A randomized controlled trial of chiropractic management of the lower limb kinetic chain for the treatment of hip osteoarthritis: a study protocol

Objective: Our objective is to document the methodology of a randomized controlled clinical trial that demonstrates sound research methodology. The chiropractic treatment performed may be useful to allow practitioners to adopt a similar approach when treating hip osteoarthritis.

Methods: This study is a registered, ethics-approved, single-blinded, randomized controlled clinical trial. Recruitment included a controlled media release, phone screening, and physical assessment to rule out nonosteoarthritic hip pain. Primary outcome measures were the McMaster Overall Therapy Effectiveness Tool and the Western Ontario and McMaster Universities Osteoarthritis Index, which were assessed at baseline and after 1, 3, 6, and 9 months. Participants were randomly allocated to 1 of 2 intervention groups: protocol A or B. Protocol A received preadjustive stretches of hip musculature, followed by hip manipulation. Protocol B received the above intervention, followed by an additional assessment and chiropractic treatment of the lower limb kinetic chain. Participants received 9 treatments and then after 3 months were offered an additional 6 treatments. Statistics will be performed by an independent biostatistician.

Results: This article provides a valid and reliable protocol for a randomized controlled trial for the treatment of hip osteoarthritis with chiropractic care. Data should be analyzed for statistical significance to provide evidence for the efficacy of the interventions.

Conclusions: This study is an example of sound research methodology, which was scored as excellent on the Physiotherapy Evidence Database scale. Findings may be important in the scope of treatment, providing evidence for conservative management options for hip osteoarthritis.