Osteo Arthritis of HipNCT07401719
Effects of Modified Clamshell Exercises in Patients With Hip Osteoarthritis Grade Ⅱ.
A study testing Modified clamshell exercise, Clamshell Exercises and Conventional exercises in people with Osteo Arthritis of Hip, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
Trial summary
This study focuses on patients diagnosed with Grade II hip osteoarthritis, a degenerative joint condition characterized by pain, reduced range of motion, muscle weakness, and functional limitations. Read more about this study
- Who is it for?
- Ages 45 to 60 years
- Conditions the study is for
- Osteo Arthritis of Hip
- What is being tested?
- Modified clamshell exercise, Clamshell Exercises and Conventional exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 54 participants
- Where
- 1 sitePakistan
- Study dates
- 30 Mar 2026to 5 Jul 2026
- 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 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Patients between 45 to 60 years
- Both male and female patients with hip osteoarthritis grade II were selected for this study
- Patients with Hip Osteoarthritis grade II
- Patients with pain more than 6 months
Who cannot join
- Patients with Cardiac disorders
- Patient with other current lower extremity pathologies (e.g., peripheral vascular disease, septic arthritis)
- Patients with low back surgery.
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Ghurki Trust and Teaching Hospital
Lahore, Punjab Province, 54600
About this study
Official title: Effects Of Modified Clamshell Exercises On Pain, Range Of Motion, And Functional Outcomes In Patients With Hip Osteoarthritis In Grade Ⅱ.
This study focuses on patients diagnosed with Grade II hip osteoarthritis, a degenerative joint condition characterized by pain, reduced range of motion, muscle weakness, and functional limitations. Hip osteoarthritis is commonly assessed using the Kellgren-Lawrence (KL) classification system, with Grade II representing definite osteophyte formation with possible joint space narrowing, where conservative management is strongly recommended. Exercise therapy, particularly strengthening of the hip abductor muscles, plays a key role in improving pelvic stability, reducing pain, and enhancing functional outcomes. Clamshell exercises are widely used to activate the gluteus medius and minimus muscles, while modified clamshell exercises are designed to optimize muscle recruitment and reduce compensatory movements.
A total of 54 participants with Grade II hip osteoarthritis will be included in the study and allocated into three groups. Group A will receive clamshell exercises along with conventional exercise therapy, Group B will receive modified clamshell exercises in addition to conventional exercise therapy, and Group C will receive a conventional exercise program alone. Pain intensity will be assessed using the Visual Analog Scale (VAS), which ranges from 0 to 10. Hip joint range of motion will be measured using a goniometer, and functional outcomes will be evaluated using the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12). The aim of this study is to compare the effects of clamshell exercises, modified clamshell exercises, and conventional exercise programs to determine the most effective intervention for reducing pain, improving hip joint range of motion, and enhancing functional outcomes in patients with Grade II hip osteoarthritis.
Read the detailed description
Hip osteoarthritis (OA) is a chronic degenerative joint disorder characterized by progressive deterioration of articular cartilage, changes in subchondral bone, osteophyte formation, and narrowing of the joint space. These structural changes lead to pain, stiffness, reduced range of motion, muscle weakness, gait abnormalities, and functional limitations, ultimately affecting mobility, independence, and quality of life. Hip osteoarthritis is a common musculoskeletal condition, particularly in middle-aged and older adults, with global prevalence estimates indicating that approximately 5-10% of adults over the age of 45 are affected. Mechanical factors such as altered joint biomechanics, abnormal load distribution across the hip joint, femoroacetabular impingement, repetitive joint loading, previous trauma, and weakness of surrounding musculature play a significant role in the development and progression of the disease.
