A cycling and education intervention for the treatment of hip osteoarthritis: A quality improvement replication programme

Thomas W Wainwright; Louise C Burgess; Tikki Immins; Neil Cowan; Robert G Middleton

doi:10.1177/2050312120946522

A cycling and education intervention for the treatment of hip osteoarthritis: A quality improvement replication programme

SAGE Open Med. 2020 Jul 31:8:2050312120946522. doi: 10.1177/2050312120946522. eCollection 2020.

Authors

Thomas W Wainwright^{1

2}, Louise C Burgess¹, Tikki Immins¹, Neil Cowan^{2

3}, Robert G Middleton^{1

2}

Affiliations

¹ Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK.
² The Royal Bournemouth and Christchurch Hospitals NHS Trust, Bournemouth, UK.
³ Royal Perth Bentley Group, Perth, WA, Australia.

Abstract

Objectives: The Cycling against Hip Pain programme is a 6-week exercise and education treatment pathway for people with hip osteoarthritis. Preliminary results of the Cycling against Hip Pain programme found significant improvements in clinical and patient-reported outcome measures for patients referred from primary care. This article evaluates the effectiveness of the changes made to the pathway in a quality improvement replication programme.

Methods: The replicated Cycling against Hip Pain programme was delivered between February 2018 and September 2019 in a region of England with a high percentage of adults aged over 65 years. All participants were referred from the orthopaedic outpatient department of the funding hospital (secondary care). The programme was delivered at a local leisure centre and combined 30 min of education on osteoarthritis with 30 min of progressive static cycling, once a week for 6 weeks.

Results: The participants on the replicated Cycling against Hip Pain programme did not differ from the original cohort in terms of age or pre-programme weight, however, presented with worse hip symptoms at baseline. Consistent with the findings from the original cohort, participants demonstrated significant improvements to their Oxford Hip Score, 30-s chair stand performance, Timed Up and Go score, Hip Osteoarthritis Outcome Score function and pain, EQ5D health rating, EQ5D-5L score and pain at rest and on weight bearing. In addition, participants reported an increase in knowledge, confidence and motivation to exercise.

Conclusion: A 6-week cycling and education intervention for the treatment of hip osteoarthritis provided benefits to function, pain and quality of life for patients referred from secondary care. These results are consistent with findings from patients who were referred from primary care and further support the potential of the pathway in the conservative management of hip osteoarthritis.

Keywords: Hip osteoarthritis; cycling; exercise therapy; group exercise; patient education; self-management.