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. 2022 Dec;30(6):315-327.
doi: 10.1080/10669817.2022.2037193. Epub 2022 Feb 22.

The influence of manual therapy dosing on outcomes in patients with hip osteoarthritis: a systematic review

Mark H Shepherd  1 , Joshua Shumway  1 , Robert T Salvatori  1 , Daniel I Rhon  1 , Jodi L Young  1
Affiliations

The influence of manual therapy dosing on outcomes in patients with hip osteoarthritis: a systematic review

Mark H Shepherd et al. J Man Manip Ther. 2022 Dec.

Abstract

Objective: To 1) Determine if specific dosing parameters of manual therapy are related to improved pain, disability, and quality of life outcomes in patients with hip osteoarthritis and 2) to provide recommendations for optimal manual therapy dosing based on our findings.

Design: A systematic review of randomized controlled trials from the PubMed, CINAHL, and OVID databases that used manual therapy interventions to treat hip osteoarthritis was performed. Three reviewers assessed the risk of bias for included studies and extracted relevant outcome data based on predetermined criteria. Baseline and follow-up means and standard deviations for outcome measures were used to calculate effect sizes for within and between-group differences.

Results: Ten studies were included in the final analyses totaling 768 participants, and half were graded as high risk of bias. Trends emerged: 1) large effect sizes were seen using long-axis distraction, mobilization and thrust manipulation, 2) mobilization with movement showed large effects for pain and range of motion, and (3) small effects were associated with graded mobilization. Durations of 10 to 30 minutes per session, and frequency 2-3 times per week for 2-6 weeks were the most common dosing parameters.

Conclusions: There were varied effect sizes associated with pain, function, and quality of life for both thrust and non-thrust mobilizations, and mobilization with movement into hip flexion and internal rotation. Due to the heterogeneity of MT dosage, it is difficult to recommend a specific manual therapy dosage for those with hip osteoarthritis.

Keywords: Manual therapy; disability; dosage; hip osteoarthritis.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Attached as a separate file titled ‘Figure 1_shepherd_the influence of manual therapy dosing on outcomes in patients with hip OA’.
Figure 2.
Figure 2.
Flow diagram. attached as a separate file titled ‘Figure 2_shepherd_the influence of manual therapy dosing on outcomes in patients with hip OA’.
Figure 3.
Figure 3.
Cochrane risk of bias assessment. Attached as a separate file titled ‘REVISED_Figure 3_The influence of MT with Hip OA’.
See this image and copyright information in PMC

References

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