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Hip OsteoarthritisHipBoosterNCT04714047

Progressive Resistance Training Compared to Neuromuscular Exercise in Patients With Hip Osteoarthritis

A study testing Progressive Resistance Training and no booster sessions, Progressive Resistance Training and booster sessions and Neuromuscular exercise and no booster sessions in people with Hip Osteoarthritis, run by University of Aarhus at 3 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary aim of this randomized controlled trial is to investigate the effectiveness of 12 weeks of progressive resistance training (PRT) compared to neuromuscular exercise (NEMEX) on functional performance in patients with hip OA measured by the 30-seconds chair stand test. Read more about this study

Who is it for?
Ages 45 years and older
Conditions the study is for
Hip Osteoarthritis
What is being tested?
Progressive Resistance Training and no booster sessions, Progressive Resistance Training and booster sessions and Neuromuscular exercise and no booster sessions
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
3 sitesDenmark
Study dates
18 Jan 2021to 3 May 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Clinically diagnosed OA of the hip joint according to the National Institute for Health and Care Excellence criteria
  • Have experienced pain of at least 3 out of 10 on the visual analog scale in the index hip within the last two weeks
  • Age ≥ 45 years
  • No surgery in the lower extremities six months prior to inclusion
  • No comorbidity that prevents exercising
  • Adequacy in written and spoken Danish
  • Not being a candidate for total hip arthroplasty

Who cannot join

  • BMI score > 40
  • Pregnancy
  • Resistance training or neuromuscular training for the lower extremities for more than 12 sessions in the last 6 months or 6 sessions in the last 3 months (resistance training is defined by the American College of Sports Medicine guidelines while neuromuscular training is defined by exercises involving multiple joints and muscle groups performed in functional weight-bearing positions with emphasis on the quality and efficiency of movement, as well as alignment of the trunk and lower limb joints)
  • Planned vacation for more than 14 days within the 12-week intervention period without the possibility of expanding the intervention accordingly

Trial locations and contacts

3 sites in 1 country.

Denmark3 sites
  • Aarhus University

    Aarhus

  • Aarhus University Hospital

    Aarhus N, 8200

  • Næstved-Slagelse-Ringsted Hospitals

    Slagelse

Other trials in Denmark

About this study

Official title: Progressive Resistance Training Compared to Neuromuscular Exercise in Patients With Hip Osteoarthritis, and the Additive Effect of Booster Sessions: A Multicenter Randomized Controlled Trial

The primary aim of this randomized controlled trial is to investigate the effectiveness of 12 weeks of progressive resistance training (PRT) compared to neuromuscular exercise (NEMEX) on functional performance in patients with hip OA measured by the 30-seconds chair stand test. Secondary aims are to investigate; the determinants of improvement in physical function following PRT or NEMEX; the effectiveness of booster sessions in prolonging the effects of the initial interventions (12 months), the cost-effectiveness of booster sessions (12 months). We will test the hypothesis that PRT is superior to NEMEX in improving physical function measured with the 30s sit-to-stand test at 12 week follow-up.

Read the detailed description

This randomized controlled trial will be a multicenter trial involving hospitals and physiotherapy clinics across Denmark. Part 1: For the initial 12-week exercise intervention, participants will be randomized into two groups: PRT or NEMEX. Part 2: After the initial intervention, participants in each group will be randomized to booster sessions (PRT+B and NEMEX+B) or to receive no further treatment (PRT-B and NEMEX-B). Booster sessions will be provided at 4, 6, 8 and 10 months after baseline. Outcomes will be measured at baseline, after 12 weeks of intervention, and at 6-, 9- and 12-months follow-up.

The exercise interventions will be performed at the collaborating hospitals and physiotherapy clinics across Denmark. All sessions will be conducted in group sessions with one physiotherapist supervising the exercises. The duration and frequency of the interventions will be 12 weeks with 2 supervised sessions each week. If participants experience pain during exercise exceeding 5 out of 10 on a Visual Analogue Scale (VAS), the physiotherapist will modify the exercise, decreasing the exercise intensity (load) or modifying the range of motion. All unilateral exercises will be performed for both sides.

The NEMEX intervention will follow the NEMEX program as described by Ageberg et al. The sessions consist of a 10-minute submaximal warm up on an exercise bike followed by 50 minutes of NEMEX training with exercises focused on stability, postural function, postural orientation, lower extremity muscle strength, and functional exercises.

The PRT intervention will follow the same protocol for training frequency and duration as the NEMEX intervention. The sessions consist of a 10-minute submaximal warm up on an exercise bike followed by 50 minutes of PRT with exercises targeting the muscles of the hip and knee joints; leg press, hip extension, hip abduction, hip flexion and knee extension.

