OBJECTIVE: To determine whether manual therapy or exercise therapy or both is beneficial for people with hip osteoarthritis in terms of reduced pain, improved physical function and improved quality of life. METHODS: Databases such as Medline, AMED, Embase, CINAHL, SPORTDiscus, PubMed, Cochrane Library, Web of Science, Physiotherapy Evidence Database, and Scopus were searched from their inception till September 2015. Two authors independently extracted and assessed the risk of bias in included studies. Standardised mean differences for outcome measures (pain, physical function and quality of life) were used to calculate effect sizes. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for assessing the quality of the body of evidence for each outcome of interest. RESULTS: Seven trials (886 participants) that met the inclusion criteria were included in the meta-analysis. There was high quality evidence that exercise therapy was beneficial at post-treatment (pain SMD -0.27, 95%CI -0.5 to -0.04; physical function SMD -0.29, 95%CI -0.47 to -0.11) and follow-up (pain SMD -0.24, 95%CI -0.41 to -0.06; physical function SMD -0.33, 95%CI -0.5 to -0.15). There was low quality evidence that manual therapy was beneficial at post-treatment (pain SMD -0.71, 95%CI -1.08 to -0.33; physical function SMD -0.71, 95%CI -1.08 to -0.33) and follow-up (pain SMD -0.43, 95%CI -0.8 to -0.06; physical function SMD -0.47, 95%CI -0.84 to -0.1). Low quality evidence indicated that combined treatment was beneficial at post-treatment (pain SMD -0.43, 95%CI -0.78 to -0.08; physical function SMD -0.38, 95%CI -0.73 to -0.04) but not at follow-up (pain SMD 0.25, 95%CI -0.35 to 0.84; physical function SMD 0.09, 95%CI -0.5 to 0.68). There was no effect of any interventions on quality of life. CONCLUSION: An exercise therapy intervention provides short-term as well as long-term benefits in terms of reduction in pain, and improvement in physical function among people with hip osteoarthritis. The observed magnitude of the treatment effect would be considered small to moderate.

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