BACKGROUND: It is believed that clinical management of osteoarthritis should address muscle weakness to improve physical function and prevent disability and frailty. OBJECTIVES: This sub-study investigated the effects of supervised progressive resistance training (RT), supervised Nordic walking (NW), and unsupervised home-based exercise (HBE) on muscle and functional performance; and associations between these exercise-induced changes in persons with hip osteoarthritis. METHODS: Forty-two patients with hip osteoarthritis were recruited from a larger RCT (NCT01387867). All the groups (RT, n = 15; NW, n = 12; HBE, n = 15) exercised 1 h 3 times/week for 4 months. Quadriceps cross-sectional area (QCSA, MRI-determined); quadriceps strength (QMVC); leg extensor power (LEP); functional performance (chair stands (30sCS); stair climbs (TSC); and 6-minute walk (6MWT)) were assessed at baseline and 4 months. RESULTS: Per protocol analyses (one-way ANOVA and Bonferroni test) showed significant between-group differences for improvements in QCSA in the most symptomatic leg favoring RT versus NW (2.3 cm2, 95% CI (0.6 to 3.9)) and HBE (2.3 cm2 (0.8 to 3.9)); and 30sCS (1.8 repetitions (0.2 to 3.3)), and 6MWT (35.1 m (3.5 to 66.7)) favoring NW versus HBE. Associations existed between exercise-induced changes in QCSA and QMVC (r = 0.366, p = 0.019) for the most symptomatic leg and between changes in 6MWT and QMVC (r = 0.320, p = 0.04) and LEP (r = 0.381, p = 0.01), respectively, for the least symptomatic leg. CONCLUSIONS: Resistance training appeared effective for improving muscle mass, but less effective for improving muscle strength, power, and functional performance. Only exercise-induced changes in muscle strength and power of the least symptomatic leg, not the most symptomatic leg, were related to changes in functional performance.

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