OP0006-HPR Even in The Long Run Nordic Walking Is Superior To Strength Training and Home Based Exercise for Improving Physical Function in Older People with Hip Osteoarthritis - An RCT

BackgroundLack of regular physical activity is a risk factor for functional decline. In hip osteoarthritis, exercise therapy aims to improve patients' overall function. Systematic reviews have shown beneficial effects on pain and physical function from exercise therapy (1) but also that these positive effects are not sustained in the long term (2). The patients' self-efficacy and additional booster sessions offered after the treatment period are factors shown to positively influence physical activity maintenance (3) and beneficial posttreatment effects (2).ObjectivesIn an observer-blinded, randomized trial to compare the long term effects of 4 months of supervised strength training (ST), supervised Nordic Walking (NW), and unsupervised home based exercise (HBE, control group) on functional performance.Methods60+ years old people (n=152; 49 men, 103 women, age 70±6 years) with clinical hip osteoarthritis not on a waiting list for surgery were randomized to ST in a local fitness center (n=50), NW in a local park (n=50) or HBE (n=52). The ST- and NW-groups were offered individual counseling interviews, patient education and telephone-assisted counselling in order to improve adherence and maintenance of exercise/physical activity. Functional performance, i.e. 30s chair stand test (primary outcome), timed stair climbing and 6-minute walk test; and secondary self-reported outcomes, i.e. physical function, pain, physical activity level, self-efficacy and health related quality of life, were measured at baseline, 4- and 12 months.ResultsIntention-to-treat-analyses showed equal improvements (mean (95%CI)) after intervention in number of chair stands in all three groups at 4-months (ST: 0.9 (0.2–1.6), NW: 1.9 (0.8–3.0), HBE: 1.1 (0.1–2.0)), while a between-group difference in favor for the NW-group (1.4 (0.0–2.8)) compared to ST-group were present at 12 months. Significant between-group differences (p