Effects of Grade III Traction-mobilization in End-range Joint Position in Patients With Hip Osteoarthritis

Study Overview
=================
Brief Summary
-----------------
Lower limb osteoarthritis is a major health problem in the westernized countries. The current gold standard treatment is joint replacement. However clinical guidelines recommend physical therapy as first option for these patients. Manual therapy has reported good reports in function, range of motion and pain in patients with hip osteoarthritis. The main aim of this study is to test the effects of a manual therapy protocol based on manual traction mobilization of the hip joint in an end range position and compare them with the effects achieve with the same protocol based on manual traction mobilization of the hip joint in a resting position. The investigators will use the caudal traction mobilization described by Kaltenborn. The study will test the effects of both treatments in passive range of motion, function and pain after three weeks of treatment, three weeks after finalizing the treatment and six weeks after.

Conditions
-----------------
Osteoarthritis, Hip

Intervention / Treatment
-----------------
* Other: Manual caudal traction mobilization in resting position
* Other: Manual caudal traction mobilization in end range position
* Other: Selftreatment


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Hip osteoarthritis diagnosis Diminished range of motion Sign the informed consent Exclusion Criteria: Contraindications to Manual Therapy. Sensitivity impairments in low back, pelvis, knee or foot regions. Being involved in other physical therapy treatments To change medication use during the study

Ages Eligible for Study
-----------------
Minimum Age: 45 Years
Maximum Age: 90 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resting position mobilization group<br>This group receive six manual therapy interventions based on manual traction mobilization in a resting position of the hip joint. In addition the physical therapist teach the patients six exercises to do at home between manual mobilization sessions. | Other: Manual caudal traction mobilization in resting position<br> <br> Other: Selftreatment<br>* Each subject is advice to do some exercises at home<br>|
| Experimental: End range position mobilization group<br>This group receive six manual therapy interventions based on manual traction mobilization in an end range position of the hip joint. In addition the physical therapist teach the patients six exercises to do at home between manual mobilization sessions. | Other: Manual caudal traction mobilization in end range position<br> <br> Other: Selftreatment<br>* Each subject is advice to do some exercises at home<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Passive Hip Range of Motion after intervention, at 3 weeks post-intervention and at 6 weeks post intervention |  | 3 weeks, 6 weeks, 9 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from Baseline in Functional Tests (TUG, fast-paced walk test, stair climb test, 30sec. chair stand test), after intervention, at 3 weeks post-intervention and at 6 weeks post intervention |  | 3 weeks, 6 weeks, 9 weeks | 
| Change from Baseline in Pain on the Visual Analog Scale after intervention, at 3 weeks post-intervention and at 6 weeks post intervention |  | 3 weeks, 6 weeks, 9 weeks | 
| Change from Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale after intervention and at 6 weeks post intervention |  | 3 weeks, 9 weeks |