Radiographic assessment is commonly used to classify the severity of hip osteoarthritis, with the Kellgren-Lawrence (KL) grading system being the most widely accepted. The KL classification ranges from Grade 0 to Grade IV. Grade 0 indicates no radiographic evidence of osteoarthritis. Grade I shows doubtful joint space narrowing with possible osteophyte formation. Grade II is characterized by definite osteophyte formation with possible joint space narrowing. Grade III includes multiple moderate osteophytes, definite joint space narrowing, sclerosis, and possible bony deformity. Grade IV represents severe osteoarthritis with large osteophytes, marked joint space narrowing, severe sclerosis, and definite bony deformity. Grade II hip osteoarthritis represents an early stage of the disease in which conservative management is strongly recommended to reduce symptoms, improve function, and slow disease progression.
Exercise therapy is a core component of conservative management for hip osteoarthritis and plays a vital role in improving muscle strength, joint stability, range of motion, and overall functional performance. Strengthening of the hip abductor muscles is particularly important, as these muscles contribute to pelvic stability and optimal load transfer during functional activities such as walking and stair climbing. Clamshell exercises are commonly prescribed to activate and strengthen the gluteus medius and minimus muscles. Modified clamshell exercises involve changes in positioning or execution to enhance muscle recruitment, improve neuromuscular control, and minimize compensatory movements, potentially resulting in improved clinical outcomes.
- Conditions
- Osteo Arthritis of Hip
- Being tested
- Modified clamshell exercise, Clamshell Exercises, Conventional exercises
- Keywords
- Hip Osteoarthritis, Clamshell Exercises
- Medical subject headings
- Osteoarthritis, Hip
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Modified clamshell exerciseOther
This group will receive modified clamshell exercises along with conventional exercises. Time for each session will be 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks.
Clamshell ExercisesOther
This group will receive Clamshell exercises along with conventional exercises. Each session will last for 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks.
Conventional exercisesOther
This group will only receive conventional exercises including TENS, hot pack bridging, sideways hip lifts, standing hip extension and double hip rotation. time of each session will be 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Modified Clamshell Exercise | Experimental | This group will receive modified clamshell exercises along with conventional exercises. Receives: Other: Modified clamshell exercise; Other: Conventional exercises |
| Clamshell exercise | Experimental | Participants in this group will receive clamshell exercises along with conventional exercises. Receives: Other: Clamshell Exercises; Other: Conventional exercises |
| Conventional Exercises | Active comparator | This group will only receive conventional exercises including TENS, hot pack, bridging, sideways hip lifts, standing hip extension, and double hip rotation exercises. Receives: Other: Conventional exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity
Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is a widely used, valid, and reliable subjective measure of pain intensity, where participants rate pain on a scale from 0 to 10 . A score of 0 means no pain, while 10 represent worst imaginable pain. Participants. The VAS is sensitive to changes over time and is commonly used in clinical and research settings to evaluate treatment effectiveness. Pain intensity will be assessed at baseline, 3 weeks, 6 weeks, and 12 weeks
Measured: 12 weeks
ROM
Range of motion (ROM) of the hip joint will be assessed using a universal goniometer. Goniometric measurement is a standard and objective clinical method used to evaluate joint mobility and functional movement in individuals with hip osteoarthritis. Hip abduction, and external rotation will be measured following standardized positioning and measurement procedures to ensure consistency and reliability. Goniometric ROM measurements provide quantitative data to identify movement limitations, monitor functional improvements, and assess the effectiveness of therapeutic exercise interventions. ROM assessments will be performed at baseline, 3 weeks, 6 weeks, and 12 weeks.
Measured: 12 weeks
Secondary outcomes (1)
Functional Outcomes
Functional outcome will be assessed using the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12). The HOOS-12 is a validated, patient-reported outcome measure designed to evaluate hip-related symptoms, pain, and functional limitations in individuals with hip osteoarthritis. It consists of 12 items covering key domains of hip function and quality of life. Each item is scored on a Likert scale, and scores are transformed to a 0-100 scale, with higher scores indicating better hip function and fewer symptoms. The HOOS-12 is sensitive to clinical changes and suitable for both short-term and long-term assessment of functional improvement. Functional outcomes will be measured at baseline, 3 weeks, 6 weeks, and 12 weeks
Measured: 12 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Feb 2026
- Study start30 Mar 2026
- Primary completion5 Jul 2026
- Study completion5 Jul 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Osteo Arthritis of HipStudies of the same condition, open and under way.
