Clinical Pilates in Hip Osteoarthritis: A Randomised Controlled Trial

Investigation of the Effectiveness of Clinical Pilates in Hip Osteoarthritis: A Randomised Controlled Trial

The aim of this study is to investigate the effect of a clinical Pilates exercise program on reducing symptoms in individuals with hip osteoarthritis. The main questions it aims to answer are:

• Does a clinical Pilates exercise program have an effect on pain, range of motion, physical function, performance, spinal mobility, postural control, disability, self-efficacy, and quality of life in individuals with hip osteoarthritis?
• Does a conventional therapeutic exercise program have an effect on pain, range of motion, physical function, performance, spinal mobility, postural control, disability, self-efficacy, and quality of life in individuals with hip osteoarthritis? Researchers will compare clinical pilates program to conventional therapeutic exercise program to see if exercise works to reducing hip osteoarthritis symptoms.

Participants will:

• Take clinical pilates or Conventional Therapeutic Exercise twice a week for 12 weeks
• The patients will be assessed by a blind evaluator both before and after the treatment.

The clinical Pilates group will perform 45-minute exercise sessions under the supervision of a physiotherapist twice a week for 12 weeks, focusing on fundamental spinal alignments and Pilates principles. The program will include exercises that engage all body segments and combine movement with breathing. Participants will progress to more advanced levels as long as they can maintain proper alignment. Clinical Pilates exercises are structured into three levels of difficulty, and participants who complete the current level without compromising alignment will advance to the next level. The Conventional Therapeutic Exercise group will participate in an exercise program under the supervision of a physiotherapist twice a week for 12 weeks. The program, consisting of stretching and strengthening exercises, will last approximately 45 minutes. Resistance bands will be used to facilitate progression. Based on the individual's perceived difficulty level, resistance bands will be introduced or adjusted by changing their color to increase or decrease resistance.

Inclusion Criteria:

• Age above 18 years
• Diagnosis of hip osteoarthritis (OA) according to the American College of Rheumatology
• Not on the waiting list for hip replacement surgery
• Willingness to participate in the exercise program

Exclusion Criteria:

• Symptomatic OA in the knee or big toe
• Presence of other types of arthritis
• History of hip and/or knee prosthesis or fracture
• Use of walking aids
• Regular exercise habit of two or more sessions per week
• Corticosteroid injection into the hip within the past 12 months
• Participation in a physical therapy program for hip pain within the past 3 months
• Severe cardiovascular disorders or other comorbidities that significantly limit daily physical capacity or contraindicate physical exertion