Manual Therapy Dosing & Outcomes in Hip Osteoarthritis

Manual Therapy Dosing & Outcomes in Hip Osteoarthritis

Hip osteoarthritis (OA) is often managed by conservative treatments, one of the most important being manual therapy (MT), which aims to relieve symptoms by improving mobility and general tissue extensibility. Clinical guidelines currently recommend thrust, non-thrust and soft tissue mobilization for those with mild to moderate OA symptoms, although dosing recommendations regarding these interventions tend to vary significantly, with little consensus.

The challenge with utilizing MT for OA is to accurately dose treatment such that a clinical benefit is observed without setback and within a reasonable amount of time.  Overdosing may cause exacerbation or worsening of symptoms, while underdosing may minimize the treatment effect, both of which tend to waste time and frustrate both the patient and the clinician.  Specific dosing of MT interventions has been shown to improve pain and function in conditions such as lateral epicondylalgia, and neck and low back pain.  Whether this dose-response relationship has been observed in the treatment of hip OA, though, remains unclear.   

There is some evidence from systematic reviews regarding the use of MT in hip OA, although there is a significant gap in the literature in terms of dosage in the context of type of MT, direction of force, frequency, intensity, number of sessions, etc.  To address this gap, the authors sought to: 1) characterize the association between MT dosing and treatment outcomes and 2) to make recommendations for MT dosing based on reported effect sizes.

RESEARCH REVIEW: “Manual Therapy Dosing & Outcomes in Hip Osteoarthritis”

This paper was published in the Journal of Manual & Manipulative Therapy (2022).

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