- More trials run by Lahore University of Biological and Applied SciencesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- This study follows a randomized controlled trial (RCT) design to compare the effectiveness of modified clamshell exercises and clamshell exercises, each combined with conventional hip osteoarthritis exercises, in patients with Grade II hip osteoarthritis. Eligible participants will be randomly allocated into three parallel groups using a computer-generated randomization sequence to ensure balanced group assignment. The first group will receive modified clamshell exercises in combination with conventional exercises, the second group will receive clamshell exercises with conventional exercises, and the third group will receive conventional exercises only. A double-blinded approach will be used, in which both the participants and outcome assessors will be blinded to group allocation. Outcomes will be assessed at baseline and at 3, 6, and 12 weeks to evaluate changes in pain intensity, hip function, and range of motion. This study design allows for a controlled comparison of exercise-based
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 54 participants (actual)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Principal investigator, Principal investigator, Ghurki Trust and Teaching Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07401719
- Sponsor's protocol ID
- LCPT/DPT/ERB/44
- Status last verified
- Jul 2026
- First submitted
- 3 Feb 2026
- Last updated
- 22 Jul 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Exercise Therapy Program in Rehabilitation of Patients with Primary Hip Osteoarthritis
Bieler T, Kristensen ALR, Nyberg M, Magnusson SP, Kjaer M, Beyer N. Exercise in patients with hip osteoarthritis - effects on muscle and functional performance: A randomized trial. Physiother Theory Pract. 2022 Dec;38(12):1946-1957. doi: 10.1080/09593985.2021.1923096. Epub 2021 May 6.
PubMed 33956561Kaleem S, Noor R, Salman Bashir M, Ikram M. Effects of clamshell exercises in terminal extension lag after ACL reconstruction. Knee. 2024 Jun;48:226-233. doi: 10.1016/j.knee.2024.04.007. Epub 2024 May 20.
PubMed 38763073Effect of modified clamshell exercise on gluteus medius, quadratus lumborum and anterior hip flexor in participants with gluteus medius weakness
Study at a glance
From the registry record, last updated by the sponsor on 22 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects Of Modified Clamshell Exercises On Pain, Range Of Motion, And Functional Outcomes In Patients With Hip Osteoarthritis In Grade Ⅱ.
- ClinicalTrials.gov ID
- NCT07401719
- Acronym / sponsor ID
- LCPT/DPT/ERB/44
- Conditions
- Osteo Arthritis of Hip
- Keywords
- Hip Osteoarthritis, Clamshell Exercises
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 54 participants (actual)
- Lead sponsor
- Lahore University of Biological and Applied SciencesUniversity, hospital or other
- Study start
- 30 Mar 2026 (actual)
- Primary completion
- 5 Jul 2026 (actual)
- Study completion
- 5 Jul 2026 (actual)
- First posted
- 10 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study focuses on patients diagnosed with Grade II hip osteoarthritis, a degenerative joint condition characterized by pain, reduced range of motion, muscle weakness, and functional limitations. Hip osteoarthritis is commonly assessed using the Kellgren-Lawrence (KL) classification system, with Grade II representing definite osteophyte formation with possible joint space narrowing, where conservative management is strongly recommended. Exercise therapy, particularly strengthening of the hip abductor muscles, plays a key role in improving pelvic stability, reducing pain, and enhancing functional outcomes. Clamshell exercises are widely used to activate the gluteus medius and minimus muscles, while modified clamshell exercises are designed to optimize muscle recruitment and reduce compensatory movements.
