Effect of Exercise as Non-surgical Treatments on Time to Total Hip Replacement Surgery (HipSPORT)

• Cumulative Survival analysis (Kaplan-Maier survival curve) [ Time Frame: one year ] [ Designated as safety issue: No ]
  Cumulative Survival analysis as time in days without surgery since inclusion
  
  

• The Hip disability and Osteoarthritis Outcome Score (HOOS 2.0) [ Time Frame: Baseline, 3 and 12 months ] [ Designated as safety issue: No ]
  HOOS is patient-reported outcome measure with 5 subscales for pain, other symptoms, function in daily living, function in sport and recreation and hip related Quality of Life. A 5-point Likert-scale is used and converted into a 100-point scale with zero indicating the worst possible health (http://www.koos.nu).
  
  
• University of California Los Angeles activity score (UCLA) [ Time Frame: Baseline, 3 and 12 months ] [ Designated as safety issue: No ]
  Physical activity levels in populations. UCLA is a 10-point likert scale recommended and used extensively in similar populations
  
  
• Global perceived effect (GPE) score [ Time Frame: 3 and 12 months ] [ Designated as safety issue: No ]
  Patients will be asked to rate possible change in their pain, symptoms, ADL, sports and recreation, quality of life, level of physical activity since the initial administration (baseline) on a 7-point Likert-scale.
  
  

• Self-reported exercise pain (VAS-scale) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  Pain intensity using the VAS-scale. Participants will be followed for the duration of the exercise intervention (3 months) and be asked to rate pain intensity before and after each exercise session (total 24 sessions)
  
  
• Exercise adherence [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  'The extent to which a person's behavior corresponds with agreed recommendations from a health care provider' using no. of weeks, and no. of completed sessions
  
  
• Cost-effectiveness analysis [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  Cost-effectiveness analysis will be estimated as the ratio between cost of the intervention and the effect it produces. The total cost will be estimated from register-based costing of primary care, secondary care and patient's out-of-pocket costs (transportation expenses and time spent on transportation and receiving health care). Patient-reported values are weighted using Danish tariffs
  
  
• General health status EuroQol (EQ-5D-5L) [ Time Frame: Baseline, 3 and 12 months ] [ Designated as safety issue: No ]
  The EQ-5D is a generic instrument for describing and valuing health. It is based on a descriptive system that defines health in terms of 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression (http://www.euroqol.org)
  
  
• Mechanical Muscle Function [ Time Frame: Baseline, 3 and 12 months ] [ Designated as safety issue: No ]
  Isometric muscle strength (iMVC) will be collected for knee extensors, hip extensors, -flexors and hip abductors.
  
  
• Physical performance battery [ Time Frame: Baseline, 3 and 12 months ] [ Designated as safety issue: No ]
  Physical performance-based measures will include; 30 s chair stand (number completed), 20 meter fast-paced walk (time in (s)), 30 s single-leg knee bending (number completed), and timed up and go (time in sec.)
  
  
• Poor compliance [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  Reasons for poor compliance will be recorded.
  
  
• Joint specific adverse events [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  Joint specific adverse events will be determined as: 1) not attending a training session and/or ceasing training because of increased pain/problems in the index joint related to the training; and 2) self-reported exercise pain > 5 on the VAS-scale after training. The reasons for not attending a session due to pain/problems related to training or to other reasons will be recorded.
  
  

Hip replacements are performed at an increasing rate, also in younger and less disabled patients. Recent studies indicate non-surgical interventions being effective in reducing pain and disability also at later stages of disease when hip replacement is considered. Possible, non-surgical treatments can be used to postpone hip replacement. The effect of education and supervised exercise on time to hip replacement is largely unknown