Examining the Effect of Neuromuscular Exercises on Movement Control in Hip & Knee Osteoarthritis: A Randomised Proof of Concept and Feasibility Study

Summary

This completed study evaluated the effects of a six-week neuromuscular exercise programme on movement control in individuals with hip and/or knee osteoarthritis (OA). The trial also assessed the feasibility of conducting a future definitive randomised controlled trial.

A total of 90 participants with symptomatic hip or knee OA were recruited from NHS outpatient physiotherapy clinics and cluster-randomised to either an intervention group or a control group. The intervention group received a structured neuromuscular exercise programme based on the GLA:D® approach, delivered once weekly for six weeks. The control group received usual care, including general physiotherapy advice and standard exercises.

The primary outcome was change in movement control, assessed using the Short Hip and Lower Limb Movement Screen (Short-HLLMS) at baseline and six weeks. Secondary outcomes included joint-specific function measured by KOOS-12 and HOOS-12 questionnaires, and pain intensity assessed using the Numeric Pain Rating Scale (NPRS). Feasibility measures included recruitment rate, participant adherence, and study retention.

The study was completed successfully and demonstrated that neuromuscular exercise may improve short-term movement control and functional outcomes in individuals with OA. Feasibility outcomes supported the acceptability of the intervention and the procedures for conducting a future large-scale trial.

Conditions

• Osteoarthritis
• Hip
• Knee OA
• Motor Control

Interventions

BEHAVIORAL

Neuromuscular Exercise Programme (GLA:D®-based

Participants underwent supervised neuromuscular exercise sessions based on the Good Life with osteoArthritis in Denmark (GLA:D®) programme. Exercises targeted dynamic joint stability, balance, proprioception, functional movements, and muscle strengthening. Sessions were held once weekly, lasting approximately 60 minutes each, over six consecutive weeks. The intervention was tailored progressively to each participant's capabilities, symptoms, and pain tolerance.

BEHAVIORAL

Usual Physiotherapy Care (NHS Standard)

Participants received standard NHS physiotherapy care for hip or knee osteoarthritis. This included routine joint mobility exercises, strengthening activities, general education, and advice. Sessions were delivered in outpatient clinics following standard practice without specific emphasis on neuromuscular control training. Frequency and duration-matched usual clinical care.

Sponsors & Collaborators

• Ashford and St. Peter's Hospitals NHS Trust

  collaborator OTHER

• University of Southampton

  lead OTHER

Principal Investigators

• Umer Umer Sheikh, MSc · University of Southampton, School of Health Sciences

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

30 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-18

Primary Completion

2025-03-07

Completion

2025-03-07

Countries

• United Kingdom

Study Locations