A total of 54 participants with Grade II hip osteoarthritis will be included in the study and allocated into three groups. Group A will receive clamshell exercises along with conventional exercise therapy, Group B will receive modified clamshell exercises in addition to conventional exercise therapy, and Group C will receive a conventional exercise program alone. Pain intensity will be assessed using the Visual Analog Scale (VAS), which ranges from 0 to 10. Hip joint range of motion will be measured using a goniometer, and functional outcomes will be evaluated using the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12). The aim of this study is to compare the effects of clamshell exercises, modified clamshell exercises, and conventional exercise programs to determine the most effective intervention for reducing pain, improving hip joint range of motion, and enhancing functional outcomes in patients with Grade II hip osteoarthritis.
Detailed description
Hip osteoarthritis (OA) is a chronic degenerative joint disorder characterized by progressive deterioration of articular cartilage, changes in subchondral bone, osteophyte formation, and narrowing of the joint space. These structural changes lead to pain, stiffness, reduced range of motion, muscle weakness, gait abnormalities, and functional limitations, ultimately affecting mobility, independence, and quality of life. Hip osteoarthritis is a common musculoskeletal condition, particularly in middle-aged and older adults, with global prevalence estimates indicating that approximately 5-10% of adults over the age of 45 are affected. Mechanical factors such as altered joint biomechanics, abnormal load distribution across the hip joint, femoroacetabular impingement, repetitive joint loading, previous trauma, and weakness of surrounding musculature play a significant role in the development and progression of the disease.
Radiographic assessment is commonly used to classify the severity of hip osteoarthritis, with the Kellgren-Lawrence (KL) grading system being the most widely accepted. The KL classification ranges from Grade 0 to Grade IV. Grade 0 indicates no radiographic evidence of osteoarthritis. Grade I shows doubtful joint space narrowing with possible osteophyte formation. Grade II is characterized by definite osteophyte formation with possible joint space narrowing. Grade III includes multiple moderate osteophytes, definite joint space narrowing, sclerosis, and possible bony deformity. Grade IV represents severe osteoarthritis with large osteophytes, marked joint space narrowing, severe sclerosis, and definite bony deformity. Grade II hip osteoarthritis represents an early stage of the disease in which conservative management is strongly recommended to reduce symptoms, improve function, and slow disease progression.
Exercise therapy is a core component of conservative management for hip osteoarthritis and plays a vital role in improving muscle strength, joint stability, range of motion, and overall functional performance. Strengthening of the hip abductor muscles is particularly important, as these muscles contribute to pelvic stability and optimal load transfer during functional activities such as walking and stair climbing. Clamshell exercises are commonly prescribed to activate and strengthen the gluteus medius and minimus muscles. Modified clamshell exercises involve changes in positioning or execution to enhance muscle recruitment, improve neuromuscular control, and minimize compensatory movements, potentially resulting in improved clinical outcomes.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
- Model description
- This study follows a randomized controlled trial (RCT) design to compare the effectiveness of modified clamshell exercises and clamshell exercises, each combined with conventional hip osteoarthritis exercises, in patients with Grade II hip osteoarthritis. Eligible participants will be randomly allocated into three parallel groups using a computer-generated randomization sequence to ensure balanced group assignment. The first group will receive modified clamshell exercises in combination with conventional exercises, the second group will receive clamshell exercises with conventional exercises, and the third group will receive conventional exercises only. A double-blinded approach will be used, in which both the participants and outcome assessors will be blinded to group allocation. Outcomes will be assessed at baseline and at 3, 6, and 12 weeks to evaluate changes in pain intensity, hip function, and range of motion. This study design allows for a controlled comparison of exercise-based
| Arm | Type | Receives |
|---|---|---|
| Modified Clamshell Exercise | Experimental | Other: Modified clamshell exercise, Other: Conventional exercisesThis group will receive modified clamshell exercises along with conventional exercises. |
