Physiotherapy management of osteoarthritis of the hip: a survey of current practice in acute hospitals and private practice in the Republic of Ireland

Abstract

Objective To identify the current management of osteoarthritis of the hip by physiotherapists in private practice and acute hospital settings in the Republic of Ireland. Design Cross-sectional postal questionnaire survey. Participants Physiotherapists in 35 acute hospitals ( n = 150) and a random selection of physiotherapists in private practice ( n = 172) in the Republic of Ireland were surveyed. Results A valid response rate of 65% ( n = 210) was achieved. The most common intervention used by therapists was exercise therapy (210/210, 100%), followed by education (207/210, 99%), manual therapy (202/210, 96%), thermal agents (154/210, 73%) and electrotherapy (130/210, 62%). Hydrotherapy and acupuncture were used by 29% (61/210) and 18% (38/210) of respondents, respectively. Statistical differences in these interventions between public and private settings existed only for thermal agents ( P = 0.001) and acupuncture ( P = 0.002). A total of 84% (177/210) of those surveyed used outcome measures, most commonly pain severity scales (163/210, 78%). Osteoarthritis-specific questionnaires (33/210, 16%) and quality of life (16/210, 8%) measures were used less frequently. Conclusions The importance of exercise therapy, education and manual therapy in the management of osteoarthritis of the hip was demonstrated. There was little difference overall in the physiotherapy management of osteoarthritis of the hip between public and private settings. The use of these interventions compared to known scientific evidence is discussed. Although there was high usage of outcome measures, hip osteoarthritis-specific outcomes and quality of life measures were not commonly used. This survey identified interventions most commonly used in clinical practice including exercise, education and manual therapy, and highlights a need for further research to evaluate the effectiveness of such interventions.