A Single-Group Pretest Posttest Design Using Full Kinetic Chain Manipulative Therapy With Rehabilitation in the Treatment of 18 Patients With Hip Osteoarthritis

Brantingham, James W.; Globe, Gary A.; Cassa, Tammy Kay; Globe, Denise; de Luca, Katie; Pollard, Henry; Lee, Felix; Bates, Charles; Jensen, Muffit; Mayer, Stephan; Korporaal, Charmaine

doi:10.1016/j.jmpt.2010.06.005

« Previous Next »Journal of Manipulative and Physiological Therapeutics
Volume 33, Issue 6 , Pages 445-457, July 2010

A Single-Group Pretest Posttest Design Using Full Kinetic Chain Manipulative Therapy With Rehabilitation in the Treatment of 18 Patients With Hip Osteoarthritis

James W. Brantingham, DC, PhD
- Director of Research and Associate Professor, Department of Research, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
- Adjunct Research Faculty, Durban University of Technology, South Africa
- Submit requests for reprints to: James W. Brantingham, DC, PhD, Director of Research and Associate Professor, Department of Research, Cleveland Chiropractic College Los Angeles, 590 North Vermont Avenue, Los Angeles, CA 90004
Gary A. Globe, DC, MBA, PhD
- Provost and Academic Dean, Academic Affairs, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
Tammy Kay Cassa, DC
- Research Assistant and Instructor, Department of Research, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
Denise Globe, DC, MHSA, PhD
- Director, Global Health Economics, Amgen Inc., Thousand Oaks, Calif
Katie de Luca, B App Sci (Ex & Sp Sci), M Chiro
- Researcher, Department of Chiropractic, Macquarie University, Australia
Henry Pollard, DC, PhD
- Associate Professor, Faculty of Science, Department of Chiropractic, Macquarie University, Australia
Felix Lee, DC
- Clinician and Assistant Professor, Health Center, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
Charles Bates, DC
- Clinician and Assistant Professor, Health Center, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
Muffit Jensen, DC
- Professor, Faculty, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
Stephan Mayer, DC
- Associate Dean and Clinical Professor, Health Center, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif
Charmaine Korporaal, M.Tech (Chiro)
- Researcher, Senior Lecturer and Head of Department of Chiropractic and Somatology, Department of Chiropractic and Somatology, Durban University of Technology, South Africa
- Adjunct Research Faculty, Cleveland Chiropractic College Los Angeles, Los Angeles, Calif

Received 5 November 2009; received in revised form 15 April 2010; accepted 29 April 2010.

Abstract

Objective

Hip osteoarthritis (HOA) affects 30 million Americans or more, and is a leading cause of disability, suffering, and pain. Standard treatments are minimally effective and carry significant risk and expense. This study assessed treatment effects of a chiropractic protocol for HOA.

Methods

Eighteen individuals, who did not qualify due to low baseline Western Ontario and McMaster Osteoarthritis Index scores (WOMAC) for other ongoing HOA randomized control trials, were selected. A prospectively planned protocol, consisting of axial manipulation to the affected hip with modified Thomas and active assisted stretch, was combined with full kinetic chain treatment or manipulative therapy to the spine, knee, ankle, or foot and assessed with use of valid and reliable outcome measures.

Results

The primary outcome measure, the Overall Therapy Effectiveness Tool, was assessed with χ² and demonstrated that 83.33% of participants were improved after the ninth visit, P = .005, and 78% improved at the 3-month follow-up, P = .018. Using the paired t test, WOMAC was improved 64% at the ninth visit, P = .000, and 47% at follow-up, P = .016.

Conclusion

In HOA patients with lower WOMAC scores, a highly organized HOA treatment appears to have resulted in statistically and clinically meaningful intragroup changes in the Overall Effectiveness Therapy Tool, WOMAC, Harris Hip Scale, and range of motion, all with P ≤ .05. Although the directionality and strength of the findings are encouraging, fully powered clinical trials are necessary to report generalizable findings.

Key Indexing Terms: Osteoarthritis, Hip, Extremities, Manipulation, Chiropractic