Assoc Prof Rod Green

Recipient: Assoc Prof Rod Green
Intended department: Department of Pharmacy & Applied Science- La Trobe University- Funded By Zimmer Biomet
Project:

 

The efficacy and feasibility of a targeted gluteal exercise program for improving hip function and increasing activity levels in people with hip osteoarthritis

Hip arthritis patients are known to suffer significant pain and loss of function during activities such as normal walking (gait).  The loss of function has been related to atrophy of the gluteal muscles that stabilize the hip.  Previous studies have shown limited benefits from rehabilitation programs that have been designed to improve hip muscle function.  This research project is a randomized controlled trial (RCT) that aims to compare a new targeted gluteal exercise program to a sham exercise program to see if the targeted program can successfully improve hip muscle function and therefore improve activity levels of people with hip arthritis.

Both of the programs involve 12 weekly visits to specifically trained physiotherapists and home exercises.  The targeted program targets not only particular muscles, but particular parts of those muscles with high intensity exercises should increase muscle size (hypertrophy).  This program also involves gait retraining in an attempt to correct uneven gait (limping) and pelvic stability exercises to increase stability of the hip joint. In contrast, the sham program involves similar duration of exercise but not targeting particular muscles around the hip and usually non-weight-bearing exercises so is therefore less likely to result in improvements in muscle structure and function.  Random allocation of participants to the two groups ensures that there is no bias in the study and checks whether any apparent benefits at the end of the study are in fact due to the targeted program or could be due to co-called placebo effect, whereby participation in even a sham program brings about benefits in the affected group.

The project is running across three sites; La Trobe University Bendigo, La Trobe University Melbourne and Otago University in New Zealand.  Participants will have their hip muscle structure and function and their activity levels assessed prior to and after the 12-week rehabilitation program.

The major question that the grant set out to answer is whether the targeted program, in contrast to the sham program, results in improved gluteal muscle structure and function and whether the activity levels of the participants are improved as a consequence of any improved function. Our hypothesis is that previous rehabilitation programs for hip arthritis, unlike knee arthritis program, have not been adequately targeted at the affected muscle segments and that is why they have not been shown to be successful in improving patient outcomes.  If the program is successful this should improve function, and potentially delay hip replacement surgery, for hip arthritis patients. Because data collection is still underway we have no outcomes to report at this stage.  However in this interim report we can outline progress as follows:

  • Ethics approval was obtained at all 4 sites (initially one site was at the University of Queensland, but one of our Chief Investigators, Dr Adam Semciw, has relocated to La Trobe University in Melbourne during the course of the grant so this site was abandoned.
  • The Bendigo site currently has 9 (of intended 30) participants that have completed the rehabilitation with all data collected and a further 5 participants that have commenced the program (baseline data collected). Recruitment is continuing in the hands of Zac Rostron, a new PhD student on this project and we hope to complete data collection by the end of 2018.
  • The Otago site currently has 13 (of intended 20) participants that have commenced the program (baseline data collected) and recruitment is continuing in the hands of Steph Woodley and Pete Lawrenson, a research assistant being employed under complementary funding through Arthritis New Zealand is conducting the data collection. Again it is hoped that data collection will be completed by the end of 2018.
  • The Melbourne site has been delayed but training of the physiotherapy staff has been completed and Belinda Pacella has been employed as a research assistant to undertake recruitment and data collection activities. Belinda is being employed using Arthritis Australia funding from this grant.  We hope that data collection for the intended 40 participants (20 transferred from University of Queensland site) will proceed more efficiently now that Adam Semciw will also be present at this site to assist.
  • If necessary, we may recruit additional participants at each of the Bendigo and Otago sites if their numbers are reached before Bundoora site reaches target numbers.