An investigation into the effects of exercise on walking economy in individuals with osteoarthritis of the hip: A randomized clinical trial

Abstract Background Hip joint osteoarthritis (OA) is a chronic condition that can significantly affect the energetic cost of walking. Exercise is a high-value method for the management and maintenance of function in people with hip joint OA. Walking economy is a measure of the energetic cost of steady-state walking and is associated with declines in physical activity. Previous research has highlighted the ability of exercise programs focusing on improving gait symmetry and reducing step-to-step variability to improve walking economy in older adults. It is unknown if walking economy can be influenced by neuromuscular exercise in those with hip joint OA. Therefore, this study aims to investigate the effects of a neuromuscular exercise program on walking economy in adults with hip joint OA. Methods Fifty individuals (25 per group) with hip joint OA will be recruited from the community. Following a baseline assessment, they will be randomly allocated to either 1) an exercise intervention or 2) a control group continuing usual care. The intervention group will undergo a 12-week neuromuscular exercise program focused on improving gait symmetry and reducing step-to-step variability in a group exercise setting. The primary outcome is walking economy at standard and preferred walking speeds. Secondary outcomes include spatiotemporal gait measures (step frequency, length, and width as well as stance and swing duration) and lower limb strength (handheld dynamometer, isometric mid-thigh pull, and wall sit test). Additional measures include self-reported pain, hip function, and physical activity, and body mass index (BMI). Discussion The findings from this study will assist practitioners in the prescription of exercises for individuals with hip joint OA. Specifically, we will determine whether a 12-week neuromuscular exercise program can improve walking economy and the likely mechanisms. Trial registration Australian New Zealand Clinical Trials Registry, registration number ACTRN12624000411549. Registered 4th April 2024.