Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis

Review written by Dr Anthony Teoli info

Key Points

  1. There appears to be additional benefit to adding hip exercises to a quadriceps exercise program for improving walking, sit to stand, and stair negotiation, but not for improving pain, function or quality of life in individuals with symptomatic knee osteoarthritis (OA).
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BACKGROUND & OBJECTIVE

Hip strengthening alone and in conjunction with quadriceps strengthening is recommended in individuals with knee osteoarthritis (OA) (1). However, previous research suggests similar improvements in pain, function and quality of life [QoL] in patients with knee OA when comparing quadriceps strengthening alone with more general lower extremity strengthening exercises, including hip strengthening (2). As a result, there is a need to synthesize the evidence to inform recommendations regarding exercise prescription for knee OA.

The objectives of this study were to determine the effectiveness of adding hip exercises to a quadriceps exercise program, and to determine what type of hip exercises have the strongest evidence for improving pain, function and QoL in individuals with knee OA.

Previous research suggests similar improvements in patients with knee OA when comparing quadriceps strengthening alone with more general lower extremity strengthening exercises.
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When participants were stratified by medial knee OA, hip and quadriceps exercises were shown to be significantly more effective in improving patient-reported function compared with quadriceps exercises alone.

METHODS

Randomized controlled trials (RCTs) investigating the effect of adding hip exercises to quadriceps exercises, compared to quadriceps exercises alone, on pain, function and/or QoL in individuals with symptomatic tibiofemoral OA (radiographically confirmed in either one or both knees) were eligible

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