BACKGROUND: Hip adductors and abductors are weak in patients with knee osteoarthritis (KOA). However, most studies have not investigated selective adductor strengthening. OBJECTIVE: To compare the effects of adding selective hip abductors versus adductors strengthening to lower limb multimodal exercise program for pain, self-reported function, knee-related quality of life, medication ingested and performance-based tests in patients with symptomatic KOA. DESIGN: Randomized controlled trial. METHODS: Sixty-six patients with KOA were randomly assigned to two treatment groups: hip abductor group (HABG) or hip adductor group (HADG). Both groups performed a lower limb multimodal exercise program. HABG and HADG groups added three hip abduction and three hip adduction exercises, respectively. Intensity of pain through numeric pain scale, Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, Lequesne questionnaire, global perceived effect scale, medication ingested, performance-based tests were assessed at baseline, after 6 weeks, and 6 months. RESULTS: No significant between-group differences were found in primary outcomes: pain intensity (mean difference -1.15, 95% CI -2.44 to 0.12, p = 0.07), KOOS-pain (mean difference 1.64, 95% CI -6.79 to 10.07, p = 0.70) and KOOS-function in daily living (mean difference -0.12, 95% CI -8.78 to 8.54, p = 0.97) in 6 weeks. Groups did not differ in any secondary outcome after 6 weeks or after 6 months (p > 0.05). CONCLUSIONS: There is no difference between adding hip abductors or adductors strengthening to lower limb multimodal exercise program in improving pain, self-reported function, quality of life, medication ingested and performance-based tests in patients with KOA.

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