Being tested
Progressive Resistance Training and no booster sessions, Progressive Resistance Training and booster sessions, Neuromuscular exercise and no booster sessions, Neuromuscular exercise and booster sessions
Keywords
Progressive Resistance Training, Neuromuscular Exercise, Physical Therapy, Physical Rehabilitation
Medical subject headings
Osteoarthritis, Hip

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Progressive Resistance Training and no booster sessionsOther

    An initial 12-week exercise intervention, consisting of 1-hour group sessions of progressive resistance training supervised by a physiotherapist 2 times per week.

    The sessions consist of a 10-minute submaximal warm up on an exercise bike followed by 50 minutes of PRT with exercises targeting the muscles of the hip and knee joints; leg press, hip extension, hip abduction, hip flexion and knee extension. The progression will be in line with guidelines provided by the American College of Sports Medicine. The intensity will follow repetition maximum (RM) targets, from 12 RM for the first week towards 8 RM for the last weeks.

    After the 12 weeks, this group consists of patients who are randomized to receive no further treatment. For the following 9 months, these patients are given a membership to a fitness center where they are encouraged to continue the same exercise regime.

  • Progressive Resistance Training and booster sessionsOther

    An initial 12-week exercise intervention, consisting of 1-hour group sessions of progressive resistance training supervised by a physiotherapist 2 times per week.

    The sessions consist of a 10-minute submaximal warm up on an exercise bike followed by 50 minutes of PRT with exercises targeting the muscles of the hip and knee joints; leg press, hip extension, hip abduction, hip flexion and knee extension. The progression will be in line with guidelines provided by the American College of Sports Medicine. The intensity will follow repetition maximum (RM) targets, from 12 RM for the first week towards 8 RM for the last weeks.

    After the 12 weeks, this group consists of patients who are randomized to receive 4 booster sessions (at 1, 3, 5 and 7 months after termination of the initial 12 week intervention). Additionally, for the following 9 months, these patients are given a membership to a fitness center where they are encouraged to continue the same exercise regime without supervision.

  • Neuromuscular exercise and no booster sessionsOther

    An initial 12-week exercise intervention, consisting of 1-hour group sessions of progressive resistance training supervised by a physiotherapist 2 times per week.

    The sessions consist of a 10-minute submaximal warm up on an exercise bike followed by 50 minutes of NEMEX training with exercises focused on stability, postural function, postural orientation, lower extremity muscle strength, and functional exercises. Progression is made when an exercise is performed with good sensorimotor control and good quality of the performance and with minimal exertion and adequate control of the movement.

    After the 12 weeks, this group consists of patients who are randomized to receive no further treatment. For the following 9 months, these patients are given equipment and encouraged to continue the same exercise regime at home without supervision.

  • Neuromuscular exercise and booster sessionsOther

    An initial 12-week exercise intervention, consisting of 1-hour group sessions of progressive resistance training supervised by a physiotherapist 2 times per week.

    The sessions consist of a 10-minute submaximal warm up on an exercise bike followed by 50 minutes of NEMEX training with exercises focused on stability, postural function, postural orientation, lower extremity muscle strength, and functional exercises. Progression is made when an exercise is performed with good sensorimotor control and good quality of the performance and with minimal exertion and adequate control of the movement.

    After the 12 weeks, this group consists of patients who are randomized to receive 4 booster sessions (at 1, 3, 5 and 7 months after termination of the initial 12 week intervention). Additionally, for the following 9 months, these patients are given equipment and encouraged to continue the same exercise regime at home.

Study groups in NCT04714047
Study groupRoleWhat they receive
Group 1:ExperimentalPRT
Receives: Other: Progressive Resistance Training and no booster sessions
Group 2:ExperimentalPRT + Booster sessions
Receives: Other: Progressive Resistance Training and booster sessions
Group 3:Active comparatorNEMEX
Receives: Other: Neuromuscular exercise and no booster sessions
Group 4:ExperimentalNEMEX + Booster sessions
Receives: Other: Neuromuscular exercise and booster sessions

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in functional performance measured by the 30-seconds chair stand test

    The 30-second chair stand test is a valid and responsive measure of lower-extremity muscle strength evaluating sit-to-stand function, which is limited in people with lower extremity OA.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

Secondary outcomes (14)
  1. Change in 40m fast-paced walk test

    Time (in seconds) taken to complete a 40 m course at fast walking pace.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  2. Change in 9 step stair climb test

    Time (in seconds) taken to negotiate 9 steps on a standard step-height stair-way (up and down).

