.9).
• The Patient Specific Functional Scale and 30-second sit-to-stand test showed greater improvement in the aerobic physical activity and resistance exercise group than in the resistance exercise-only group, with mean differences of −1.2 (P = .001) and −2.7 (P < .0001), respectively.
• Adverse events were minor and similar across both groups, with 24 in the aerobic physical activity and resistance exercise group and 31 in the resistance exercise-only group, none of which were serious.
• Similar proportions of participants in each group achieved the minimal clinically important difference for pain at 3 and 9 months and for function at 3 months. More participants in the resistance exercise-only group reached the minimal clinically important difference for function at 9 months than those in the aerobic physical activity and resistance exercise group (relative risk, 1.31; 95% CI, 1.05-1.64).

IN PRACTICE:

"Hall and colleagues have shown that, for individuals with hip osteoarthritis, adding aerobic physical activity to a resistance training program holds no additional benefits for pain and physical function," experts wrote in a related comment.

SOURCE:

This study was led by Michelle Hall, PhD, The Kolling Institute, University of Sydney, Sydney, Australia. It was published online on February 5, 2025, in The Lancet Rheumatology.

LIMITATIONS:

The lack of blinding for physiotherapists and participants may have influenced the treatment effects. COVID-19 restrictions may have led to missing objective secondary outcome data and affected the delivery mode of interventions, potentially affecting the findings. The study population was predominantly women, which may limit the applicability of the findings to men, and the exclusion of non-English speakers and those with low levels of hip pain further restricted generalizability.

DISCLOSURES:

This study was supported by grants from Australia’s National Health and Medical Research Council. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.