| Clamshell exercise | Experimental | Other: Clamshell Exercises, Other: Conventional exercisesParticipants in this group will receive clamshell exercises along with conventional exercises. |
| Conventional Exercises | Active comparator | Other: Conventional exercisesThis group will only receive conventional exercises including TENS, hot pack, bridging, sideways hip lifts, standing hip extension, and double hip rotation exercises. |
Who may qualify
- Ages
- 45 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Patients between 45 to 60 years
- Both male and female patients with hip osteoarthritis grade II were selected for this study
- Patients with Hip Osteoarthritis grade II
- Patients with pain more than 6 months
Key exclusion criteria (3 listed)
- Patients with Cardiac disorders
- Patient with other current lower extremity pathologies (e.g., peripheral vascular disease, septic arthritis)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Modified clamshell exerciseThis group will receive modified clamshell exercises along with conventional exercises. Time for each session will be 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks. | Other | Modified Clamshell Exercise |
| Clamshell ExercisesThis group will receive Clamshell exercises along with conventional exercises. Each session will last for 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks. | Other | Clamshell exercise |
| Conventional exercisesThis group will only receive conventional exercises including TENS, hot pack bridging, sideways hip lifts, standing hip extension and double hip rotation. time of each session will be 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks. | Other | Clamshell exercise, Conventional Exercises, Modified Clamshell Exercise |
Primary outcome
Pain Intensity
Time frame: 12 weeks
Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is a widely used, valid, and reliable subjective measure of pain intensity, where participants rate pain on a scale from 0 to 10 . A score of 0 means no pain, while 10 represent worst imaginable pain. Participants. The VAS is sensitive to changes over time and is commonly used in clinical and research settings to evaluate treatment effectiveness. Pain intensity will be assessed at baseline, 3 weeks, 6 weeks, and 12 weeks
ROM
Time frame: 12 weeks
Range of motion (ROM) of the hip joint will be assessed using a universal goniometer. Goniometric measurement is a standard and objective clinical method used to evaluate joint mobility and functional movement in individuals with hip osteoarthritis. Hip abduction, and external rotation will be measured following standardized positioning and measurement procedures to ensure consistency and reliability. Goniometric ROM measurements provide quantitative data to identify movement limitations, monitor functional improvements, and assess the effectiveness of therapeutic exercise interventions. ROM assessments will be performed at baseline, 3 weeks, 6 weeks, and 12 weeks.
1 secondary outcome
Functional Outcomes
Time frame: 12 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jul 2026.
- BackgroundExercise Therapy Program in Rehabilitation of Patients with Primary Hip Osteoarthritis
- Background: PubMed 33956561Bieler T, Kristensen ALR, Nyberg M, Magnusson SP, Kjaer M, Beyer N. Exercise in patients with hip osteoarthritis - effects on muscle and functional performance: A randomized trial. Physiother Theory Pract. 2022 Dec;38(12):1946-1957. doi: 10.1080/09593985.2021.1923096. Epub 2021 May 6.
- Background: PubMed 38763073Kaleem S, Noor R, Salman Bashir M, Ikram M. Effects of clamshell exercises in terminal extension lag after ACL reconstruction. Knee. 2024 Jun;48:226-233. doi: 10.1016/j.knee.2024.04.007. Epub 2024 May 20.
- BackgroundEffect of modified clamshell exercise on gluteus medius, quadratus lumborum and anterior hip flexor in participants with gluteus medius weakness
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Principal investigator principal investigator
Ghurki Trust and Teaching Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Modified clamshell exercise, Clamshell Exercises and Conventional exercises in people with Osteo Arthritis of Hip, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
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 4 inclusion and 3 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 22 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. 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?
Pain Intensity (time frame: 12 weeks). The study lists 2 primary outcomes in all. 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 NCT07401719, which also lists 4 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 22 Jul 2026.