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  3. Change in leg extension muscle power (watt/kg bodyweight)

    Leg extensor muscle power (force times acceleration) will be measured using the Nottingham Power Rig (NPR). The NPR measures the power output in total watt and watt pr. bodyweight in kilograms from a seated push on a flat pedal which is transmitted by a lever and chain to spin a flywheel. The NPR is a safe and reliable method to measure explosive knee extensor muscle power and has been validated as a clinically important measure of muscle function in elderly individuals.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  4. Change in the HOOS pain subscale

    The HOOS pain subscale is a 10-item patient-reported outcome measure designed to assess other hip symptoms in patients with hip osteoarthritis. The total score ranges from 0 to 100, with higher scores indicating better symptoms status.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  5. Change in the HOOS activities of daily living (ADL) function subscale

    The HOOS ADL function subscale is a 17-item patient-reported outcome measure designed to assess ADL function in patients with hip osteoarthritis. The total score ranges from 0 to 100, with higher scores indicating better ADL function status.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  6. Change in the HOOS quality-of-life subscale

    The HOOS quality-of-life subscale is a four-item patient-reported outcome measure designed to assess hip-related quality-of-life in patients with hip osteoarthritis. The total score ranges from 0 to 100, with higher scores indicating better quality-of-life status.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  7. Change in the HOOS sports and recreation subscale

    The HOOS sports and recreation subscale is a four-item patient-reported outcome measure designed to assess sports and recreation function in patients with hip osteoarthritis. The total score ranges from 0 to 100, with higher scores indicating better sports and recreation status.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  8. Global Perceived Effect (GPE)

    The GPE of the interventions will be assessed for three domains on a 7-point Likert scale

    Measured: Measured at 12 week and 12 month follow-up.

  9. Change in muscle strength

    Muscle strength is measured in a standardized one-repetition maximum test for the leg press exercise.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  10. Change in the HOOS symptoms subscale

    The HOOS symptoms subscale is a five-item patient-reported outcome measure designed to assess hip symptoms in patients with hip osteoarthritis. The total score ranges from 0 to 100, with higher scores indicating better symptoms status.

    Measured: Measured at baseline, 12 week and 12 month follow-up.

  11. Adherence to the 12 week initial intervention

    High adherence is defined as ≥ 80% attendance to the supervised interventions.

    Measured: Registered throughout the 12 week initial intervention.

  12. Adherence to the 9 months of self-administered training

    High adherence is defined by ≥ 80% of the assigned exercise programs performed at home or at the fitness center.

    Measured: Registered throughout the 9 months follow-up period.

  13. AE (Adverse Events) & Serious Adverse Events (SAE)

    Continous registration of health issues and injuries. Physiotherapists in charge of the training sessions will monitor potential AE and SAE. Also, during the follow-up visits at week 12 and 12 months, the participants will be asked about potential AE's and SAE's using open-probe questions.

    Measured: Registered throughout the 12 month study period.

  14. Drop-outs

    Number og drop-out from the training interventions.

    Measured: Registered throughout the 12 month study period.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Jan 2021
  2. Study start18 Jan 2021
  3. Primary completion3 May 2024
  4. Study completion3 May 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
160 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04714047
Sponsor's protocol ID
HipBooster
Acronym
HipBooster
Status last verified
May 2023
First submitted
15 Jan 2021
Last updated
24 May 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Anonymised patient-level data for the primary and all secondary outcome measures will be made available if required by the scientific journal, in which the results of the trial are published.

Publications

  • Kjeldsen T, Dalgas U, Skou ST, Tonning LU, Ingwersen KG, Birch S, Holm PM, Garval M, Varnum C, Callesen J, Foldager F, Bibby BM, Mechlenburg I. Booster sessions for maintaining the effect of neuromuscular exercise and progressive resistance training in hip osteoarthritis: 12-month follow-up from a multicenter cluster-randomized controlled trial. Osteoarthritis Cartilage. 2025 Nov;33(11):1393-1403. doi: 10.1016/j.joca.2025.07.012. Epub 2025 Jul 23.

    PubMed 40712915
  • Kjeldsen T, Skou ST, Dalgas U, Tonning LU, Ingwersen KG, Birch S, Holm PM, Frydendal T, Garval M, Varnum C, Bibby BM, Mechlenburg I. Progressive Resistance Training or Neuromuscular Exercise for Hip Osteoarthritis : A Multicenter Cluster Randomized Controlled Trial. Ann Intern Med. 2024 May;177(5):573-582. doi: 10.7326/M23-3225. Epub 2024 Apr 9.

    PubMed 38588540
  • Kjeldsen T, Dalgas U, Skou ST, van Tulder M, Bibby BM, Mechlenburg I. Progressive resistance training compared to neuromuscular exercise in patients with hip osteoarthritis and the additive effect of exercise booster sessions: protocol for a multicentre cluster randomised controlled trial (The Hip Booster Trial). BMJ Open. 2022 Sep 15;12(9):e061053. doi: 10.1136/bmjopen-2022-061053.

    PubMed 36109033

Questions about this trial

What is this clinical trial studying?

A study testing Progressive Resistance Training and no booster sessions, Progressive Resistance Training and booster sessions and Neuromuscular exercise and no booster sessions in people with Hip Osteoarthritis, run by University of Aarhus at 3 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in functional performance measured by the 30-seconds chair stand test (time frame: Measured at baseline, 12 week and 12 month follow-up.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04714047, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 May 2024.

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