The effects of a combined lifestyle intervention in overweight patients with hip osteoarthritis: a pilot study

Osteoarthritis (OA) is a common musculoskeletal disorder and its prevalence increases with age. In the Netherlands every year a total of 200,000 people between twenty and sixty-five years of age visit the general practitioner because of OA. When considering people above the age of 65 an extra 450,000 persons are added to the previously mentioned number. Previous research has proven that even patients with severe OA can benefit from conservative treatment.
In this study the conservative treatment consists of a program which influences the lifestyle (exercise and eating habits). Until now this kind of treatment is applied and known to be effective in patients with knee OA (Messier 2004). Insufficient evidence is available of the positive effects of weight reduction and exercise in patients with hip OA.
Significant improvements of self reported and objectively measured functional abilities and pain after applying a combination program of exercise and weight loss as is seen with knee OA, is therefore also expected in patients with hip OA.
The combination program of exercise and weight loss will be implemented in a prospective cohort study. The patients will be overweight (BMI> 27), with clinical confirmed osteoarthritis of the hip and/or knee and not yet suitable for joint replacement. Primary outcome measurements are self reported physical function and pain, assessed with the Dutch-Womac. Measurements will be performed upon recruitment (T0, baseline), 3 months after recruitment (T1) and upon completion of the program, 6 months after recruitment (T2).

It is our hypothesis that a combined life style intervention of exercise and weight loss will result in a reduction of pain and improvement of function of the affected hip joint, which will postpone a chirurgical intervention.

The physical exercise therapy will be divided in an individual phase (2 to 3
months) and a group phase (3 months) (total of 6 months). Additionally the patients will be stimulated to get active, or sustain being active, at home in order to satisfy the Dutch National Standard Healthy Movement (Kemper et al., 1999), during the group phase. Alongside the physical exercise therapy the dietary intervention will take place in 8 contact moments, executed by a certificated dietary therapist. In this intervention dietary advice and dietary problems will be discussed.